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Title: The significance of single V-P mismatches found in Kr-81m/Tc-99m lung scans

Abstract

Ventilation-perfusion lung scans demonstrating two or more areas of V-P mismatch (MM) are considered by most nuclear medicine physicians to indicate a high probability of pulmonary embolism (PE). Considerable disagreement exists, however, with regard to the significance of a single area of segmental (S) or subsegmental (SS) MM. The authors reviewed the studies of 22 patients suspected of having PE reviewed the studies of 22 patients suspected of having PE whose lung scans demonstrated a single area of V-P MM and whose diagnosis was confirmed by pulmonary angiography. All V scans were multi-view studies performed with Kr-81m. P scans were performed either with Tc-99m macroaggregated albumin or human albumin microspheres. P defects greater than 75% of the size of a brochopulmonary segment (BPS) were reported as S; defects between 25% and 75% of a BPS were reported as SS. The area of V-P MM was found in the lower lobes in 13 patients, the middle lobe or lingula in 6, and the upper lobes in 3. Of 17 patients with a VP MM and a clear chest x-ray, 4 of 10 patients with a SS MM had PE, as did 4 of 6 patients with a S MM; one patientmore » with a single regional (R) area of V-P MM did not have PE. An additional 5 cases demonstrated a single area of V-P MM and an x-ray opacity of comparable size in the same location; three of these 5 patients had PE. Thus, 11 of the total 22 patients had PE (S:6/9, R:0/2, SS:5/11. The data demonstrate an intermediate level of probability of PE in all subgroups with a single V-P MM, and suggest that V-P lung scans showing a single area of V-P MM should be reported as indeterminate for PE.« less

Authors:
; ; ;
Publication Date:
Research Org.:
Columbia Univ., New York, NY
OSTI Identifier:
6856184
Report Number(s):
CONF-850611-
Journal ID: CODEN: JNMEA; TRN: 87-010652
Resource Type:
Conference
Journal Name:
J. Nucl. Med.; (United States)
Additional Journal Information:
Journal Volume: 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD VESSELS; BIOMEDICAL RADIOGRAPHY; CHEST; EMBOLI; SCINTISCANNING; LUNGS; RESPIRATORY SYSTEM DISEASES; DIAGNOSIS; KRYPTON 81; NUCLEAR MEDICINE; RADIOPHARMACEUTICALS; RESPIRATORY SYSTEM; TECHNETIUM 99; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; BODY AREAS; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; EVEN-ODD NUCLEI; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; KRYPTON ISOTOPES; LABELLED COMPOUNDS; MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY; SECONDS LIVING RADIOISOTOPES; TECHNETIUM ISOTOPES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics; 550602 - Medicine- External Radiation in Diagnostics- (1980-)

Citation Formats

Rosen, J M, Palestro, C J, Markowitz, D, and Alderson, P O. The significance of single V-P mismatches found in Kr-81m/Tc-99m lung scans. United States: N. p., 1985. Web.
Rosen, J M, Palestro, C J, Markowitz, D, & Alderson, P O. The significance of single V-P mismatches found in Kr-81m/Tc-99m lung scans. United States.
Rosen, J M, Palestro, C J, Markowitz, D, and Alderson, P O. 1985. "The significance of single V-P mismatches found in Kr-81m/Tc-99m lung scans". United States.
@article{osti_6856184,
title = {The significance of single V-P mismatches found in Kr-81m/Tc-99m lung scans},
author = {Rosen, J M and Palestro, C J and Markowitz, D and Alderson, P O},
abstractNote = {Ventilation-perfusion lung scans demonstrating two or more areas of V-P mismatch (MM) are considered by most nuclear medicine physicians to indicate a high probability of pulmonary embolism (PE). Considerable disagreement exists, however, with regard to the significance of a single area of segmental (S) or subsegmental (SS) MM. The authors reviewed the studies of 22 patients suspected of having PE reviewed the studies of 22 patients suspected of having PE whose lung scans demonstrated a single area of V-P MM and whose diagnosis was confirmed by pulmonary angiography. All V scans were multi-view studies performed with Kr-81m. P scans were performed either with Tc-99m macroaggregated albumin or human albumin microspheres. P defects greater than 75% of the size of a brochopulmonary segment (BPS) were reported as S; defects between 25% and 75% of a BPS were reported as SS. The area of V-P MM was found in the lower lobes in 13 patients, the middle lobe or lingula in 6, and the upper lobes in 3. Of 17 patients with a VP MM and a clear chest x-ray, 4 of 10 patients with a SS MM had PE, as did 4 of 6 patients with a S MM; one patient with a single regional (R) area of V-P MM did not have PE. An additional 5 cases demonstrated a single area of V-P MM and an x-ray opacity of comparable size in the same location; three of these 5 patients had PE. Thus, 11 of the total 22 patients had PE (S:6/9, R:0/2, SS:5/11. The data demonstrate an intermediate level of probability of PE in all subgroups with a single V-P MM, and suggest that V-P lung scans showing a single area of V-P MM should be reported as indeterminate for PE.},
doi = {},
url = {https://www.osti.gov/biblio/6856184}, journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 26:5,
place = {United States},
year = {Wed May 01 00:00:00 EDT 1985},
month = {Wed May 01 00:00:00 EDT 1985}
}

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