Détection de l’embolie pulmonaire aiguë : apport du scanner X faible dose à la tomoscintigraphie pulmonaire de ventilation et de perfusion |
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| Authors: | E Mathias N Didot G Karcher P-Y Marie |
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| Institution: | 1. Service de médecine nucléaire, centre hospitalier universitaire Ibn Sina, université MedV, CHIS, hôpital Ibn Sina, Suissi, Rabat, Maroc;2. Laboratoire national de contrôle de médicaments, direction du médicament et de pharmacie, Rabat, Maroc;1. Département de médecine nucléaire, centre hospitalier universitaire Vaudois, 46, rue du Bugnon, 1011 Lausanne, Suisse;2. Département de radiologie, centre hospitalier universitaire Vaudois, Lausanne, Suisse;3. Chaire de pathologie, département de médecine, faculté des sciences, université de Fribourg, Fribourg, Suisse;1. Moscow Civil Engineering University, 26, Yaroslavskoe Shosse, 129337, Moscow, Russia;2. SCAD Soft Ltd, 3a Osvity str., 03037, Kyiv, Ukraine;1. Service de radiologie, département d’imagerie et des sciences de l’information médicale, hôpitaux universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1211, Genève 14, Suisse;2. Service de médecine nucléaire et d’imagerie moléculaire, département d’imagerie et des sciences de l’information médicale, hôpitaux universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1211, Genève 14, Suisse;3. Département de médecine nucléaire, centre hospitalier de l’université de Montréal, 3840, rue Saint-Urbain, Montréal, Canada;1. A-818 Anzhong Building, College of Civil Engineering and Architecture, Zhejiang University, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China;2. A-821 Anzhong Building, College of Civil Engineering and Architecture, Zhejiang University, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China |
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| Abstract: | Ventilation and perfusion (V/Q) lung SPECT, performed according to the new recommendations of European Association of Nuclear Medicine (EANM), is a first-line examination for the detection of acute pulmonary embolism. Since low-dose CT scan acquisitions may be recorded during the same examination on hybrid cameras, the corresponding additional information should be assessed. The aim of this study is to compare the diagnostic information provided by lung V/Q SPECT, alone and combined with a low-dose CT scan. Each analysis is performed by two readers; one is more experienced (assistant, A) and one less (interne, I).ResultsThe addition of low-dose CT Scan to lung V/Q SPECT: (1) seldom changes the main diagnostic answer in example the presence or absence of pulmonary embolism (2% for A and 6% for I); (2) frequently gives more minor additional informations, 69% for A and 79% for I (localisation of the involved segments, non embolic pleuroparenchymal abnormalities…) and (3) is associated with a concordance of 87% between the two readers with regard to the final diagnosis of pulmonary embolism (84% for SPECT without CT scan). Seventy-nine percent of these discordances were associated with a low quality of ventilation images.ConclusionWhen added to V/Q lung SPECT, low-dose CT scan commonly provides an additional diagnostic information, without affecting interobserver reproducibility, but this information is generally minor without impact on the diagnosis of pulmonary embolism. |
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