CENTRAL PULMONARY-EMBOLISM WITH NORMAL VENTILATION PERFUSION SCAN-DIAGNOSIS BY NUCLEAR PULMONARY-ARTERY FLOW STUDIES

被引:1
作者
HACKBARTH, R
KUHNS, L
SARNAIK, A
机构
[1] Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
[2] Department of Radiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
关键词
pulmonary embolism; radionuclide imaging;
D O I
10.1016/S0196-0644(05)81131-X
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Pulmonary embolism, although uncommon in children, occurs in as many as 104 per 100,000 pediatric patients. Undiagnosed and untreated pulmonary embolism has a high mortality rate; thus, a high index of clinical suspicion and reliable diagnostic modalities are necessary to ensure prompt and accurate diagnosis. We report the case of a patient with severe central pulmonary embolism with a normal ventilation-perfusion scan. The embolus was identified by a nuclear pulmonary flow study using dynamic imaging, which obviated the need for contrast pulmonary angiography. The traditional ventilation-perfusion scan may appear normal despite severe central pulmonary embolism. In this situation, early dynamic imaging is necessary to detect severe obstruction of the central pulmonary arteries. This approach may obviate the need for contrast pulmonary angiography in hemodynamically stable patients.
引用
收藏
页码:95 / 97
页数:3
相关论文
共 11 条
  • [1] Buck, Connors, Coon, Et al., Pulmonary embolism in children, J Pediatr Surg, 16, pp. 385-391, (1981)
  • [2] Caracci, Rumbolo, Mainini, Et al., How accurate are ventilation-perfusion scans for pulmonary embolism?, Am J Surg, 156, pp. 477-480, (1988)
  • [3] Kipper, Moser, Kortman, Et al., Longterm follow-up of patients with suspected pulmonary embolism and a normal lung scan, Chest, 82, pp. 411-415, (1982)
  • [4] Hull, Raskob, Coates, Et al., Clinical validity of a normal perfusion lung scan in patients with suspected pulmonary embolism, Chest, 97, pp. 23-26, (1990)
  • [5] Ceraldi, Schabel, Waxman, Normal ventilation/perfusion lung scan in a patient with pulmonary embolus, Crit Care Med, 18, pp. 577-578, (1990)
  • [6] Alderson, Doppman, Diamond, Et al., Ventilation-perfusion lung imaging and selective pulmonary angiography in dogs with experimental pulmonary embolism, J Nucl Med, 19, pp. 164-171, (1978)
  • [7] Moser, Harsanyi, Rius-Garriga, Et al., Assessment of pulmonary photoscanning and angiography in experimental pulmonary embolism, Circulation, 39, pp. 663-674, (1969)
  • [8] Stjernholm, Landis, Marcus, Et al., Perfusion and ventilation radioisotope lung scans in stenosis of the pulmonary arteries and their branches, Am Heart J, 78, pp. 37-42, (1969)
  • [9] Lund, Schifter, Nielsen, Et al., Scintigraphy and angiography in pulmonary embolism, Nucl Med Commun, 7, pp. 83-89, (1986)
  • [10] Dalen, Alpert, Natural history of pulmonary embolism, Prog Cardiovasc Dis, 17, pp. 259-270, (1975)