Pulmonary embolism

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Often caused by emboli arising from pelvic or lower extremity DVT


CT Angiography

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Possible Fat Embolus
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Nuclear Medicine

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High Probability
High Probability
  • Ventinlation
    • Xe133 gas in closed system, get initial, equilibrium adn washout images
    • Tc99m-DTPA aerosol (nebulizer)
    • Defects due to consolidation, COPD (air trapping)
  • Perfusion - Inject Tc99m-MAA 3-5 mCi supine, image upright


Two or more moderate/large segmental mismatch defects on VQ scan has high probability per PIOPED criteria.


Stripe Sign - rim of perfusion distal to are of decreased radiotracer uptake, low probability, likely COPD.

Fissure Sign - decreased line of perfusion a/w fluid in fissure


Triple Match - V, Q and CXR, often intermediate probability


Whole lungperfusion defect - pulmonary agenesis, hilar mass, medistinal fibrosis