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

Document Type : Original Article

Authors

1 Preclinical Lab, Core Facility, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Department of Medical Physics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Nuclear Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

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 2021 and January 2023 were included. Perfusion scans were performed using low-dose Tc-99m macroaggregated albumin ([99mTc]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 74 pregnant women were evaluated. The mean maternal age was approximately 30 years, and most patients were in the third trimester of pregnancy (75%). Normal perfusion scans were observed in 70 patients (94.5%), while 4 patients (5.5%) 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.

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References

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