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ventilation perfusion scintigraphy

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https://www.readbyqxmd.com/read/28298387/diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#1
REVIEW
Deepa Gopalan, Marion Delcroix, Matthias Held
Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of pulmonary hypertension. Rapid and accurate diagnosis is pivotal for successful treatment. Clinical signs and symptoms can be nonspecific and risk factors such as history of venous thromboembolism may not always be present. Echocardiography is the recommended first diagnostic step. Cardiopulmonary exercise testing is a complementary tool that can help to identify patients with milder abnormalities and chronic thromboembolic disease, triggering the need for further investigation...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28293001/-congenital-bronchial-atresia-requiring-differentiation-from-intralobar-sequestration
#2
Yusuke Tanaka, Isao Matsumoto, Daisuke Saito, Syuhei Yoshida, Seiichi Kakegawa, Masaya Tamura, Hirofumi Takemura, Kaori Yoshimura, Hiroko Ikeda
We reported a case of bronchial atresia requiring differentiation from the intralobar sequestration. A 42-year-old man was referred to our institution with suspicion of intralobar sequestration, based on a 3-dimensional computed tomography (CT) angiography that showed abnormal blood vessels from the right inferior phrenic artery flowing into the right lower lobe. CT revealed a lesion between S9 and S10 wherein there were refluxed blood vessels from A9 without an accompanying bronchus, with polycysts and emphysematous changes...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28262522/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-scintigraphic-data
#3
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: Pulmonary embolism (PE) is a common condition associated with significant morbidity and mortality. Diagnostic test characteristics reported in terms of sensitivity and specificity are difficult to translate at the clinical level. More relevant measures are likelihood ratios (LRs), which can convert a pretest into a posttest probability. The aim of our study was to calculate the LRs and posttest probabilities for multiple-level test result for ventilation/perfusion (V/Q) lung scintigraphy and for perfusion scintigraphy combined with chest radiography using modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria for each clinical probability level for the most commonly used clinical prediction rules (CPR) using the PIOPED data...
March 2, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28095020/current-status-of-ventilation-perfusion-scintigraphy-for-suspected-pulmonary-embolism
#4
Darlene Metter, Mark Tulchinsky, Leonard M Freeman
OBJECTIVE: The purpose of this article is to outline recent progress made in ventilation-perfusion (V/Q) scintigraphy imaging techniques and the interpretation systems used for the diagnosis of pulmonary embolism (PE). Various state-of-the-art approaches that can be selected according to the needs dictated by the medical practice environment and specific patient groups are presented. CONCLUSION: Although advances in tomographic imaging have certainly improved the sensitivity of V/Q scans for the diagnosis of PE, they may lead to overdiagnosis by revealing small and clinically insignificant PEs...
March 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27977536/incidence-of-a-single-subsegmental-mismatched-perfusion-defect-in-single-photon-emission-computed-tomography-and-planar-ventilation-perfusion-scans
#5
Matthew Stubbs, Kenneth Chan, Helena McMeekin, Shaunak Navalkissoor, Thomas Wagner
OBJECTIVE: This study aims to compare the incidence of ventilation/perfusion (V/Q) scans interpreted as indeterminate for the diagnosis of pulmonary embolism (PE) using single-photon emission computed tomography (SPECT) versus planar scintigraphy and to consider the effect of variable interpretation of single subsegmental V/Q mismatch (SSM). METHODS: A total of 1300 consecutive V/Q scans were retrospectively reviewed. After exclusion and matching for age and sex, 542 SPECT and 589 planar scans were included in the analysis...
