Lung scans with significant perfusion defects limited to matching pleural effusions have a low probability of pulmonary embolism
Patients with a pleural effusion on chest x-ray often undergo a lung scan to exclude pulmonary embolism (PE). According to other studies, when the scan shows a perfusion defect equal in size to a radiographic abnormality on chest x-ray, the scan should be classified as indeterminate or intermediate probability for PE. However, since those studies dealt primarily with alveolar infiltrates rather than pleural effusions, the authors undertook a retrospective study to determine the probability of PE in patients with pleural effusion and a matching perfusion defect. The authors reviewed 451 scans and x-rays of patients studied for suspected PE. Of those, 53 had moderate or large perfusion defects secondary to pleural effusion without other significant (>25% of a segment) effusion without other significant (>25% of a segment) defects on the scan. Final diagnosis was confirmed by pulmonary angiography (16), thoracentesis (40), venography (11), other radiographic and laboratory studies, and clinical course. Of the 53 patients, only 2 patients had venous thrombotic disease. One patient had PE on pulmonary angiography, the other patient had thrombophlebitis on venography. The remainder of the patients had effusions due to congestive heart failure (12), malignancy (12), infection (7), trauma (7), collegen vascular disease (7), sympathetic effusion (3) and unknown etiology (3). The authors conclude that lung scans with significant perfusion defects limited to matching pleural effusions on chest x-ray have a low probability for PE.
- Research Organization:
- Univ. of Utah School of Medicine, Salt Lake City, UT
- OSTI ID:
- 6758202
- Report Number(s):
- CONF-850611-
- Journal Information:
- J. Nucl. Med.; (United States), Journal Name: J. Nucl. Med.; (United States) Vol. 26:5; ISSN JNMEA
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
BODY AREAS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CAT SCANNING
CHEST
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DETECTION
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
EMBOLI
EQUIPMENT
LUNGS
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOLOGY
RESPIRATORY SYSTEM
RESPIRATORY SYSTEM DISEASES
SCINTISCANNING
THROMBOSIS
TOMOGRAPHY
VASCULAR DISEASES
X-RAY EQUIPMENT