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- Title:
- VQ Scan Pulmonary Embolism
- Description:
- Ventilation-perfusion scintigraphy in a woman taking oral contraceptives and valdecoxib. (A) After inhalation of 20.1 mCi of Xenon-133 gas, scintigraphic images were obtained in the posterior projection, showing uniform ventilation to lungs. (B) After intravenous injection of 4.1 mCi of Technetium-99m-labeled macroaggregated albumin, scintigraphic images were obtained, shown here in the posterior projection. This and other views showed decreased activity in the following regions: apical segment of right upper lobe, anterior segment of right upper lobe, superior segment of right lower lobe, posterior basal segment of right lower lobe, anteromedial basal segment of left lower lobe, and lateral basal segment of left lower lobe.
- Keyword:
- Radioisotope Scanning, PE, Thromboembolisms, Pulmonary, Pulmonary Thromboembolism, Thromboembolism, Pulmonary, Radiodermatitis, Embolisms, Pulmonary, Scintigraphy, Embolism, Pulmonary, Pulmonary Thromboembolisms, Diagnosis, Gamma Camera Imaging, Scintiphotography, Pulmonary Embolisms, Scanning, Radioisotope
- Subject:
- Diagnostic Techniques and Procedures, Pulmonary Embolism, Respiratory Tract Diseases, Multimodal Imaging, Lung Diseases, Diagnostic Imaging
- Creator:
- Westgate EJ, FitzGerald GA
- Publisher:
- Wikimedia Commons http://en.wikipedia.org/wiki/File:Pulmonary_embolism_scintigraphy_PLoS.png from Pulmonary Embolism in a Woman Taking Oral Contraceptives and Valdecoxib. PLoS Medicine Vol. 2, No. 7, e197. doi:10.1371/journal.pmed.0020197
- Language:
- English
- Rights:
- https://creativecommons.org/licenses/by/2.0
- Resource Type:
- Medical imaging
- Identifier:
- 1648
- Title:
- Diagnostic algorithm: Pulmonary embolism
- Description:
- A diagnostic algorithm for pulmonary embolism (estimated frequencies of test results and associated prevalences of pulmonary embolism for a hypothetical cohort of 1000 outpatients) [1]. If a very sensitive D-dimer assay is used, it can be the first test performed: a negative result excludes pulmonary embolism regardless of clinical assessment category and a positive test can be followed by a ventilation–perfusion scan [2]. A ventilation–perfusion scan can be performed as the initial test without using clinical assessment of the probability of pulmonary embolism as part of the diagnostic process [3]. Pulmonary angiography or helical CT may be considered if the clinical assessment of pulmonary embolism probability is low, particularly if a D-dimer test has not been done [4]. Additional testing (e.g., helical CT, bilateral venography) may be considered if overall assessment suggests a high probability of pulmonary embolism (e.g., 50%–80%), symptoms are severe or cardiopulmonary reserve is poor [5]. Venography should be considered if there is an increased risk of a false-positive ultrasound result (e.g., previous venous thromboembolism, equivocal ultrasound findings, preceding findings suggest low probability of pulmonary embolism [e.g., ≤ 10%]) [6]. It is reasonable not to repeat ultrasound testing, or to do only 1 more ultrasound after 1 week, if preceding findings suggest a low probability of pulmonary embolism (e.g., ≤ 10%) [7]. If helical CT is used in place of ventilation–perfusion lung scanning: (i) intraluminal filling defects in segmental or larger pulmonary arteries are generally diagnostic for pulmonary embolism; (ii) all other findings (i.e., a normal CT scan or intraluminal filling defects confined to the subsegmental pulmonary arteries) are nondiagnostic and can be managed as shown for a nondiagnostic lung scan.
- Keyword:
- Embolism, Pulmonary Thromboembolism, Thromboembolism, Pulmonary, Embolism, Pulmonary Pulmonary Thromboembolisms, Embolisms, Pulmonary, Thromboembolisms, Pulmonary, Vascular Diseases, Pulmonary Embolisms
- Subject:
- Pulmonary Infarction, Respiratory Tract Diseases, Lung Diseases, Pulmonary Artery, Embolism, Pulmonary Embolism
- Creator:
- L.M. Tierney; M.C. Henderson
- Publisher:
- McGraw-Hill
- Language:
- English
- Copyright Holder:
- McGraw-Hill
- Rights:
- http://www.i-human.com/service-agreement-print
- Resource Type:
- Chart/Diagram
- Identifier:
- 1650