Ventilation-perfusion lung scintigraphy as a guide for pulmonary angiography in the localization of pulmonary emboli

被引:3
作者
Davey, NC [1 ]
Smith, TP [1 ]
Hanson, MW [1 ]
Lee, VS [1 ]
Stackhouse, DJ [1 ]
Coleman, RE [1 ]
机构
[1] Duke Univ, Med Ctr, Dept Radiol, Durham, NC 27710 USA
关键词
embolism; pulmonary; lung; radionuclide studies; pulmonary angiography;
D O I
10.1148/radiology.213.1.r99oc5051
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To assess the appropriateness of ventilation-perfusion (V-P) scintigraphic abnormalities as a guide to pulmonary angiography for the diagnosis of pulmonary embolism (PE). MATERIALS AND METHODS: V-P scintigrams and pulmonary angiograms of 104 patients with angiographically proved PE were reviewed by two nuclear medicine physicians and two interventional radiologists. For V-P scintigrams, the lung with the larger amount of perfusion abnormality was determined followed by identification of specific robes. Pulmonary angiograms were similarly evaluated for lateralization and lobar distribution of PE. Conclusions were initially reached independently and subsequently by consensus. RESULTS: Interobserver agreement for lateralization was 88% (kappa = 0.75) for V-P scintigraphy and 98% (kappa = 0.96) for pulmonary angiography. In 72 patients, V-P scintigrams predicted unilateral embolus; 64 patients underwent pulmonary angiography of the suspected side. Eight patients underwent contralateral angiography only. Of the 64 patients, 61 (95%) had PE on the predicted side at angiography. V-P scintigrams predicted lobar distribution in 55 patients. Of these, PE was found in the predicted lobe in 42 (76%). CONCLUSION: Localization of perfusion abnormalities at V-P scintigraphy provides useful information for the interventional radiologist and serves as an accurate guide for determining the initial approach for pulmonary angiography.
引用
收藏
页码:51 / 57
页数:7
相关论文
共 22 条
[1]   EPIDEMIOLOGY AND NATURAL-HISTORY OF VENOUS THROMBOEMBOLISM [J].
ALPERT, JS ;
DALEN, JE .
PROGRESS IN CARDIOVASCULAR DISEASES, 1994, 36 (06) :417-422
[2]   Acute pulmonary embolism: Assessment of helical CT for diagnosis [J].
Drucker, EA ;
Rivitz, SM ;
Shepard, JAO ;
Boiselle, PM ;
Trotman-Dickenson, B ;
Welch, TJ ;
Maus, TP ;
Miller, SW ;
Kaufman, JA ;
Waltman, AC ;
McLoud, TC ;
Athanasoulis, CA .
RADIOLOGY, 1998, 209 (01) :235-241
[3]  
Fleiss J. L, 1981, STAT METHODS RATES P, P212
[4]  
GOLDHABER SZ, 1988, LANCET, V2, P293
[5]   Can pulmonary angiography be limited to the most suspicious side if the contralateral side appears normal on the ventilation/perfusion lung scan? Data from PIOPED [J].
Gottschalk, A ;
Stein, PD ;
Henry, JW ;
Relyea, B .
CHEST, 1996, 110 (02) :392-394
[6]   PULMONARY ANGIOGRAPHY AND THE DIAGNOSIS OF PULMONARY-EMBOLISM [J].
GREENSPAN, RH .
PROGRESS IN CARDIOVASCULAR DISEASES, 1994, 37 (02) :93-105
[7]   Pulmonary angiography performed with iopamidol: Complications in 1,434 patients [J].
Hudson, ER ;
Smith, TP ;
McDermott, VG ;
Newman, GE ;
Suhocki, PV ;
Payne, CS ;
Stackhouse, DJ .
RADIOLOGY, 1996, 198 (01) :61-65
[8]   Pulmonary embolism: Prospective comparison of spiral CT with ventilation-perfusion scintigraphy [J].
Mayo, JR ;
RemyJardin, M ;
Muller, NL ;
Remy, J ;
Worsley, DF ;
HosseinFoucher, C ;
Kwong, JS ;
Brown, MJ .
RADIOLOGY, 1997, 205 (02) :447-452
[9]  
MEANEY JF, 1997, NEW ENGL J MED, V333, P1422
[10]   COMPARISON OF PERFUSION LUNG-SCANNING AND ANGIOGRAPHY IN THE ESTIMATION OF VASCULAR OBSTRUCTION IN ACUTE PULMONARY-EMBOLISM [J].
MEYER, G ;
COLLIGNON, MA ;
GUINET, F ;
JEFFREY, AA ;
BARRITAULT, L ;
SORS, H .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE, 1990, 17 (6-8) :315-319