Comparison of ventilation / perfusion and multi- detector computerized tomography in asemptomatic pulmonary embolism diagnosis after developed lower extremity deep vein thrombosis

Deep vein thrombosis (DVT) which occurs in about 1 per 1000 persons per year is a common disease. During course of the disease, pulmonary thromboemboli (PTE) having 30% mortaility rate may develop. PTE named due to migration of clots formed in systemic venous system to pulmonary vascular bed is a clinical table. After acute DVT, asymptomatic PTE is seen about 40-60% and this situation can not be discovered because of silent clinical course.The diagnostic methods such as D-dimer, ECG, arterial blood gase analysis, chest x-ray, multi-detector computed tomography (MDCT), magnetic resonance imaging (MRI), MR angiography, Echocardiography, ventilation/perfusion (V/P) scintigraphy, pulmuner angiography are used for PTE.In this study, we aimed to compare sensivity and spesifity of MDCT recently used extensively and of V/P scintigraphy formerly used for diagnosis of asymptomatic PTE developed from acute lower extremity DVT. The study was carried out 25 patients who were admitted to our clinic and treated for lower extremity acute DVT. Pregnants, and cases with recurrent DVT, presence of symptomatic PTE during admission, thrombosis extending to vena cava, and history of passed PTE were excluded from the study. DVTs in patients were diagnosed by color doppler, and confirmed by D-dimer test. After patients?s admission, V/P scintigraphy and MDCT were used to detects asymptomatic PTE at 1st and 8 th day of the admission.At the end of the study, D-dimer was measured as higher in 24 of 25 patients with asemptomatic PTE. 10 patients were diagnosed by MDCT. Development of asymptomatic PTE related to acute DVT was determined as 40%. In terms of diagnostic value, MDCT was found more usefull than V/P scintigraphy.Key Words Deep vein thrombosis, pulmonary embolism, ventilation-perfusion scintigraphy, multi detector computerized tomography.