Ventilation-perfusion-chest radiograph match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent

Chun Ki Kim, Daniel F. Worsley, Abass Alavi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: The authors' goal was to determine whether the prevalence of pulmonary embolism in patients with matching ventilation-perfusion (V-Q) defects and chest radiographic opacities differs depending on the degree of perfusion deficit (absent versus decreased). Methods: The authors performed a retrospective analysis of the data obtained from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. In 233 patients, angiograms were of diagnostic quality for 275 lung zones that showed matching V-Q defects and chest radiographic opacities (triple matches). Of these, V-Q scans and chest radiographs from 217 patients with triple matches in 255 lung zones were retrieved and reviewed. Areas corresponding to chest radiographic opacities were scored as having either decreased perfusion or absent perfusion by consensus. Information regarding the presence or absence of pulmonary embolism in corresponding lung zones was obtained from the Pioped database. Results: The overall prevalence of pulmonary embolism in all lung zones with triple matches was 27% (69 of 255). Of the 255 areas of triple matches, the perfusion was decreased in 153 (60%) and absent in 102 (40%). The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion was 13% (20 of 153) and 48% (49 of 102), respectively (p = 0.0001 by the chi-square test). When these were divided further by lung zones, triple matches with decreased perfusion and triple matches with absent perfusion in the upper-middle lung zone were associated with a prevalence of 0% (0 of 44), and 25% (9 of 36), respectively. The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion in the lower lung zone was 18% (20 of 109), and 61% (40 of 66), respectively. Conclusions: A V-Q/chest radiographic match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. The overall prevalence of pulmonary embolism associated with all triple matches in all lung zones varied from very low (0% in this series) to upper intermediate (61%), depending on whether perfusion was decreased or absent and also on the location of the triple match.

Original languageEnglish
Pages (from-to)665-669
Number of pages5
JournalClinical Nuclear Medicine
Volume25
Issue number9
DOIs
StatePublished - 2000 Sep 12

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Pulmonary Embolism
Ventilation
Thorax
Perfusion
Lung
Chi-Square Distribution
Angiography
Databases

Keywords

  • Intermediate probability
  • Lung Scan
  • Pulmonary embolism
  • V-Q and Chest radiographic match

Cite this

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title = "Ventilation-perfusion-chest radiograph match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent",
abstract = "Purpose: The authors' goal was to determine whether the prevalence of pulmonary embolism in patients with matching ventilation-perfusion (V-Q) defects and chest radiographic opacities differs depending on the degree of perfusion deficit (absent versus decreased). Methods: The authors performed a retrospective analysis of the data obtained from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. In 233 patients, angiograms were of diagnostic quality for 275 lung zones that showed matching V-Q defects and chest radiographic opacities (triple matches). Of these, V-Q scans and chest radiographs from 217 patients with triple matches in 255 lung zones were retrieved and reviewed. Areas corresponding to chest radiographic opacities were scored as having either decreased perfusion or absent perfusion by consensus. Information regarding the presence or absence of pulmonary embolism in corresponding lung zones was obtained from the Pioped database. Results: The overall prevalence of pulmonary embolism in all lung zones with triple matches was 27{\%} (69 of 255). Of the 255 areas of triple matches, the perfusion was decreased in 153 (60{\%}) and absent in 102 (40{\%}). The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion was 13{\%} (20 of 153) and 48{\%} (49 of 102), respectively (p = 0.0001 by the chi-square test). When these were divided further by lung zones, triple matches with decreased perfusion and triple matches with absent perfusion in the upper-middle lung zone were associated with a prevalence of 0{\%} (0 of 44), and 25{\%} (9 of 36), respectively. The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion in the lower lung zone was 18{\%} (20 of 109), and 61{\%} (40 of 66), respectively. Conclusions: A V-Q/chest radiographic match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. The overall prevalence of pulmonary embolism associated with all triple matches in all lung zones varied from very low (0{\%} in this series) to upper intermediate (61{\%}), depending on whether perfusion was decreased or absent and also on the location of the triple match.",
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Ventilation-perfusion-chest radiograph match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. / Kim, Chun Ki; Worsley, Daniel F.; Alavi, Abass.

