Assessment of the diagnostic value of perfusion scintigraphy in diagnosis of pulmonary artery thromboembolism

Kudryashova N.E.¹, Karalkin A.V.², Ermolov A.S.¹, Migunova E.V.¹, Sinyakova O.G.¹, Nikitina O.V.¹

1 Scientific Research Institute of Emergency Ambulance Care named after N.V. Sklifosovsky
2 Municipal Clinical Hospital No 1 named after N.I. Pirogov, Moscow, Russia

The present work was aimed at specifying the place of perfusion scintigraphy of the lungs in the diagnostic algorithm of pulmonary artery thromboembolism (PATE) and at determining sensitivity, specificity, and accuracy of the method concerned. The authors analysed the data regarding a total of 211 patients divided into two groups (Group One with an arbitrary algorithm of investigation, comprising 108 patients and Group Two with the suggested algorithm of «pulmonary roentgenography → Doppler ultrasonography → perfusion scintigraphy of the lungs») in clinically suspected pulmonary artery thromboembolism and scintigraphy-revealed defects of perfusion. The diagnostic complex included ECG, Doppler ultrasonography of the veins, roentgenography, perfusion scintigraphy of the lungs, and in a series of doubtful cases Echo-CG and CT angiography of the lungs. We revealed reliable signs of pulmonary artery thromboembolism (PATE) by the findings of instrumental diagnostic methods, having demonstrated a considerable increase in specificity and accuracy of perfusion scintigraphy in diagnosing PATE using the proposed diagnostic algorithm, when scintigraphy stands on the third position (specificity increased by 78% and accuracy by 22%). The following recommendations were made: the findings of scintigraphy should be interpreted with due regard for the data of roentgenography and Doppler ultrasonography of the veins; if the patient’s condition is severe, the examination may be limited to roentgenography alone prior to performing perfusion scintigraphy of the lungs.

KEY WORDS: pulmonary artery thromboembolism, perfusion scintigraphy of the lungs.

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