COMPARISON OF TC-99M APCITIDE SCINTIGRAPHY WITH CT ANGIOGRAPHY IN INTERMEDIATE PROBABILITY OF PULMONARY EMBOLI BY PIOPED CRITERIA USING PULMONARY ANGIOGRAPHY AS A GOLD STANDARD.
Keywords:
Pulmonary embolism, GPIIB/IIIA receptor, scintigraphy, helical CT, pulmonary angiographyAbstract
Objectives: Ventilation-perfusion (V/Q) lung scintigraphy has been considered to be the first-line investigation for suspected pulmonary thromboembolism (PTE). An intermediate probability finding is problematic. Further investigation is needed to confirm or exclude clots. This study was aimed to evaluate the role of Tc-99m apcitide to diagnose PTE and to compare the diagnostic efficiency with CT angiography (CTA) and pulmonary angiography (PAgram).
Design: Prospective study comparing efficiency of Tc-99m apcitide scintigraphy and CTA to diagnose acute PTE by using PAgram as a gold standard.
Setting: Patients in tertiary care hospital (King Chulalongkorn Memorial Hospital)
Participants: Six out of eightteen patients with intermediate probability for PTE by V/Q lung scintigraphy.
Results: Six patients were studied by Tc-99m apcitide (planar and SPECT) scintigraphy and CTA. Four of these had PAgram. Only one positive planar Tc-99m apcitide study were observed. Three out of four patients had concordant results of SPECT Tc-99m apcitide with PAgram. In one patient with negative Tc-99m apcitide, CTA and PAgram were diagnosed to be pulmonary infarction. For 2 patients in whom PAgram were not performed, Tc-99m apcitide agreed with CTA. Tc-99m apcitide had more positive lesions than CTA and PAgram in 2 patients.
Conclusion: Tc-99m apcitide scintigraphy is a promising mean to detect active clots in PTE. It has a potential to detect more active clots than CTA.
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