Ventilation-perfusion scan for diagnosing pulmonary embolism: do chest x-rays matter?
Nucl Med Commun
; 45(3): 181-187, 2024 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-38247659
ABSTRACT
BACKGROUND:
Ventilation-perfusion (V/Q) scan coupled with single photon emission computed tomography (SPECT) is commonly used for the diagnosis of pulmonary embolism (PE). An abnormal chest x-ray (CXR) is deemed to hinder the interpretation of V/Q scan and therefore a normal CXR is recommended prior to V/Q scan.AIMS:
To determine if an abnormal CXR impacted on V/Q scan interpretation and subsequent management.METHODS:
A retrospective cohort analysis of all patients who underwent a V/Q scan for diagnosis of suspected acute PE between March 2016 and 2022 was performed. CXR reports were reviewed and classified as normal or abnormal. Low-dose computerised tomography was routinely performed in patients above the age of 70. Data regarding V/Q scan results and subsequent management including initiation of anticoagulation for PE or further diagnostic investigations were collected.RESULTS:
A total of 340 cases were evaluated. Of the positive V/Q scans (92/340), 98.3% of the normal CXR were anticoagulated compared to 100% of the abnormal CXR group. Of the negative V/Q scans (239/340), no cases were started on anticoagulation and no further investigations were performed across both normal and abnormal CXR groups. Indeterminate results occurred in only 9 cases with no significant difference in management between normal and abnormal CXR groups.CONCLUSION:
An abnormal CXR does not affect the reliability of V/Q scan interpretation in the diagnosis of PE when coupled with SPECT. Unless clinically indicated, the mandate by clinical society guidelines for a normal CXR prior to V/Q should be revisited.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
/
Perfusão
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Nucl Med Commun
Ano de publicação:
2024
Tipo de documento:
Article