Document Detail

Perfusion lung scintigraphy for the diagnosis of pulmonary embolism: a reappraisal and review of the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis methods.
MedLine Citation:
PMID:  19331839     Owner:  NLM     Status:  MEDLINE    
In this article, we review the evolution of scintigraphy for the diagnosis of acute pulmonary embolism (PE). We begin with perfusion (Q) scintigraphy, review the development of diagnostic systems that combine ventilation (V) scintigraphy and chest radiography with the Q scan, and describe in detail the Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for diagnostic categorization of the Q scan read in conjunction with the chest radiograph. Finally, we review the results obtained with the PISAPED criteria in clinical research studies. The PISAPED method for lung scan interpretation provides sensitivity and specificity for diagnosing acute PE that is comparable to V/Q scanning and to computed tomography angiography (CTA), with fewer nondiagnostic results than either V/Q or CTA. The criteria can be used effectively in a diagnostic management approach that incorporates the use of a clinical prediction rule. Clinical outcomes in patients in whom PE is excluded in this way are comparable to outcomes for patients in whom the diagnosis is excluded by CTA or conventional angiography.
Massimo Miniati; H Dirk Sostman; Alexander Gottschalk; Simonetta Monti; Massimo Pistolesi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in nuclear medicine     Volume:  38     ISSN:  1558-4623     ISO Abbreviation:  Semin Nucl Med     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1264464     Medline TA:  Semin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  450-61     Citation Subset:  IM    
Department of Critical Care, Section of Respiratory Medicine, University of Florence, Florence, Italy.
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MeSH Terms
Acute Disease
Angiography / methods
Lung / radionuclide imaging*
Perfusion Imaging / methods*,  statistics & numerical data
Prospective Studies
Pulmonary Artery / radiography
Pulmonary Embolism / diagnosis,  radiography,  radionuclide imaging*
Sensitivity and Specificity
Tomography, X-Ray Computed / methods
Ventilation-Perfusion Ratio

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