Is perfusion scintigraphy sufficient in pregnant or post-partum women?

Objective. Pulmonary embolism is one of the leading cause of maternal mortality. The purpose of our study was to validate if perfusion scintigraphy alone, with low injected activity, was sufficient to diagnose pulmonary embolism. Material and methods. In this retrospective study, we reviewed the charts and the lung scans performed in our institution over one decade for the diagnosis of PE. Revised PIOPED criteria were used in the interpretation of lung scans. Diagnosis of PE was obtained from composite clinical and paraclinical data. Doses received by the foetus and the mother were calculated. Results. For the whole group, there was 89.6% of normal studies, 2.8% high probability scans, 2.8% intermediate probability and 4.8% low probability. Pulmonary embolism was diagnosed in 4 post-partum women. One pregnant woman had a clinical diagnosis of pulmonary embolism following a low probability perfusion scintigraphy but did not present thromboembolic event on follow-up. Only one post-partum patient with a normal perfusion scan had a thromboembolic event on follow-up. The injected Tc-99 in MAA activity was lower in the pregnant population than in the post-partum population. Dosimetry to both mother and baby was reduced. Conclusion. Lung perfusion scanning with low injected activity of Tc99m-MAA was found to be a reliable technique to rule out PE. (C) 2015 Elsevier Masson SAS. All rights reserved.