Radiology, Vol 159, 391-394, Copyright © 1986 by Radiological Society of North America
Role of chest radiography in predicting the extent of airway disease in patients with suspected pulmonary embolism
R Smith, K Ellis and PO Alderson
An independent evaluation of the chest radiographs and ventilation-
perfusion (VP) scintigrams of 119 patients (121 studies) was performed to
assess the ability of radiographic findings to indicate the extent of
ventilation abnormalities in patients suspected of having pulmonary
embolism (PE). VP scans were obtained with krypton-81m in 72 cases and with
xenon-133 in 49. All scintigrams showing ventilation abnormalities in
greater than 50% of the lung were considered indeterminate for PE, owing to
an increased likelihood of false-negative interpretations, as reported in
previous studies. Indeterminate VP studies were found in all 21 patients
who had radiographic findings of widespread obstructive pulmonary disease
(OPD), in 35% with radiographic findings of focal OPD (P less than .001),
and in only 18% with no OPD seen radiographically (P less than .001). VP
scintigraphy is likely to be indeterminate for PE when widespread OPD is
seen by chest radiography and ventilation imaging may not be warranted in
these patients.
