DETECTION OF PULMONARY EMBOLI AND ASSOCIATED RIGHT HEART DYSFUNCTION BY COMBINING VENTILATION-PERFUSION LUNG-SCANNING AND XENON VENTRICULOGRAPHY

Purpose: The authors sought to determine if the right ventricular ejec tion fraction (RVEF), as measured by xenon ventriculography, is depres sed in patients with pulmonary emboli, The authors also sought to corr elate any decrement in RVEF with the extent of lung perfusion defects. Materials and Methods: The authors identified all patients who had lu ng ventilation-perfusion (V/Q) scans between January 1994 and December 1996, that were interpreted as high probability for pulmonary embolis m, From these patients, the authors selected those who had undergone c oncurrent xenon ventriculography (XV) (n = 23), and then reprocessed t he initial ventriculography data for confirmation, The authors also re viewed original V/Q scans, chest radiographs, and clinical data, a con trol group was drawn from patients with normal V/Q scans who had under gone XV. Results: Fifteen patients (65%) with high probability V/Q sca ns had an abnormally low RVEF (<.32). Patients with high probability V /Q scans also had a significantly lower mean RVEF (0.28 +/- .08) than patients with normal V/Q scans (.39 +/- .08 SD), The degree of RVEF de cline correlated poorly with the number of segmental perfusion defects (r = -.39). Conclusions: RVEF is often depressed in patients with hig h probability V/Q scans. XV can identify these patients, while routine lung V/Q scans cannot.