February 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27764879/state-of-the-art-imaging-in-pulmonary-embolism-ventilation-perfusion-single-photon-emission-computed-tomography-versus-computed-tomography-angiography-controversies-results-and-recommendations-from-a-systematic-review
#6
REVIEW
Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27758995/pulmonary-stenting-for-the-treatment-of-sarcoid-induced-pulmonary-vascular-stenosis
#7
Jose F Condado, Vasilis Babaliaros, Travis S Henry, Brian Kaebnick, Dennis Kim, Gerald W Staton
BACKGROUND: The best treatment of patients with external pulmonary vascular compression due to advanced sarcoidosis is unknown. OBJECTIVES: To report a single-center experience of percutaneous treatment for pulmonary vascular stenosis caused by external compression due to advanced sarcoidosis. METHODS: We report a case series of 5 patients with biopsy confirmed advanced sarcoidosis, seen at our academic institution with worsening dyspnea despite increase of immunosuppressive therapy...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/27726408/overview-of-the-novel-and-improved-pulmonary-ventilation-perfusion-imaging-applications-in-the-era-of-spect-ct
#8
REVIEW
Saeed Elojeimy, Irene Cruite, Stephen Bowen, Jing Zeng, Hubert Vesselle
OBJECTIVE: In this article, we describe the concepts of ventilation-perfusion planar, SPECT, and SPECT/CT and outline the advantages of integrated ventilation-perfusion SPECT/CT over planar imaging. We present an overview of the traditional and new applications of ventilation-perfusion scintigraphy. CONCLUSION: SPECT/CT has improved the diagnostic accuracy of ventilation-perfusion imaging and opened the door for a new spectrum of applications.
December 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27719980/imaging-of-pulmonary-hypertension
#9
REVIEW
Christopher J François, Mark L Schiebler
Multimodality, noninvasive imaging is increasingly used in the identification and management of pulmonary hypertension (PH). Chest radiography, ventilation-perfusion scintigraphy, and Doppler echocardiography are frequently the initial studies used to evaluate patients suspected of having PH. However, their ability to evaluate the right ventricle (RV) and pulmonary vasculature is limited. Computed tomography (CT) and magnetic resonance (MR) imaging are increasingly used to identify causes of PH and assess the effect of PH on RV function...
November 2016: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27648373/the-benefit-of-personalized-hybrid-spect-ct-pulmonary-imaging
#10
Milan Simanek, Pavel Koranda
Hybrid pulmonary imaging in the present day has seen a fusion of various uses of CT scans, including angiography (CTAG), diagnostic CT, low dose CT (LDCT), and perfusion or ventilation scintigraphy in tomographic or planar imaging. Determining the most effective individualized test for the complete diagnostics of patients with pulmonary symptoms for various groups of patients is a major issue. The aim of the present study was to assess the effectiveness of the implementation of hybrid imaging in current methods of nuclear medicine in differential diagnostics of pulmonary embolism (PE)...
2016: American Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27620309/radionuclide-diagnosis-of-pulmonary-embolism
#11
Søren Hess, Poul Henning Madsen
Diagnostic imaging plays an integral role in the diagnostic workup of suspected pulmonary embolism, and several modalities have been employed over the years. In recent years, the choice has been narrowed to either computer tomographic or radionuclide based methods, i.e. computer tomographic angiography (CTA) and ventilation-perfusion scintigraphy (V/Q-scan). Both methods display advantages and shortcomings, and while we provide some insights into CTA and alternative methods, the paper's main focus is a review of the V/Q-scan...
September 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27556796/deep-vein-thrombosis-presenting-on-pulmonary-ventilation-and-perfusion-scintigraphy
#12
Malak Itani, Joanna Fair, Zachary Hillman, Fatemeh Behnia, Saeed Elojeimy
A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with Tc-DTPA [diethylene triamine pentaacetic acid aerosol] and Tc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little Tc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal Tc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound...
October 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27540433/vertebral-uptake-of-tc-99m-macroaggregated-albumin-maa-with-spect-ct-occurring-in-superior-vena-cava-obstruction
#13
Shawn Karls, Hani Hassoun, Vilma Derbekyan
A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus...
September 2016: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27497375/dual-energy-computed-tomographic-imaging-of-pulmonary-hypertension
#14
Anne-Lise Hachulla, Frédéric Lador, Paola M Soccal, Xavier Montet, Maurice Beghetti
Dual-energy computed tomography (DECT) angiography of the chest provides a combined morphological and functional analysis of the lung, usually obtained in a single acquisition without extra radiation or injection of extra intravenous iodine contrast. The parenchymal iodine maps generated by DECT are well correlated with scintigraphy, and are becoming an essential tool for evaluating patients with pulmonary vascular diseases. With a single DECT acquisition, complete imaging of pulmonary hypertension is now available, displaying vascular anatomy, parenchymal morphology and functional assessment...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27494075/d-dimer-test-for-excluding-the-diagnosis-of-pulmonary-embolism
#15
REVIEW
Fay Crawford, Alina Andras, Karen Welch, Karen Sheares, David Keeling, Francesca M Chappell
BACKGROUND: Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory rate are common...
