Skip to main content
Log in

Comparison of perfusion lung scanning and angiography in the estimation of vascular obstruction in acute pulmonary embolism

  • Original Article
  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

To determine the relationships between perfusion scan defect and angiographic severity (Miller index) in acute pulmonary embolism, we analysed examinations obtained before and after thrombolytic therapy in 34 consecutive patients free from underlying cardiopulmonary disease. The overall agreement between the two techniques was excellent (r=0.82; mean absolute difference=2.8%), although when embolic involvement was extensive (greater than 50% angiographic obstruction), the perfusion scan moderately underestimated (4%) the defect seen angiographically. These findings suggest that the pulmonary lung scan is a reliable method of assessing the initial pulmonary vascular obstruction as well as of quantifying any changes induced by or associated with the treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    PubMed  Google Scholar 

  • Brochier M, Raynaud P, Fauchier JP, Charbonnier B, Latour F, Alison D, Pellois A, Planiol T (1980) Comparison between lung scans and pulmonary angiograms in the evaluation of the perfusion defect in massive and submassive pulmonary embolism. In: Widimsky J (ed) Pulmonary embolism. Progress in respiration research, vol 13. Karger, Basel, pp 120–126

    Google Scholar 

  • Fedullo PF, Kapitan KS, Brewer NS, Ashburn WL, Hartman MT, Moser KM (1989) Patterns of pulmonary perfusion scans in normal subjects. IV The prevalence of abnormal scans in smokers 30 to 49 years of age. Am Rev Respir Dis 139:1155–1157

    PubMed  Google Scholar 

  • Goldhaber SZ, Kessler CM, Heit J, Markis J, Sharma GVRH, Dawley D, Nagel JS, Meyerovitz M, Kim D, Vaughan DE, Parker JA, Tumeh SS, Drum D, Loscalzo J, Reagan K, Selwyn AP, Anderson J, Braunwald E (1988) Randomised controlled trial of recombinant tissue plasminogen activator versus urokinase in the treatment of acute pulmonary embolism. Lancet 2:293–298

    PubMed  Google Scholar 

  • Hanson MW, Coleman RE (1989) Pulmonary nuclear medicine evaluation of thromboembolic disease. J Thorac Imag 4:40–57

    Google Scholar 

  • Hull RD, Hirsh J, Carter CJ, Jay RM, Dodd PE, Ockelford PA, Coates G, Gill GJ, Turpie AG, Doyle DJ, Buller HR, Raskob GE (1983) Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 98:891–899

    PubMed  Google Scholar 

  • Hull RD, Hirsh J, Carter CJ, Raskob GE, Gill GJ, Jay RM, Leclerc JR, David M, Coates G (1985) Diagnostic value of ventilationperfusion lung scanning in patients with suspected pulmonary embolism. Chest 88:819–828

    PubMed  Google Scholar 

  • McIntyre KM, Sasahara AA (1971) Correlation of pulmonary photoscan and angiogram as measures of the severity of pulmonary embolic involvement. J Nucl Med 12:732–738

    PubMed  Google Scholar 

  • McIntyre KM, Sasahara AA (1972) Angiography, scanning, and hemodynamics in pulmonary embolism: critical review and correlations. CRC Crit Rev Radiol Sci 3:489–521

    PubMed  Google Scholar 

  • Meyer G, Charbonnier B, Stern M, Brochier ML, Sors H (1989) Thrombolysis in acute pulmonary embolism. In: Julian DG, Kübler W, Norris RM, Swan HJ, Collen D, Verstraete M (eds) Thrombolysis in cardiovascular disease. Dekker, New York, pp 337–360

    Google Scholar 

  • Miller GAH, Sutton GC, Kerr IH, Gibson RV, Honey M (1971) Comparison of streptokinase and heparin in treatment of isolated acute massive pulmonary embolism. Br Med J 2:681–684

    PubMed  Google Scholar 

  • Parker JA, Markis JE, Palla A, Goldhaber SZ, Royal HD, Tumeh S, Kim D, Rustgi AK, Holman BL, Kolodny GM, Braunwald E (1988) Pulmonary perfusion after rt-PA therapy for acute embolism: early improvement assessed with segmental perfusion scanning. Radiology 166:441–445

    PubMed  Google Scholar 

  • Snedecor GW, Cochran WG (1957) Statistical methods, 6th edn. Iowa State University Press, Ames

    Google Scholar 

  • Stern M, Meyer G, Sors H (1988) Urokinase versus tissue plasminogen activator in pulmonary embolism. Lancet 2:691–692

    PubMed  Google Scholar 

  • Tow DE, Simon AL (1975) Comparison of lung scanning and pulmonary angiography in the detection and follow-up of pulmonary embolism: the Urokinase Pulmonary Embolism Trial experience. Prog Cardiovasc Dis 17:239–245

    PubMed  Google Scholar 

  • Urokinase Pulmonary Embolism Trial (1973) A national cooperative study. Circulation 48-48 (Suppl 2):1–108

    Google Scholar 

  • Wellman HN (1986) Pulmonary thromboembolism: current status report on the role of nuclear medicine. Semin Nucl Med 16:236–274

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

French exchange travelling fellow

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meyer, G., Collignon, M.A., Guinet, F. et al. Comparison of perfusion lung scanning and angiography in the estimation of vascular obstruction in acute pulmonary embolism. Eur J Nucl Med 17, 315–319 (1990). https://doi.org/10.1007/BF01268022

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01268022

Key words

Navigation