Ability of chest radiography to predict widespread scintigraphic ventilation abnormalities in patients with suspected pulmonary embolism (PE)
The false negative rate of ventilation-perfusion (V-P) scintigraphy for PE increases in the presence of widespread obstructive pulmonary disease (OPD) because diffuse V abnormalities conceal potential V-P mismatches. To determine whether this situation could be predicted accurately by a pre-scintigraphy chest x-ray (CXR), a double-blind evaluation of 55 CXRs and V-P scans in 53 patients (pts) was performed. Multiview Kr-81m (Kr) scans were done in 38 cases and pre-perfusion Xe-133 (Xe) studies including washout in 17. All CXRs were obtained within 24 hrs of the scans and none showed infiltrates that would otherwise render the V-P scan nondiagnostic (NDX). All V-P scans showing V abnormalities in greater than or equal to67% of the lung fields were considered NDX, and those showing V abnormalities in 50-67% of the lungs were considered ''borderline'' for interpretation. CXRs were classified as showing diffuse OPD, focal OPD, or as no evidence for OPD. All V and all P scans were abnormal; 7 cases were read as high probability for PE, 29 as low probability and the remainder as NDX. Eleven of 13 (85%) pts with diffuse OPD by CXR had NDX scans (8/9 Kr, 3/4 Xe) and two were considered borderline. However, none of 10 pts with focal OPD by CXR had NDX scans and only 2 were considered borderline. The CXR showed no OPD in 32 cases, but 8 (25%) had enough V abnormalities to be classified NDX (2 of 21 Kr scans, 6 0f 11 Xe scans) and 2 others (both Kr scans) were considered borderline. The findings confirm that V scintigraphy with either Kr or Xe is more sensitive than the CXR in detecting airways disease, but indicate that V-P scintigraphy is likely to be NDX for PE in pts whose CXRs demonstrate diffuse OPD.
- Research Organization:
- Columbia Univ., New York, NY
- OSTI ID:
- 6593394
- Report Number(s):
- CONF-840619-; TRN: 87-018937
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
Similar Records
Regional comparison of Tc-99m DTPA aerosol (A) with radioactive gas ventilation (V) studies in pts with suspected pulmonary embolism (PE)
Gallium scans of the thorax in patients with acquired immune deficiency syndrome (AIDS): Description and utilization
Related Subjects
CHEST
SCINTISCANNING
X-RAY RADIOGRAPHY
LUNGS
DYNAMIC FUNCTION STUDIES
COMPARATIVE EVALUATIONS
BIOMEDICAL RADIOGRAPHY
EMBOLI
EVALUATION
IMAGES
RADIATION DOSES
RADIONUCLIDE KINETICS
TISSUE DISTRIBUTION
BODY
BODY AREAS
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DISTRIBUTION
DOSES
INDUSTRIAL RADIOGRAPHY
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIOISOTOPE SCANNING
RADIOLOGY
RESPIRATORY SYSTEM
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550602 - Medicine- External Radiation in Diagnostics- (1980-)