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Clinicians' interpretation of the indeterminate ventilation-perfusion scan report
P G Kember1, H A Euinton, S K Morcos
1Department of Diagnostic Imaging, Northern General Hospital, Sheffield, UK.
The British Journal of Radiology
|April 16, 1998
Summary
Indeterminate ventilation-perfusion (VQ) scans for pulmonary embolism are common. Many patients are treated without further investigation or their results are misinterpreted, potentially delaying diagnosis and treatment.
Area of Science:
- Radiology
- Cardiology
- Pulmonary Medicine
Background:
- Radio-nuclide ventilation-perfusion (VQ) scanning is a primary diagnostic tool for suspected pulmonary embolism.
- A significant proportion of VQ scans, approximately 70%, yield indeterminate results, necessitating further diagnostic steps.
Purpose of the Study:
- To review the management of patients with indeterminate VQ scans in an institutional setting.
- To identify patterns of further investigation and treatment following indeterminate VQ scan results.
Main Methods:
- Retrospective review of 111 patient case notes over a 9-month period.
- Analysis of VQ scan reports, subsequent investigations, and clinical management decisions.
Main Results:
- 46% of patients were treated based on clinical grounds without further investigation.
- 35% of VQ scan reports were misinterpreted, with most misquoted as negative for pulmonary embolism.
- Only 11% of patients with indeterminate scans underwent further investigation.
Conclusions:
- Clinicians require better education on the implications of indeterminate VQ scans.
- Misinterpretation of indeterminate VQ scans can lead to undertreatment of pulmonary embolism.
- Improved understanding and management protocols for indeterminate VQ scans are crucial.