A medical imaging procedure known as lung scintigraphy may be more reliable than pulmonary CT angiography (CTA) for identifying or excluding pulmonary embolism (PE) in pregnant patients, according to a study published in the November issue of the American Journal of Roentgenology.
PE, a blood clot lodged in an artery supplying the lungs, is the leading cause of maternal death in pregnancy. CTA is the imaging modality of choice for the diagnosis of PE, however lung scintigraphy, a form of radionuclide imaging that produces two-dimensional images, has shown to produce better diagnostic quality images more often than CTA in pregnant patients.
"Our study analyzed 28 CTA studies and 25 lung scintigraphy studies performed on a group of 50 patients," said Carole A. Ridge, M.D., lead author of the study. "The results showed that lung scintigraphy is more reliable than CTA for the diagnosis of PE. Only one out of 25 lung scintigraphic studies was inadequate for diagnosis; compared to ten out of 28 CTA examinations that were found to be inadequate for diagnosis," she said. Examinations were considered inadequate when poor image quality prohibited a diagnosis.
"During CTA in pregnant patients, it is hard to achieve optimal image quality because of the hemodynamic effects (changes in blood flow and circulation) of pregnancy," said Dr. Ridge.
"Our findings confirm what recent reports in the literature have suggested — CTA is less reliable for the diagnosis of PE in pregnant patients. Lung scintigraphy is more reliable than CTA for the diagnosis or exclusion of PE in pregnant patients, and should be considered the imaging technique of choice unless the CTA image technique can be optimized for the pregnant patient," she said.
This study appears in the November issue of the American Journal of Roentgenology. For a copy of the full study, please contact Heather Curry via email at hcurry@acr-arrs.org or at 703-390-9822.
About ARRS
The American Roentgen Ray Society (ARRS) was founded in 1900 and is the oldest radiology society in the United States. Its monthly journal, the American Journal of Roentgenology, began publication in 1906. Radiologists from all over the world attend the ARRS annual meeting to participate in instructional courses, scientific paper presentations and scientific and commercial exhibits related to the field of radiology. The Society is named after the first Nobel Laureate in Physics, Wilhelm Röentgen, who discovered the x-ray in 1895.
Journal
American Journal of Roentgenology