Tromboembolia pulmonar: diagnóstico gammagráfico
Abstract
Se revisan los resultados de ganimagrafías pulmonares perfusorias realizadas en 159 pacientes con sospecha diagnóstica de embolismo pulmonar. L a edad promedio fue de 53 años (23 - 78 años); con una frecuencia mayor en el sexo femenino (74,2 o/o) en relación con el masculino (25.8 o/o).
Se establecieron 124 (70 o/o) gammagrafías positivas y 35 (22 o/o) normales. Los estudios diagnósticos demostraron defectos únicos en 7,3 o/o (9) y múltiples
en 92,7 o/o (115).
La localización fue mayor en los lóbulos inferiores de los dos pulmones, más en el pulmón derecho que en el izquierdo y menor en los lóbulos superiores.
A 10 pacientes (6,3 o/o) se les realizó seguimiento, observándose una recanalización temprana (15 días) con lesiones únicas y dobles (2 pacientes), tardía (90 días) con lesiones múltiples (8 pacientes), pero alcanzando una recanalización completa en el mismo tiempo (180 días) para ios dos grupos de lesiones.
Se confirma la utilidad de la gammagrafía pulmonar de perfusión como test diagnóstico emergente, que permite establecer la terapia anticoagulante y/ o fibrinolítica.
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References
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17. Woods E , lies S, Jackson S. Comparison of scintigraphic diagnostic criteria in suspected pulmonary embolism. Canadian Association of Radiologist Journal 1989; 40:194-197.
18. Cheely R, McCartney W, Perry J et al. The role of noninvasive tests verus pulmonary angiography in the diagnosis of pulmonary embolism. Am Journal Medicine
1981; 70:17-22.
19. Bill W, Simón T, DeMets D. The clinical features of submassive and massive pulmonary emboli. Am Journal Medicine 1987; 62:355.
20. Rosso J , Musset D, Petitpretz P, et al. Intravenous digital substraction angiography and lung imagin: compared valué in the diagnosis of pulmonary embolism clinical. Clinical Nuclear Medicine 1989;14:183-186.
21. PIOPED Investigators. Valué of the ventilation/perfusion sean in acute pulmonary embolism: Resuits of the Prospective Investigation of Pulmonary Embolism Diag- 25. nosis (PIOPED). JAMA 1990; 263:2. 753.
22.Biello D, Mattar A, Osie-Weser, et al. Interpretation of indeterminant lung scintigrams. Radiology 1989; 144: 189-194. 26.
23.Crowell R, Adams G, Koipilloi C, et al. In vivo right heart thrombus. Chest 1988;94:1236-1239.
24.Hoellerich V, Wigton R. Diagnosing Pulmonary Embo- 27. lism using Clinical Findings. Arch Internal Medicine 1986; 146:1699-1704.
25.Hoey J , Farrer P, Rosenthal L , et al. Interobserver and intraobserver variabflity in lung sean reading in suspected pulmonary embolism. Clinical Nuclear Medicine 1980;5:508-513.
26.McCartney W. Ventilation-perfusion lung scanning in pulmonary embolus. Clinical Nuclear Medicine 1981; 6 2P27-2P36.
27.Pedrosa C. El Tórax: Diagnóstico por Imágenes. Barcelona. Salvat Editores, 1987, pág 120-126.
2. Pedrosa C. El Tórax: Embolismo Pulmonar. Barcelona, Salvat Editores, 1987, pág 347-360.
3. Goldhaber S. Tratamiento del Embolismo Pulmonar. Hospital Practice 1992; 7:65-75.
4. Rubinstein I , Murray D, Haffstein V. Fatal pulmonary emboli in hospitalized patients. Arch Internal Medicine 1988; 148:1425-1426.
5. Moser K. Venous Thromboembolism State of the Art. AM Rev Respiratory Disease 1990; 141:235-249.
6. Kelley M, Biello D, Foster C et al. Diagnosing pulmonary embolism New facts and strategies. Annals Internal Medicine 1991; 114:300-306.
