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Lung Scan Evaluation of Thrombolytic Therapy for Pulmonary Embolism

Division of Nuclear Medicine, Department of Radiology, Beth Israel Hospital
Division of Nuclear Medicine and Cardiovascular Division, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
Frontier Science and Technology, Brookline, Massachusetts

Correspondence: For correspondence or reprints contact: J. Anthony Parker, MD, PhD, Division of Nuclear Medicine, Beth Israel Hospital, 330 Brookline Ave., Boston, MA 02215.

ABSTRACT

Data from three trials of thrombolytic therapy for pulmonary embolism (PE) were combined to assess the utility of perfusion lung scan defect scoring in predicting the response to thrombolytic therapy. Methods: Pre-and post-therapy lung scans and duration of symptoms were available for a total of 221 patients, 167 were treated with various thrombolytic regimes and 54 were treated with heparin alone. Results: Improvement in the lung scan defect score was correlated with larger initial defect score (r = 0.53), segmental appearance (r = 0.31) and shorter duration of symptoms (r = 0.20). There was no significant residual correlation between improvement and segmental appearance in a multiple regression analysis after accounting for initial defect score and duration of symptoms. Two lung scan scoring methods (segmental and anterior-posterior method) provided similar results with low interobserver variability (r = 0.90 for both methods). Conclusion: This study indicates that the baseline perfusion lung scan defect severity helps to predict the response to thrombolytic therapy.

Key Words: pulmonary embolism • lung • radionuclide studies • thrombolysis • thrombolytic therapy

This article has been cited by other articles:

				S. Z Goldhaber A contemporary approach to thrombolytic therapy for pulmonary embolism Vascular Medicine, May 1, 2000; 5(2): 115 - 123. [Abstract] [PDF]