Value of the Ventilation/Perfusion Scan in Acute Pulmonary Embolism
- 23 May 1990
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA
- Vol. 263 (20), 2753-2759
- https://doi.org/10.1001/jama.1990.03440200057023
Abstract
To determine the sensitivities and specificities of ventilation/perfusion lung scans for acute pulmonary embolism, a random sample of 933 of 1493 patients was studied prospectively. Nine hundred thirty-one underwent scintigraphy and 755 underwent pulmonary angiography; 251 (33%) of 755 demonstrated pulmonary embolism. Almost all patients with pulmonary embolism had abnormal scans of high, intermediate, or low probability, but so did most without pulmonary embolism (sensitivity, 98%; specificity, 10%). Of 116 patients with high-probability scans and definitive angiograms, 102 (88%) had pulmonary embolism, but only a minority with pulmonary embolism had high-probability scans (sensitivity, 41%; specificity, 97%). Of 322 with intermediate-probability scans and definitive angiograms, 105 (33%) had pulmonary embolism. Follow-up and angiography together suggest pulmonary embolism occurred among 12% of patients with low-probability scans. Clinical assessment combined with the ventilation/perfusion scan established the diagnosis or exclusion of pulmonary embolism only for a minority of patients—those with clear and concordant clinical and ventilation/perfusion scan findings. (JAMA. 1990;263:2753-2759)Keywords
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