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Computation of Ventilation-Perfusion Ratio with Kr-81m in Pulmonary Embolism

Hôpital Henri Mondor, Créteil 94010, and Hôpital Antoine Beclère, Clamart 92140 France

Correspondence: For reprints contact: Docteur Michel Meignan, Service de Médecine Nucléaire, Hôpital Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Creteil, France

ABSTRACT

Diagnostic difficulties occur in pulmonary embolism (PE) during visual analysis of ventilation-perfusion images in matched defects or in chronic obstructive lung disease (COPD). In 44 patients with angiographically confirmed PE and in 40 patients with COPD, the regional ventilation-perfusion ratios (/) were therefore computed using krypton-81m for each perfusion defect, and were displayed in a functional image. In patients with PE and mismatched defects, a high / > 1.25 was also found in nine of 11 patients having PE and indeterminate studies (studies with perfusion abnormalities matched by radiographic abnormalities). COPD was characterized by matched defects and low /. The percentage of patients correctly classified as having PE of COPD increased from 56% when considering the match or mismatched character to 88% when based on a / of 1.25 in the region of the perfusion defect. This quantitative analysis, therefore, seems useful in classifying patients with scintigraphic suspicion of PE.

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