Comparison of lung scintigraphy with multi-slice spiral computed tomography in the diagnosis of pulmonary embolism.
OBJECTIVE
To compare the diagnostic efficacy of lung perfusion scans combined with ventilation (V/Q) scans and/or chest radiography (CR) with contrast-enhanced multislice spiral CT pulmonary angiography (CTPA) in diagnosing pulmonary embolism (PE).


METHODS
Eighty-two consecutive patients with suspected PE underwent CTPA, lung perfusion scan, and CR. Of them, 28 patients underwent V/Q scans. The final diagnosis was made using a composite reference test.


RESULTS
The overall sensitivity and specificity were 89.2% and 92.1% for V/Q scan or perfusion scan combined with CR, and 97.3% and 97.4% for CTPA. For the 28 patients with V/Q scan, the sensitivity and specificity were 91.7% and 92.9% for V/Q scan, and 91.7% and 100.0% for CTPA. The segmental agreement rate between perfusion scan and CTPA was 69.5% (kappa = 0.30, P < 0.05). The perfusion scan revealed significantly more subsegmental abnormalities than CTPA (59 vs. 10, chi2 test, P < 0.05).


CONCLUSIONS
V/Q scan, perfusion scan combined with CR and CTPA all show high efficacy in diagnosing PE. V/Q scan or perfusion scan combined with CR is as accurate as CTPA.
Wang
Feng
F
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Fang
Wei
W
Lv
Bin
B
Lu
Jin-Guo
JG
Xiong
Chang-Ming
CM
Ni
Xin-Hai
XH
He
Zuo-Xiang
ZX
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013667:Technetium; D036542:Tomography, Spiral Computed; D055815:Young Adult
D019275:Radiopharmaceuticals; D013667:Technetium