Document Detail

Computerized tomographic pulmonary angiography versus ventilation perfusion lung scanning for the diagnosis of pulmonary embolism.
MedLine Citation:
PMID:  19465853     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: The purpose of this review is to focus on recent research that has addressed the relative merits of computed tomographic pulmonary angiography (CTPA) and ventilation perfusion (V/Q) scanning for the diagnosis of pulmonary embolism. RECENT FINDINGS: Computed tomographic pulmonary angiography is the most sensitive test for the diagnosis of pulmonary embolism and its use has been associated with a rising incidence of the condition. Diagnostic algorithms using either CTPA or V/Q scanning have proven to be comparably safe to exclude the diagnosis of pulmonary embolism. Negative multidetector CTPA study results essentially ruled out the diagnosis of pulmonary embolism without the need to routinely exclude the presence of deep vein thrombosis. Use of multidetector CTPA was associated with significant radiation exposure that potentially increases risk of secondary malignancies. This is particularly a concern for young women given the risk of breast cancer. Single photon emission tomography (SPECT) V/Q and modified diagnostic criteria for V/Q scan interpretation increased their diagnostic accuracy compared with V/Q scanning and offer nuclear medicine modalities that are alternatives to CTPA in at least some patients with suspected pulmonary embolism at a fraction of the risk of radiation exposure. Excluding low risk patients for pulmonary embolism as defined by clinical scoring systems and D-dimer testing would enhance the yield of diagnostic testing. SUMMARY: Computed tomographic pulmonary angiography is the most reliable test for diagnosis of pulmonary embolism. However, diagnostic algorithms using V/Q scanning are safe and may be preferred in some patient populations.
David R Anderson; David C Barnes
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in pulmonary medicine     Volume:  15     ISSN:  1531-6971     ISO Abbreviation:  Curr Opin Pulm Med     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503765     Medline TA:  Curr Opin Pulm Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  425-9     Citation Subset:  IM    
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
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MeSH Terms
Angiography / methods*
Diagnosis, Differential
Pulmonary Embolism / diagnosis*
Reproducibility of Results
Tomography, Emission-Computed, Single-Photon / methods*
Tomography, X-Ray Computed / methods*

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