The role of ventilation/perfusion scintigraphy in distinguishing acute from chronic pulmonary embolism.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Hamdi Afşin, Emine Afşin
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引用次数: 0

Abstract

Background: In this study, we examined the potential role of V/Q scintigraphy in distinguishing acute PE (APE) from chronic PE (CPE).

Materials and methods: From 2020 to 2023, 36 patients diagnosed with APE and 24 patients diagnosed with CPE were included in the study. Location (segmental, subsegmental, lobar), number and appearance (wedge/patch) of mismatch perfusion defects on V/Q scintigraphy were recorded, and data were compared between the two groups.

Results: The number of mismatch segmental defects on V/Q scintigraphy was higher in the APE group (p = 0.042). The number of wedge-shaped defects was higher in the APE group (p = 0.003), while patchy defects were more common in the CPE group (p < 0.001). A negative correlation (p = 0.002) was observed between CPE and the number of wedges, whereas a positive correlation (p < 0.001) was found between CPE and the number of patches. Pulse oxygen saturation negatively correlated with the number of patches (p = 0.012). A negative correlation also existed between the number of mismatch segmental defects and CPE (p = 0.041). APE was indicated when the number of wedges was ≥1.5 (75% sensitivity,62% specificity, p = 0.03), while CPE was indicated when the number of patches was ≥0.5 (88% sensitivity, 61% specificity, p < 0.001). Patchy defects were found to be an independent risk factor for CPE (p = 0.008, OR: 2.1, 95% CI: 1.2-3.7).

Conclusion: Patchy defects serve as an independent risk factor for CPE and correlate with the severity of hypoxemia.

通气/灌注显像在区分急性和慢性肺栓塞中的作用。
背景:在这项研究中,我们研究了V/Q闪烁成像在区分急性PE (APE)和慢性PE (CPE)方面的潜在作用。材料与方法:2020 - 2023年共纳入36例确诊为APE的患者和24例确诊为CPE的患者。记录V/Q显像上错配灌注缺陷的位置(节段、亚节段、叶段)、数量和外观(楔形/斑块),并比较两组数据。结果:APE组在V/Q显像上出现的错配节段缺陷数量较多(p = 0.042)。楔形缺损在APE组较多(p = 0.003),片状缺损在CPE组较多(p < 0.001)。CPE与斑块数量呈负相关(p = 0.002),与斑块数量呈正相关(p < 0.001)。脉搏血氧饱和度与斑块数呈负相关(p = 0.012)。错配节段缺陷数与CPE呈负相关(p = 0.041)。当斑块个数≥1.5个(75%的敏感性,62%的特异性,p = 0.03)时为APE,当斑块个数≥0.5个(88%的敏感性,61%的特异性,p < 0.001)时为CPE。发现斑片状缺损是CPE的独立危险因素(p = 0.008, OR: 2.1, 95% CI: 1.2-3.7)。结论:斑片状缺损是CPE的独立危险因素,与低氧血症的严重程度相关。
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来源期刊
Emergency Radiology
Emergency Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.60
自引率
4.50%
发文量
98
期刊介绍: To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!
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