August 5, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27461384/spect-ct-vq-versus-ctpa-for-diagnosing-pulmonary-embolus-and-other-lung-pathology-pre-existing-lung-disease-should-not-be-a-contraindication
#16
Kartik Dev Bhatia, Chaitanya Ambati, Rajiv Dhaliwal, Royce Paschkewitz, Eugene Hsu, Bao Ho, Andy Young, Louise Emmett
INTRODUCTION: Single Photon Emission Computed Tomography-Ventilation-Perfusion (SPECT-VQ) with low-dose CT (SPECT-CT/VQ) has equivalent diagnostic accuracy to CTPA for diagnosing pulmonary embolus (PE) while using lower radiation doses, but is underutilized owing to perceived inaccuracy of scintigraphy in the setting of pre-existing lung disease. This study assesses the accuracy of SPECT-CT/VQ compared with CTPA for the diagnosis of PE, including in patients with pre-existing lung disease...
August 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27445557/update-on-nonsurgical-lung-volume-reduction-procedures
#17
REVIEW
J Alberto Neder, Denis E O'Donnell
There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27354783/lung-perfusion-and-emphysema-distribution-affect-the-outcome-of-endobronchial-valve-therapy
#18
Christian Thomsen, Dorothea Theilig, Dominik Herzog, Alexander Poellinger, Felix Doellinger, Nils Schreiter, Vera Schreiter, Dirk Schürmann, Bettina Temmesfeld-Wollbrueck, Stefan Hippenstiel, Norbert Suttorp, Ralf-Harto Hubner
The exclusion of collateral ventilation (CV) and other factors affect the clinical success of endoscopic lung volume reduction (ELVR). However, despite its benefits, the outcome of ELVR remains difficult to predict. We investigated whether clinical success could be predicted by emphysema distribution assessed by computed tomography scan and baseline perfusion assessed by perfusion scintigraphy. Data from 57 patients with no CV in the target lobe (TL) were retrospectively analyzed after ELVR with valves. Pulmonary function tests (PFT), St George's Respiratory Questionnaire (SGRQ), and 6-minute walk tests (6MWT) were performed on patients at baseline...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27352239/left-lower-limb-may-be-a-forbidden-region-for-indwelling-needle-during-operation
#19
Kun Wang, Zhihua Li, Deguang Kong, Qiuxia Cui, Yu Liu, Wenbo Zhou, Shenghua Cao, Kongming Wu, Gaosong Wu
INTRODUCTION: Information about the incidence and risk factors of venous thromboembolism (VTE) after thyroid operation is limited. This study aimed to analyze the incidence and risk factors of postoperative VTE in patients who had undergone thyroid surgery. MATERIALS AND METHODS: A prospective, multi-center cohort study was performed from June 2013 to June 2015 in 3 hospitals throughout South Central China. We analyzed 5029 patients who had undergone thyroid operation and received no VTE prophylaxis postoperatively...
August 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27348165/-prognostic-value-of-some-hemostasis-related-homocysteine-high-sensitive-c-r-p-and-multidetector-computed-tomography-parameters-in-pulmonary-embolism
#20
F Todua, M Akhvlediani, E Vorobiova, A Baramidze, G Tsivtsivadze, D Gachechiladze
Nowadays, an arsenal of diagnostic methods is used in diagnosis of pulmonary embolism, which includes x-ray, angiography, perfusion-ventilation scintigraphy, CT and magnetic resonance imaging, Doppler and laboratory studies. Purpose of our study was to evaluate the diagnostic significance of determination of some parameters of hemostasis (D-dimer, Soluble fibrinmonomer complexes, fibrinogen), homocysteine, hs-CRP and multidetector computed tomography in suspected pulmonary embolism. We have examined 54 patients -31 men and 23 women, aged 18 to 76 years, with characteristics of pulmonary embolism...
May 2016: Georgian Medical News
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