Acute pulmonary embolism: comparison and integration of perfusion lung scintigraphy with multislice spiral CT.
OBJECTIVE
This study compared and integrated the data from perfusion lung scintigraphy and multislice computed tomography (CT) for the emergency diagnosis of acute pulmonary embolism in nuclear medicine and radiology departments operating around the clock.


METHODS
One hundred and seven patients with a clinical and laboratory suspicion of acute pulmonary embolism who had already undergone chest radiography were divided into four groups according to the time interval between onset of clinical suspicion and performance of the two diagnostic examinations (0-24 h, 24-48 h, 0-48 h, 2-7 days). Cohen's test for the analysis of statistical concordance was used.


RESULTS
Perfusion lung scintigraphy and multislice CT were positive in 29/107 (27.1%) and negative in 78/107 (72.89%). Positive concordance (PC) was found in 22 cases and negative concordance (NC) in 71 cases: 0-24 h: PC in 12, NC in 32 cases; 24-48 h: PC in 3, NC in 15 cases; 0-48 h: PC in 15, NC in 47 cases; 2-7 days: PC in 7, NC in 24 cases.


CONCLUSIONS
Perfusion lung scintigraphy and multislice CT demonstrated elevated concordance if performed within 7 days of the onset of suspicion of acute pulmonary embolism. Concordance was higher if the examinations were completed within 24-48 h. In suspected acute pulmonary embolism, it is mandatory to reach a correct diagnosis within few hours--48 at the most.
Rubini
G
G
Sezione di Diagnostica per Immagini, Policlinico Universitario, Piana Giulio Cesare 11, I-70124, Bari, Italy. g.rubini@mednucl.uniba.it
Niccoli Asabella
A
A
Stabile Ianora
A A
AA
Rubini
D
D
Gaudiano
A
A
Angelelli
G
G
Rotondo
A
A
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods