The Evaluation of Pulmonary Embolism Diagnosis Using SPECT V/Q Imaging Combined with D-Dimer Assay

To evaluate the early and accurate diagnostic value of SPECT V/Q imaging combined with D-dimer assay，especially in non massive pulmonary embolism group. 156 patients with computed tomographic pulmonary angiography (CTPA), Geneva score, response of anticoagulation treatments, who was selected from 321 patients with clinically suspected pulmonary embolism (PE) referred to the Nuclear Medicine Department of Beijing Anzhen Hospital from January to July 2014, were enrolled in the study. The patients were divided into PE group (n=101) and non PE group (n=55). We compared the diagnostic performance of SPECT V/Q, D-dimer and SPECT V/Q combined with D-dimer measurement. The SPECT V/Q images were reconstructed by Oasis of Philips and interpreted by the attending nuclear physician using a diagnostic cut-off of one segmental or two subsegmental mismatches. D-dimer had good sensitivity of 70.3% and bad specificity of 61.8% in the 156 patients. SPECT V/Q had good performance both sensitivity (85.1%) and specificity (90.9%). But when SPECT V/Q combined with D-dimer, there were best diagnostic sensitivity (91.1%) and specificity (98.2%) in PE detection, especially in embolization extent less than 15%. SPECT V/Q combined with D-dimer measurement are effective and safe diagnostic management.