In: Clinical Nuclear Medicine, Vol. 25, No. 9, 12.09.2000, p. 665-669.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ventilation-perfusion-chest radiograph match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent

AU - Kim, Chun Ki

AU - Worsley, Daniel F.

AU - Alavi, Abass

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N2 - Purpose: The authors' goal was to determine whether the prevalence of pulmonary embolism in patients with matching ventilation-perfusion (V-Q) defects and chest radiographic opacities differs depending on the degree of perfusion deficit (absent versus decreased). Methods: The authors performed a retrospective analysis of the data obtained from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. In 233 patients, angiograms were of diagnostic quality for 275 lung zones that showed matching V-Q defects and chest radiographic opacities (triple matches). Of these, V-Q scans and chest radiographs from 217 patients with triple matches in 255 lung zones were retrieved and reviewed. Areas corresponding to chest radiographic opacities were scored as having either decreased perfusion or absent perfusion by consensus. Information regarding the presence or absence of pulmonary embolism in corresponding lung zones was obtained from the Pioped database. Results: The overall prevalence of pulmonary embolism in all lung zones with triple matches was 27% (69 of 255). Of the 255 areas of triple matches, the perfusion was decreased in 153 (60%) and absent in 102 (40%). The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion was 13% (20 of 153) and 48% (49 of 102), respectively (p = 0.0001 by the chi-square test). When these were divided further by lung zones, triple matches with decreased perfusion and triple matches with absent perfusion in the upper-middle lung zone were associated with a prevalence of 0% (0 of 44), and 25% (9 of 36), respectively. The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion in the lower lung zone was 18% (20 of 109), and 61% (40 of 66), respectively. Conclusions: A V-Q/chest radiographic match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. The overall prevalence of pulmonary embolism associated with all triple matches in all lung zones varied from very low (0% in this series) to upper intermediate (61%), depending on whether perfusion was decreased or absent and also on the location of the triple match.

AB - Purpose: The authors' goal was to determine whether the prevalence of pulmonary embolism in patients with matching ventilation-perfusion (V-Q) defects and chest radiographic opacities differs depending on the degree of perfusion deficit (absent versus decreased). Methods: The authors performed a retrospective analysis of the data obtained from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study. In 233 patients, angiograms were of diagnostic quality for 275 lung zones that showed matching V-Q defects and chest radiographic opacities (triple matches). Of these, V-Q scans and chest radiographs from 217 patients with triple matches in 255 lung zones were retrieved and reviewed. Areas corresponding to chest radiographic opacities were scored as having either decreased perfusion or absent perfusion by consensus. Information regarding the presence or absence of pulmonary embolism in corresponding lung zones was obtained from the Pioped database. Results: The overall prevalence of pulmonary embolism in all lung zones with triple matches was 27% (69 of 255). Of the 255 areas of triple matches, the perfusion was decreased in 153 (60%) and absent in 102 (40%). The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion was 13% (20 of 153) and 48% (49 of 102), respectively (p = 0.0001 by the chi-square test). When these were divided further by lung zones, triple matches with decreased perfusion and triple matches with absent perfusion in the upper-middle lung zone were associated with a prevalence of 0% (0 of 44), and 25% (9 of 36), respectively. The prevalence of pulmonary embolism in areas of triple matches with decreased perfusion and triple matches with absent perfusion in the lower lung zone was 18% (20 of 109), and 61% (40 of 66), respectively. Conclusions: A V-Q/chest radiographic match is less likely to represent pulmonary embolism if perfusion is decreased rather than absent. The overall prevalence of pulmonary embolism associated with all triple matches in all lung zones varied from very low (0% in this series) to upper intermediate (61%), depending on whether perfusion was decreased or absent and also on the location of the triple match.

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KW - Lung Scan

KW - Pulmonary embolism

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