Distribution of lung perfusion scintigraphy findings in pregnant women with suspected pulmonary embolism

Introduction: Pulmonary embolism (PE) is a potentially life-threatening condition and a leading cause of maternal mortality. Imaging plays a central role in the evaluation of suspected PE during pregnancy; however, concerns regarding radiation exposure and diagnostic yield remain. Lung perfusion scintigraphy is frequently used in this setting, yet data on the distribution of scan outcomes in pregnant patients are limited.Methods: In this retrospective study, all pregnant women who underwent perfusion-only lung scintigraphy for suspected PE at a single tertiary center between May ۲۰۲۱ and January ۲۰۲۳ were included. Perfusion scans were performed using low-dose Tc-۹۹m macroaggregated albumin ([۹۹mTc]Tc-MAA))and interpreted independently by two nuclear medicine physicians according to PISAPED criteria. Scan results were classified as normal or high probability for PE.Results: A total of ۷۴ pregnant women were evaluated. The mean maternal age was approximately ۳۰ years, and most patients were in the third trimester of pregnancy (۷۵%). Normal perfusion scans were observed in ۷۰ patients (۹۴.۵%), while ۴ patients (۵.۵%) demonstrated high-probability findings for PE. No nondiagnostic scans were identified. All high-probability cases showed segmental or wedge-shaped perfusion defects consistent with PE.Conclusion: Most pregnant women referred for lung perfusion scintigraphy for suspected PE had normal results, indicating a low prevalence of confirmed disease despite frequent clinical suspicion. Perfusion-only lung scintigraphy, when interpreted using PISAPED criteria, provides definitive results with a high normalcy rate in this population. These findings highlight the importance of optimizing clinical selection strategies to reduce unnecessary imaging and radiation exposure during pregnancy.

کلیدواژه ها:

Pulmonary embolism ، Pregnancy ، Lung perfusion imaging ، Radionuclide imaging ، radiation exposure