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Lung ventilation/perfusion SPECT for diagnosing pulmonary embolism Is the required minimal P/V count rate ratio fulfilled in routine situation? Results from a multicentre survey

机译:诊断肺栓塞的肺通气/灌注SPECT在常规情况下是否满足所需的最低P / V计数率比?多中心调查的结果

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摘要

V/P-SPECT is a sensitive and specific procedure for the detection or exclusion of pulmonary embolism. It is important to conform to the guidelines in order to obtain reliable results. The sequence usually starts with the ventilation, followed by the perfusion scan. According to the current guidelines the count rate of the second study should be at least 3 times that of the first study. It is not always easy to meet this requirement, particularly since the deposed quantity of ventilation activity is not well known. The aim was therefore to analyse data from a multicentre survey to determine whether this essential precondition was strictly met. Methods. In a multicentre survey 48 tertiary hospitals were asked to submit projections of all V/P-SPECT studies performed in January 2014. In total, 286 complete data sets from 16 institutions could be evaluated. First, the count rates of the first projections from the V-studies were subtracted from those of the P-studies. The resulting count rates in the first SPECT projections were then divided to calculate the activity ratios between the pure perfusion and ventilation scans (P/V-ratio at least 3 according to the guidelines). Results: The range of the P/V ratio was 0.57-78.71, the mean PN ratio was 6.94 9.56. For 71 of the 286 external V/P studies (about 25%) the PN ratio was < 3, in 23 studies (about 8%) the ratio failed to even reach the factor 2. Conclusions: An activity ratio of 3 between the perfusion and ventilation scan was not reached in about 25% of the 286 V/P studies (in around 8% the PN ratio was <2), so that V/P studies were performed inadequately in a considerable number of procedures. Controlling the count rate increase during the perfusion tracer application (e.g. by handheld monitor) is therefore essential to avoid insufficient data.
机译:V / P-SPECT是检测或排除肺栓塞的灵敏且特定的程序。为了获得可靠的结果,遵守指南很重要。顺序通常从通气开始,然后进行灌注扫描。根据当前指南,第二项研究的计数率至少应为第一项研究的3倍。满足这个要求并不总是那么容易,特别是因为通风活动的废除量并不为人所知。因此,目的是分析来自多中心调查的数据,以确定是否严格满足此基本前提条件。方法。在一项多中心调查中,要求48家三级医院提交2014年1月进行的所有V / P-SPECT研究的预测。总共可以评估来自16个机构的286个完整数据集。首先,将V型研究的第一个预测的计数率从P型研究的计数率中减去。然后将第一个SPECT投影中得到的计数率相除,以计算纯灌注扫描和通气扫描之间的活度比率(根据指南,P / V比率至少为3)。结果:P / V比范围为0.57-78.71,平均PN比为6.94 9.56。在286项外部V / P研究中,有71项(约25%)的PN比<3,在23项研究中(约8%),PN比例甚至未达到因子2。结论:灌注之间的活性比为3 286项V / P研究中约有25%未达到通气扫描(约8%的PN比<2),因此在许多程序中V / P研究不足。因此,在灌注示踪剂应用期间(例如通过手持式监护仪)控制计数率的增加对于避免数据不足至关重要。

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