REPORTING VENTILATION-PERFUSION LUNG SCINTIGRAPHY - IMPACT ON SUBSEQUENT USE OF ANTICOAGULATION THERAPY

Ventilation and perfusion lung scintigraphy is an established and safe noninvasive technique which has been used for nearly 30 years to esta blish the diagnosis of pulmonary embolism. Recently, in common with ot her diagnostic tests, there has arisen the need to reassess the effect iveness of this test in the clinical setting. A retrospective analysis of 244 patients undergoing ventilation-perfusion lung scintigraphy wa s performed. A total of 203 case notes were available. It was found th at the majority of reports (68.5%) were described as either high proba bility for the presence of pulmonary embolism or normal or low probabi lity. A result of 'high probability' changed the clinical management o f the patient in 28/46 (61%) of reported cases but in only 5/91 (5.5%) of patients reported as 'normal' or 'low probability'. During the stu dy there were six deaths, five from other causes and one from pulmonar y embolism; this patient died despite anticoagulation following a 'hig h probability' ventilation - perfusion lung scintigraphy. Ventilation- perfusion lung scintigraphy is a safe and effective noninvasive method to diagnose the presence of pulmonary embolism and a test which has a significant effect on patient management.