Highlights the risk of misdiagnosing pulmonary embolism when relying solely on diminished perfusion rather than identifying an intraluminal filling defect on angiography.
May warrant caution against perfusion-only PE diagnosis; case report leaves open need for angiographic validation in modern protocols.
Seven case reports exemplify various cardiac and pulmonary disorders which produce diminished, delayed, or absent filling of pulmonary arteries in a portion of the lung. These disorders are not uncommon in patients studied angiographically for possible pulmonary emboli. Only when the embolus itself is demonstrated as an intraluminal filling defect on pulmonary angiography is its definite diagnosis possible. Diagnosis of pulmonary embolism based solely on diminished perfusion, whether detected by radionuclide photo-scans or by pulmonary angiography, may be erroneous.
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Sagel et al. (1971) studied this question.
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