[Calculation of the ventilation-perfusion ratio in the scintigraphic diagnosis of pulmonary embolism].
Ventilation perfusion scanning fails to diagnose pulmonary embolism in matched defects. In 61 patients (19 with pulmonary embolism proved by angiography, 32 with chronic obstructive lung disease and 10 with acute bacterial pneumonia) we computed the ventilation perfusion ratio (V/Q) in these matched defects, using Krypton 81 m. This analysis demonstrated that the diagnosis of pulmonary embolism could be made with a specificity of 100% when the V/Q ratio was greater than 1.2 in the matched defects. Pulmonary embolism was characterized by a perfusion defect with a high V/Q ratio, even in Laennec infarction. In contrast, the analysis excluded the diagnosis of pulmonary embolism and suggested another disease when the V/Q was less than 0.95 with a specificity of 95%. Perfusion defects in acute pneumonia always had a V/Q less than 1. The diagnosis remained difficult in chronic obstructive lung disease when pulmonary embolism was suspected on subsegmental defects. Nevertheless this could be solved in about 50% of the cases by quantitative analysis. We feel, therefore, that ventilation perfusion scanning should be quantified by V/Q analysis to improve the diagnosis of pulmonary embolism.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008173:Lung Diseases, Obstructive / Q000000981:diagnostic imaging; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011877:Radionuclide Imaging; D014692:Ventilation-Perfusion Ratio
Le calcul du rapport ventilation-perfusion dans le diagnostic scintigraphique de l'embolie pulmonaire.