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Abnormal chest radiographs preceding VQ scans: Does the type of abnormality matter?

Arun Lakhanpal, Zahra Raisi Estabragh, Adeel Ashraf, Joseph Abbott, Robert Hewson, Hassan Burhan
European Respiratory Journal 2011 38: p584; DOI:
Arun Lakhanpal
Respiratory Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
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Zahra Raisi Estabragh
Respiratory Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
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Adeel Ashraf
Respiratory Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
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Joseph Abbott
Respiratory Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
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Robert Hewson
Respiratory Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
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Hassan Burhan
Respiratory Medicine, Royal Liverpool University Hospital, Liverpool, Merseyside, United Kingdom
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Abstract

Introduction: Abnormal chest radiographs (CXR) have been considered to affect the interpretation of Ventilation/Perfusion scans (V/Q) for the investigation of suspected Pulmonary Embolism (PE). Recommendations suggest a V/Q scan only if a contemporaneous CXR is normal. Impact of individual CXR abnormalities on the outcome of V/Q scan has not been fully explored.

Aim: To study the impact of individual CXR abnormalities suggestive of a range of cardiopulmonary diseases on V/Q scan results for the investigation of suspected PE.

Method: All V/Q scan and preceding CXR reports from February '08-January '09 at our 960 bed teaching hospital were included in the study.

Results: Data for a total of 1041 subjects who had a CXR prior to V/Q was collected. Total number of V/Q done on those with abnormal CXR findings was 345. The CXR abnormalities were classified as per the underlying cardiopulmonary pathology suggested by the report.

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Discussion: Regardless of whether the CXR report preceding the VQ scan was suggestive of infection, effusion, congestion or “COPD”, the proportion of low probability VQ scans was high (71-95%). This proportion was particularly high at 95% (and with no high probability scans) in those with CXRs suggestive of pulmonary oedema/congestion.

When used in the correct clinical context a V/Q scan can be used with a high degree of accuracy despite certain CXR abnormalities.

  • © 2011 ERS
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Abnormal chest radiographs preceding VQ scans: Does the type of abnormality matter?
Arun Lakhanpal, Zahra Raisi Estabragh, Adeel Ashraf, Joseph Abbott, Robert Hewson, Hassan Burhan
European Respiratory Journal Sep 2011, 38 (Suppl 55) p584;

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Abnormal chest radiographs preceding VQ scans: Does the type of abnormality matter?
Arun Lakhanpal, Zahra Raisi Estabragh, Adeel Ashraf, Joseph Abbott, Robert Hewson, Hassan Burhan
European Respiratory Journal Sep 2011, 38 (Suppl 55) p584;
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