THE ROLE OF VENOUS COLOR-FLOW DOPPLER TO AID THE NONDIAGNOSTIC LUNG SCINTIGRAM FOR PULMONARY-EMBOLISM

Sixty patients admitted with a clinical diagnosis of pulmonary embolism underwent a prospective analysis of the value of lung ventilation/perfusion scintigraphy and lower limb colour flow venous Doppler. Twenty-two per cent of scintigrams gave a high probability of pulmonary embolus (PE) and 45% a low probability/normal. The remainder were classed as indeterminate scintigrams (33%) and of these, 55% showed leg thrombi on the ultrasound scan. These patients were therefore treated by anticoagulation. A small number of the low probability scintigrams also proved to have lower limb thrombi by ultrasound. As a result of these two investigations just over half of these patients with a clinical diagnosis of PE were anticoagulated (31 out of 60). In 62% of these the ultrasound suggested thrombi confined to the calf as a source of PE.