7. Cheely R, McCartney W, Perry J, et al. The role of noninvasive tests verus pulmonary angiography in the diagnosis of pulmonary embolism. Am Journal Medicine
1981; 70:17-22.
8. McNeil B. Ventilation-perfusion studies and the diagnosis of pulmonary embolism. J Nuclear Medicine 1980; 21:319-320.
9. Hanson M, Coleman R. Pulmonary nuclear medicine evaluation of thromboembolic disease. J Thoracic Imaging 1989; 4:40-57.
10. Juni J, Alavi A. Lung scanning in the diagnosis of pulmonary embolism: the emperor redressed. Seminars in Nuclear Medicine 1991; 21:281-296.
11. Meyer G, CoUignan M, Guinet F , Jeffrey A, Barritault L , Sors H. Comparison of perfusión lung scanning and angiography in the estimation of vascular obstruction in the acute pulmonary embolism. European Journal Nuclear Medicine 1990; 17:315-319.
12.Coffman J. Trombosis venosa y diagnóstico de embolia pulmonar. Hospital Practice 1992; 7:35-44.
13.Gray H, McKillop J , Bessent R, Fogelman I , Smith M, Moran F. Lung scanning for pulmonary embolism: clinical and pulmonary angiographic correlations. Quarterly J Medicine 1990; 77:1135-1150A.
14.Bell W. Pulmonary embolism: Progress and problems. Am Journal Medicine 1982; 72:181-183.
15. Fennerty A, Shetty H, Patón D, Roberts G, Routledge P, Campbell I . Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism. Postgraduate Medical Journal 1990;66:285-289.
16. Specker B, Saenger E , Buncher C, McDevitt R. Pulmonary embolism and lung scanning: cost-effectiveness and benefit: risk. J Nulcear Medicine 1987; 28:1521-1530.
17. Woods E , lies S, Jackson S. Comparison of scintigraphic diagnostic criteria in suspected pulmonary embolism. Canadian Association of Radiologist Journal 1989; 40:194-197.
18. Cheely R, McCartney W, Perry J et al. The role of noninvasive tests verus pulmonary angiography in the diagnosis of pulmonary embolism. Am Journal Medicine
1981; 70:17-22.
19. Bill W, Simón T, DeMets D. The clinical features of submassive and massive pulmonary emboli. Am Journal Medicine 1987; 62:355.
20. Rosso J , Musset D, Petitpretz P, et al. Intravenous digital substraction angiography and lung imagin: compared valué in the diagnosis of pulmonary embolism clinical. Clinical Nuclear Medicine 1989;14:183-186.
21. PIOPED Investigators. Valué of the ventilation/perfusion sean in acute pulmonary embolism: Resuits of the Prospective Investigation of Pulmonary Embolism Diag- 25. nosis (PIOPED). JAMA 1990; 263:2. 753.
22.Biello D, Mattar A, Osie-Weser, et al. Interpretation of indeterminant lung scintigrams. Radiology 1989; 144: 189-194. 26.
23.Crowell R, Adams G, Koipilloi C, et al. In vivo right heart thrombus. Chest 1988;94:1236-1239.
24.Hoellerich V, Wigton R. Diagnosing Pulmonary Embo- 27. lism using Clinical Findings. Arch Internal Medicine 1986; 146:1699-1704.
25.Hoey J , Farrer P, Rosenthal L , et al. Interobserver and intraobserver variabflity in lung sean reading in suspected pulmonary embolism. Clinical Nuclear Medicine 1980;5:508-513.
26.McCartney W. Ventilation-perfusion lung scanning in pulmonary embolus. Clinical Nuclear Medicine 1981; 6 2P27-2P36.
27.Pedrosa C. El Tórax: Diagnóstico por Imágenes. Barcelona. Salvat Editores, 1987, pág 120-126.
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Published
2017-06-16
How to Cite
1.
Rubio E, Hidalgo J, Cifuentes A, Moncayo F. Tromboembolia pulmonar: diagnóstico gammagráfico. Rev Fac Cien Med (Quito) [Internet]. 2017 Jun. 16 [cited 2024 Jul. 22];19(1-4):33-6. Available from: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/774
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