Clinical value of pulmonary ventilation and perfusion of radionuclide imaging combined with D-dimer assay in diagnosis of pulmonary embolism

Objective: To investigate the clinical value of pulmonary ventilation and perfusion (V/Q) radionuclide scintigraphy combined with plasma D-dimer assay in the diagnosis of pulmonary embolism (PE). Methods: 85 cases of clinical suspected patients with pulmonary embolism were enrolled in this study. The plasma D-dimer levels in patients were determined and eight position of pulmonary ventilation and perfusion planar imaging were carried out in one or next day. Two experienced nuclear medicine physicians made diagnosis based on the detection result and PIOPED II standards, and then compared with clinical diagnosis results. Results: In total 85 patients, 39 cases were diagnosed as PE (45.9%), and 46 cases were excluded. The sensitivity, specificity and accuracy of lung ventilation and perfusion scintigraphy in the diagnosis of PE were 89.7%, 88.4% and 85.9%, respectively. The sensitivity, specificity and accuracy of plasma D-dimer were 75.7%, 62.5%, and 68.2% respectively. The diagnosis accuracy of V/Q scintigraphy was higher than that of plasma D-dimer (P < 0.01). The sensitivity, specificity and accuracy of V/Q scintigraphy combined with plasma D-dimer in the diagnosis PE were 82.1%, 66.7% and 72.9%. Conclusion: The pulmonary ventilation and perfusion radionuclide scintigraphy combined with plasma D-dimer assay could improve the accuracy and have important clinical value in the diagnosis of pulmonary embolism. (authors)