Ventilation-perfusion studies in suspected pulmonary embolism

Biello, Daniel R.; Mattar, Adel G.; McKnight, Robert C.; Siegel, Barry A.

doi:10.2214/ajr.133.6.1033

Cited by 276 publications

(76 citation statements)

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“…Perfusion imaging used 70 mBq 99Tc MAA with anterior, posterior and right and left anterior oblique views. Scans were graded according to the findings of Biello et al 4: a high probability scan (scan-positive) showed one or more unmatched segmental perfusion defects with no matching chest X-ray abnormality. A low probability (scan-negative) scan showed a normal perfusion phase, unmatched perfusion defects less than 25% of a segment, matched areas of ventilation and perfusion defects of less than 75% of a segment or perfusion defects substantially smaller than an X-ray abnormality.…”

Section: Methodsmentioning

confidence: 99%

Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism

Fennerty

Shetty

Patón

et al. 1990

Postgraduate Medical Journal

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Summary:The presenting features of 250 consecutive patients who underwent a ventilation/perfusion lung scan for suspected pulmonary embolus (PE) were analysed. Ninety-six patients had lung scans highly suggestive of PE, with one or more unmatched segmental perfusion defects (scan positive), 86 had low probability scans (scan negative) and 68 an indeterminate scan.Scan positive patients were more likely to have a PaO2 of less than 10.7 kPa, an elevated P(A-a)02 and an abnormal chest X-ray compared with scan negative patients but these measurements were of poor specificity. Furthermore, scan-positive patients had a higher incidence oflung disease. Localized chest wall tenderness was more common in scan-positive patients, occurring in 9% of patients, but there were no other significant differences in individual symptoms, signs or electrocardiographic findings between scan-positive and scan-negative patients.The diagnosis of PE should not be made on clinical grounds alone and all patients suspected of having a PE should at least undergo isotope lung scanning.

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Section: Methodsmentioning

confidence: 99%

Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism

Fennerty

Shetty

Patón

et al. 1990

Postgraduate Medical Journal

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“…Alderson and coworkers 12 later showed that the overall diagnostic accuracy for scintigraphic detection of pulmonary emboli was significantly improved when V studies were added to the Q scan and CXR. Extensive work by Biello and collaborators 13,14 further categorized Q defects matched by ventilation or radiographic abnormalities and provided grounds for reducing the number of "indeterminate" diagnoses. Further evaluation 15 confirmed that this diagnostic approach provided improved interobserver consistency and a 30% reduction in "indeterminate" readings compared with the results from an older system.…”

Section: The Profusion Of Diagnostic Approaches Using V/q Scintigraphymentioning

confidence: 99%

Perfusion Lung Scintigraphy for the Diagnosis of Pulmonary Embolism: A Reappraisal and Review of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis Methods

Miniati

Sostman

Gottschalk

et al. 2008

Seminars in Nuclear Medicine

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In this article, we review the evolution of scintigraphy for the diagnosis of acute pulmonary embolism (PE). We begin with perfusion (Q) scintigraphy, review the development of diagnostic systems that combine ventilation (V) scintigraphy and chest radiography with the Q scan, and describe in detail the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for diagnostic categorization of the Q scan read in conjunction with the chest radiograph. Finally, we review the results obtained with the PISAPED criteria in clinical research studies. The PISAPED method for lung scan interpretation provides sensitivity and specificity for diagnosing acute PE that is comparable to V/Q scanning and to computed tomography angiography (CTA), with fewer nondiagnostic results than either V/Q or CTA. The criteria can be used effectively in a diagnostic management approach that incorporates the use of a clinical prediction rule. Clinical outcomes in patients in whom PE is excluded in this way are comparable to outcomes for patients in whom the diagnosis is excluded by CTA or conventional angiography. Semin Nucl Med 38:450-461

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“…There are several categorical criteria for the diagnosis of PE, like the MCNIEL et al [30], BIELLO et al [31] or PIOPED-classifications [5], with criteria for very low-, low-, indeterminate-, normal-and highprobability for PE. Unfortunately, there is a large difference in interpretation among expert readers (25-30%), especially in the classification of low or indeterminate probability V9/Q9 lung scans [5].…”

Section: Lung Scintigraphymentioning

confidence: 99%

Diagnostic strategies for suspected pulmonary embolism

Rossum¹

2001

Eur Respir J

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Pulmonary embolism often remains a difficult diagnosis for the clinician, particularly in patients with comorbidity factors. This is in contrast with the availability of effective treatment, which should be prescribed as soon as possible.To date, there is still no ideal diagnostic test that is accurate, safe, readily available and cost-effective.Recent technical advances in computed tomography, magnetic resonance imaging and laboratory findings have raised new possibilities in the diagnosis of pulmonary embolism.This review covers the performance of different diagnostic tests, and focuses on the advantages and limitations of single diagnostic tests and the clinical usefulness of these tests in diagnostic strategies. Eur Respir J 2001; 18: 589-597.

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Ventilation-perfusion studies in suspected pulmonary embolism

Cited by 276 publications

References 1 publication

Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism

Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism

Perfusion Lung Scintigraphy for the Diagnosis of Pulmonary Embolism: A Reappraisal and Review of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis Methods

Diagnostic strategies for suspected pulmonary embolism

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