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Title: Radiological (scintigraphic) evaluation of patients with suspected pulmonar thromboembolism

The optimal strategy for diagnostic evaluation of patients with suspected pulmonary thromboembolism (PE) is subject of controversial and often conflicting opinions. If untreated, as many as 30% of patients with PE may die. Conversely, anticoagulant therapy significantly decreases mortality from PE, but bleeding complications occur. Underdiagnosis may result in a preventable death, and overdiagnosis may lead to significant hemorrhage from unnecessary anticoagulant therapy. This article outlines a practical guide for the use of pulmonary ventilation-perfusion (V-P) scintigraphy in patients with suspected PE. Perfusion imaging involves the intravenous injection of radiolabeled particles ranging from 10 to 60 ..mu..m in diameter (technetium Tc 99m macroaggregated albumin or technetium Tc 99m serum albumin microspheres); these particles are trapped in the capillaries and precapillary arterioles of the lung. The radiolabeled particles are distributed to the lungs in proportion to regional pulmonary blood flow. The correspondence of perfusion defects to bronchopulmonary segments is best appreciated in the posterior oblique views.
Authors:
Publication Date:
OSTI Identifier:
6469912
Resource Type:
Journal Article
Resource Relation:
Journal Name: JAMA, J. Am. Med. Assoc.; (United States); Journal Volume: 257:23
Research Org:
Washington Univ. School of Medicine, St. Louis
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; LUNGS; SCINTISCANNING; THROMBOSIS; DIAGNOSIS; ALBUMINS; ISOMERIC NUCLEI; MICROSPHERES; PATIENTS; PERFUSED TISSUES; TECHNETIUM 99; ANIMAL TISSUES; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR DISEASES; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANIC COMPOUNDS; ORGANS; PROTEINS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RESPIRATORY SYSTEM; TECHNETIUM ISOTOPES; TISSUES; VASCULAR DISEASES; YEARS LIVING RADIOISOTOPES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics