Balan K K, Critchley M, Vedavathy K K, Smith M L, Vinjamuri S
Regional Department of Nuclear Medicine, Royal Liverpool University Hospital, UK.
Br J Radiol. 1997 Apr;70(832):338-40. doi: 10.1259/bjr.70.832.9166067.
Pulmonary embolism (PE) is a major cause of maternal death during pregnancy. The aims of this retrospective study were to review 5 years experience of ventilation-perfusion (V/Q) imaging in pregnancy, to evaluate the effect of the V/Q scan report on the referring clinician's use of anticoagulants and to monitor the course and outcome of pregnancy. 82 patients (aged 17-44 years, gestation 6-40 weeks) underwent V/Q imaging for suspected PE, over a 5 year period. Modified PIOPED criteria were used to assess the probability of PE. 31 patients were shown to have normal scans (38%); 19 (23%) had low probability (LP) scans; 14 (17%) had intermediate probability (IP) scans and 18 (22%) had high probability (HP) scans for PE. Referring clinicians saw the reports and took action within 12 h. Anticoagulation was continued or started in 31 patients (all HP, 12 IP and 1 LP). Anticoagulation was considered unnecessary in 52 patients (all normal, 19 LP and 2 IP). None of the patients with normal or LP scans had documented PE during the follow-up period (median 25 months, range 3-60 months). No complications of anticoagulation were observed and no adverse outcome of pregnancy were reported. V/Q imaging is a valuable technique in the management of pregnant women suspected of having PE.
肺栓塞（PE）是孕期孕产妇死亡的主要原因。这项回顾性研究的目的是回顾5年孕期通气灌注（V/Q）成像的经验，评估V/Q扫描报告对转诊临床医生使用抗凝剂的影响，并监测孕期的过程和结局。在5年期间，82例（年龄17 - 44岁，孕周6 - 40周）疑似PE的患者接受了V/Q成像检查。采用改良的PIOPED标准评估PE的可能性。结果显示，31例患者扫描结果正常（38%）；19例（23%）为低可能性（LP）扫描；14例（17%）为中等可能性（IP）扫描；18例（22%）为高可能性（HP）扫描。转诊临床医生在12小时内查看了报告并采取了行动。31例患者（全部为HP、12例IP和1例LP）继续或开始使用抗凝剂。52例患者（全部为正常、19例LP和2例IP）被认为无需抗凝。随访期间（中位时间25个月，范围3 - 60个月），扫描结果正常或LP的患者均未记录到PE。未观察到抗凝相关并发症，也未报告不良妊娠结局。V/Q成像在疑似患有PE的孕妇管理中是一项有价值的技术。
