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Retro Is the Rage!

Ventilation-Perfusion Scanning Is Alive and Well in the Diagnosis of Pulmonary Embolism
  • Lisa K. Moores
    Correspondence
    Correspondence to: Lisa K. Moores, MD, Office for Student Affairs, Uniformed Services University of the Health Sciences, Bldg C, Room 1020, 4301 Jones Bridge Rd, Bethesda, MD 20814
    Affiliations
    Uniformed Services University of the Health Sciences, Bethesda, MD
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      In the past 2 decades, we have seen a changing pattern in the use of CT pulmonary angiography (CTPA) vs lung perfusion scintigraphy (ventilation-perfusion ratio [] scanning) in the investigation of pulmonary embolism (PE). scanning was the imaging modality of choice, but it has largely been supplanted by CTPA in recent years.

      Estrada YMRM, Oldham SA. CTPA as the gold standard for the diagnosis of pulmonary embolism [published online ahead of print August 6, 2010]. Int J Comput Assist Radiol Surg doi:10.1007/s11548-010-0526-4

      CTPA has been shown to be accurate and safe when used as part of a diagnostic algorithm for suspected PE.
      • Galipienzo J
      • García de Tena J
      • Flores J
      • Alvarez C
      • Alonso-Viteri S
      • Ruiz A
      Safety of withholding anticoagulant therapy in patients with suspected pulmonary embolism with a negative multislice computed tomography pulmonary angiography.
      • Quiroz R
      • Kucher N
      • Zou KH
      • et al.
      Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review.
      • Stein PD
      • Fowler SE
      • Goodman LR
      • PIOPED II Investigators
      • et al.
      Multidetector computed tomography for acute pulmonary embolism.
      • van Belle A
      • Büller HR
      • Huisman MV
      • Writing Group for the Christopher Study Investigators
      • et al.
      Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography.
      Further, CTPA can lead to additional diagnoses for patients who do not have PE, can provide prognostic information by focusing on the right ventricle, and is available 24 h a day at most institutions. Thus, CTPA currently is recommended as the primary imaging modality for suspected acute PE.
      • Agnelli G
      • Becattini C
      Acute pulmonary embolism.
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      References

      1. Estrada YMRM, Oldham SA. CTPA as the gold standard for the diagnosis of pulmonary embolism [published online ahead of print August 6, 2010]. Int J Comput Assist Radiol Surg doi:10.1007/s11548-010-0526-4

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