Comparison of chest multiple detector computed tomography and perfusion scintigraphy in pulmonary embolism diagnosis

Fuad Zukić, Adi Behmen


Objectives: Pulmonary embolism (PE) occurs most commonly as a complication of deep vein thrombosis (DVT) and emboli, where thrombus leads to blockage of the pulmonary artery. Chest multiple detector computed tomography (MDCT) and lung perfusion scintigraphy are diagnostic modalities that are of immense importance in the diagnosis of PE. The aim of this study was to compare chest MDCT and lung perfusion scintigraphy in the PE diagnosis and to determine which modality is superior in the diagnosis of PE.

Materials and methods: This was a cross-sectional study. Based on recorded predisposing factors, symptoms, laboratory findings and clinical presentation patients with clinically suspected PE were screened for the study. Chest MDCT and lung perfusion scintigraphy were used for PE detection.

Results: In total 57 patients without significant difference in gender were enrolled in the study. Chest MDCT detected PE in 49.1% of patients while in 50.9% of patients PE was not proven. By means of lung perfusion scintigraphy, PE was listed as a diagnosis for 59.6% of patients while for 40.4% of patients there were no scintigraphy signs of PE. Segmental PE was more frequently demonstrated than massive PE. Chest MDCT in the diagnosis of PE showed a sensitivity of 100%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 100%. Perfusion scintigraphy showed a sensitivity of 83.35%, specificity of 73.91%, PPV of 82.35% and NPV of 73.91%. Perfusion scintigraphy showed false positive findings in 17.6% of patients in the diagnosis of PE.

Conclusion: Chest MDCT is superior diagnostic modality in the diagnosis of PE compared to lung perfusion scintigraphy because it allows direct visualization of the thrombus in the pulmonary arteries and visualization of sub segmental branches of the pulmonary artery, and display of lung parenchyma and mediastinal structures.

Keywords: Pulmonary embolism, chest multiple detector computed tomography, lung perfusion scintigraphy.

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