بررسی میزان تطابق تست D-dimer و اسکن پرفیوژن-ونتیلاسیون ریه در بیماران مشکوک به آمبولی ریوی. (Persian)

Evaluation of D-dimer Test Correlation with Lung Perfusion-Ventilation Scan in Patients Suspected of Pulmonary Embolism. (English)

Background: Pulmonary embolism refers to the blockage of pulmonary arteries or a condition in which blood flow to the lungs is interrupted by a blood or fat clot. This phenomenon eventually leads to ischemia and respiratory failure, which, without diagnosis and treatment, will result in the lungs losing their efficiency. Along with other diagnostic methods such as CT angiography and the D-dimer test, nuclear medicine scans are very helpful in embolism cases as a non-invasive diagnostic method. The purpose of this study is to compare D-dimer tests with perfusion-ventilation scans in patients suspected of having pulmonary embolisms. Materials and Methods: According to the Nuclear Medicine Association protocol, 112 patients underwent lung scintigraphy (V/Q) with SPECT imaging systems (Siemens Ecam models). D-dimer tests were administered to all patients before the scan, at the discretion of the attending physician. Data were collected and the distribution of embolism probability (normal, low, high, and intermediate probabilities) among the participating patients was evaluated using Modified PIOPED criteria. In addition, D-dimer test values were evaluated and compared with possible pulmonary embolism diagnoses and clinical conditions (age, surgery, pregnancy, and underlying diseases). Results: This study showed that 26.2% of the patients with normal V/Q and 15.4% of the patients with V/Q with a low probability of embolism had positive D-dimer tests. Accordingly, patients with intermediate and high probabilities of pulmonary embolism had 33.3% and 50% positive D-dimer tests, respectively. Additionally, the results of the studies showed that the correlation with D-dimers negative (positive) in individuals less than or equal to 60 years, who had a normal scan and a low, intermediate, or high embolism probability was 74% (26%), 92.3% (7.7%), 83.3% (16.7%), and 0% (100%) respectively. Patients over 60 years old showed the same correlation with 73.3% (26.7%), 76.9% (23.1%), 55.6% (44.4%), and 100% (0%) respectively. Conclusion: A higher D-dimer level does not correspond to a positive pulmonary embolism finding on V/Q scans. Furthermore, according to the obtained results, high D-dimer values are significantly correlated with V/Q scan findings in patients younger than or equal to 60 years old, but there is no significant statistical correlation between high D-dimer values in patients with surgery, underlying diseases and pregnant women with V/Q scan findings. [ABSTRACT FROM AUTHOR]

Copyright of Iranian South Medical Journal is the property of Bushehr University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)