Although most interventional radiologists (73% in one survey) routinely obtain ventilation-perfusion scintigrams prior to pulmonary angiography, little data existed to show whether these images provide accurate guidance for locating thrombi.
In a review of scintigrams and angiograms of 104 patients with angiographically proven PE, Duke University researchers found that V-P scintigraphy served as an "accurate guide" as to which lung to study first at angiography. Specifically, the V-P image predicted the correct side in 95% of the cases reviewed.
In addition, V-P scintigrams predicted lobar distribution in 55 patients, which was found in the predicted lobe in 76% of these cases.
The researchers concluded that V-P guidance may prove vital in patients who cannot tolerate prolonged angiography because of illness or intolerance of contrast media.
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