[Current diagnosis of pulmonary embolism in Spain: ventilation-perfusion lung scan versus helical CT. Findings from the National Health Service and RIETE Registry].
OBJECTIVE
To analyze the trends in the utilization of ventilation/perfusion pulmonary scintigraphy (V/QSc), spiral CT (sCT) and pulmonary angiography for diagnosis of pulmonary embolism (PE) in Spain, taking in account the information from the National System of Health (NSH) and RIETE Registry. To examine the diagnostic conformities of V/QSc and sCT in RIETE, with special reference to V/QSc of intermediate/indeterminate probability (V/QScIP).


METHODS
We examined annual trends of diagnostic imaging for PE in 5,678 Spanish patients included in RIETE (period 2001-2005) and in those of the NHS Databases (1999-2003 period). In RIETE the agreement between diagnostics was compared in cases with both V/QSc and sCT and angiography and V/QSc or sCT.


RESULTS
We observed an increasing trend in sTC use, which overcame to V/QSc in 2002 (RIETE) and 2003 (NHS). In 732 cases with both techniques there was a diagnostic conformity of 53%. In 116 cases with V/QScIP a concomitant sTC was + for PE in 87%. If clinical signs of PE were present, then sTC was + in 95% of cases. In 29 cases with sCT and angiography agreement was 83% and in 31 cases with angiography and V/QSc was 77%.


CONCLUSIONS
Nowadays in Spain the sTC is the most utilized method to diagnose EP. However, V/QSc studies are also broadly used. In studies V/QScIP it is advisable to look for deep venous thrombosis and, if present, the results of RIETE allow to assure EP coexistence in 87-95% of cases.
Montes-Santiago
Julio
J
Servicio de Medicina Interna, Hospital do Meixoeiro-CHUVI, Vigo Pontevedra, Spain. julio.montes.santiago@sergas.es
Lado Castro-Rial
Marta
M
Guijarro Merino
Ricardo
R
San Román Terán
Carlos M
CM
Fernández-Capitán
Carmen
C
García-Bragado
Ferrán
F
Monreal
Manuel
M
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012042:Registries; D013030:Spain; D036542:Tomography, Spiral Computed; D014692:Ventilation-Perfusion Ratio