Key result
Perfusion defect extent on V/Q scintigraphy fails to correlate with pulmonary embolism severity.
Why the study?
Does the extent of perfusion defects on high-probability V/Q scintigraphy correlate with clinical severity and prognosis in patients with pulmonary embolism?
Observational (n=43)
No
Does the extent of perfusion defects on high-probability V/Q scintigraphy correlate with clinical severity and prognosis in patients with pulmonary embolism?
Absolute Event Rate: 22.2% vs 28.6%
p-value: p=0.681
In patients with a high-probability V/Q scan for pulmonary embolism, the size and extent of perfusion defects do not correlate with clinical severity parameters or length of hospital stay.
Defect extent on V/Q should not guide PE risk stratification now; leaves open whether quantitative scintigraphy adds prognostic value beyond SPESI.
Purpose: While computed tomography pulmonary angiography plays an effective role in the diagnosis and prognosis of pulmonary embolism (PE), there are not enough studies regarding ventilation/perfusion (V/Q) scintigraphy. We aimed to evaluate the clinical outcomes of PE patients whose V/Q scintigraphy was reported as high probability for PE. Method: Demographic data, Simplified Pulmonary Embolism Severity Index (SPESI), radiological findings, V/Q scintigraphy and echocardiographic (ECHO) findings, laboratory data, treatment information and comorbidities of 43 patients whose V/Q scintigraphy was reported as high probability for PE between January 2020 and January 2023 was recorded. Perfusion scintigraphy defects were classified as subsegmental, multiple subsegmental, segmental, and multiple segmental. Those with subsegmental, multiple subsegmental, and segmental perfusion defects were classified as Group 1, and those with multiple segmental defects as Group 2. Results: The mean age of the patients was 74 years (31-94), being 27 women (62.8 %) and 16 men (37.2 %), and there was no significant difference between the two groups. Multisegmental perfusion defect was detected in 23 (53.5 %) patients. 25 % of patients reported as high-probability PE had a SPESI score of ≥2. There was no significant difference between Groups 1 and 2 in terms of SPESI scoring. Perfusion defect had no significant correlation with SPESI score, D-Dimer, Troponin, pulmonary artery systolic pressure, right ventricular dilatation, and length of hospital stay. The presence of comorbidity was significantly positively correlated only with the SPESI score. There was no difference between the two groups regarding laboratory, radiological, echocardiographic findings, presence of comorbidity, unit of treatment, and duration of hospitalization. Conclusion: Parameters predicting clinical severity and providing treatment benefits are required in PE patients diagnosed with V/Q scintigraphy.
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Afşin et al. (2023) conducted an observational in Pulmonary embolism (n=43). Multiple segmental perfusion defects vs. Subsegmental or segmental perfusion defects was evaluated on Simplified Pulmonary Embolism Severity Index (SPESI) score ≥2 (p=0.681). The size and extent of perfusion defects on V/Q scintigraphy showed no significant correlation with clinical severity, as measured by the SPESI score, laboratory markers, or echocardiographic findings.
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