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Diagnosis of Pulmonary Embolism and Infraction By Photoscanning^1,2,

Galveston, Texas

ABSTRACT

A series of twenty patients studied with lung scans performed with ¹³¹I macroaggregated albumin has pointed out some areas of usefulness and potential limitation of this procedure in clinical practice. In nine patients with probable to definite pulmonary infarction, the lung scan was abnormal, showing "cold" areas, in all but one. The chest x-ray was abnormal in seven out out of eight patients examined. Angiocardiograms were performed in five patients and were abnormal in all five patients. In seven patients with a variety of other pulmonary disorders, including one normal volunteer, the lung scan was abnormal in five showing decreased concentration in areas of pathology ranging from subdiaphragmatic abscess to pericardial effusion and pulmonary neoplasms. Irregularity of the left lung border was found in a normal patient as well as in several patients with equivocal pulmonary dieases and is felt to be a normal anatomic variation.

The lung scan is simple to perform and can be carried out as a bedside procedure on the critically ill patient. It is safe, no immediate reaction appearing and no delayed sequelae developing during the period of follow up in this series. It was possible to perform serial studies to follow the results of therapy. The lung scan, though showing a good correlation with clinical diagnosis of pulmonary embolism and infarction should not be relied upon as the only procedure in the diagnosis of this disorder. The final place of this procedure in clinical practice will await the accumulation of further data, but preliminary reports indicate a great deal of promise for the procedure.

FOOTNOTES

¹ Supported by a grant from the Texas Heart Association

⁵ Requests for reprints: Nuclear Medicine Service, University of Texas Medical Branch Galveston, Texas.

² Section of Nuclear Medicine, the University of Texas, Mo. Anderson Hospital and Tumor Institute, Houston, Texas.

³ John & Mary R. Markle Foundation Scholar in Academic Medicine

⁴ From the Departments of Internal Medicine and Radiology and The Nuclear Medicine Service. The University of Texas Medical Center, Galveston, Texas.