심부정맥 혈전증 및 폐전색증의 핵의학적 진단 및 임상상에 관한 분석 = Deep Vein Thrombosis and Pulmonary Embolism ; Clinical Features and Nuclear Medicine Studies심부정맥 혈전증 및 폐전색증의 핵의학적 진단 및 임상상에 관한 분석

다국어 초록 (Multilingual Abstract)

Pulmonary embolism (PE) is a disease caused by occlusion of the pulmonary vascular bed, usually by a dislodged thrombus whose origin is most commonly from the deep venous system of the lower extremities. It is a serious medical problem and is often the cause of significant morbidity or mortality in clinical practice. Its potential for significant sequelae necessitates its prompt recognition and managemnt. Unfortunately, however, there are many difficult problems in the accurate diagnosis of pulmonary embolism, and controversy exists as to which method of approach is best. Futhermore, the low reliability of clinical signs and symptoms adds to the confusion, In an attempt to better understand the clinical features of pulmonary embolism and to reevaluate the diagnostic value of radionuclide studies in this disease entity, we reviewed the clinical features, lung perfusion scans and radionuclide venographic studies of 71 patients who were diagnosed as having deep vein thrombosis (DVT). The results were as follows; 1) The DVTs were most commonly located in the lower extremities (67%), and of these, the left side showed a significantly higher incidence compared to the right (77% vs 23%). 2) Of the DVT patients, 40% showed high probability pulmonary embolism (HPPE) on lung perfusion scans. 3) DVTs involving the iliofemoral veins were more likely to present HPPE compared to those confined to the calf area. 4) Of the patients presenting with HPPE, 70% showed no chest symptoms. Thus, the high incidence of HPPE in patients with DVT and the few, if any, specific presenting symptoms in the majority of PE patients call for a high level of suspicion on the part of the physician. The combined use of radionuclide venography and lung perfusion scan seems to be a reasonable approach for patients suspected of DVT in order to evaluate the possibilitu of pulmonary embolism.