[Pulmonary embolism: is scintigraphy useful after initial angio-CT?].

PURPOSE: To assess the value of ventilation-perfusion scintigraphy after an initial helical CT with absence of pulmonary embolism (PE). MATERIAL: and methods. Twenty eight consecutive patients with clinical suspicion of pulmonary embolism underwent helical CT scan to look for an intra-luminal clot. When the CT-scan was positive for PE, diagnosis was retained. If the result was negative, a ventilation-perfusion scintigraphy was performed. If the result was also negative, diagnosis of PE was excluded. In case of discrepancy, a pulmonary angiography was performed and used as gold-standard. RESULTS: Twenty-one patients showed PE at CT-angio and 7 did not. Two of these 7 had normal or low probability scintigraphy, excluding diagnosis of PE. One had intermediate V/P scan and 4 had high probability V/P scan. For these 5 discrepancies, none of them had PE on angiography. CONCLUSION: In this population, scintigraphy was not appropriate after a negative CT-angio for PE. In case of persistent doubt after a normal initial helical CT, pulmonary angiography is required