V/q scan or spiral CT - vanderbilt87

[ArchivalUser]

which is the first investigation of choice for PE

[ArchivalUser]

patient stable V/Q, unstable CT/bedside echo.

[ArchivalUser]

based on ur choice ct will be done first, if negative and clinical suspicion of pe is high, then ur next step is v/q.

vander, most of the time, first test to do is cxr, which is mostly negative(Normal). if cxr is negative and then there is high clinical suspicion, then we go next to ct spiral

[ArchivalUser]

Spiral CT is gold standard
if it cant' be done say because of reanl insuffieciency and need to avoid contrast material then only VQ.

[ArchivalUser]

THANKS!!

[ArchivalUser]

if cxr is abnormal , best test is spiral CT because in presence of abnormal CXR, v/q specificy declines.
If spiral CT is negative and suspicion of PE is still high, you will need V/Q as next step as Spiral CT does not rule out small peripheral emboli. If renal insufficiency, inital test is v/q
If patient is unstable, best test is spiral CT

So look for the clues in question - unstable? or abnormal cxr? or hx of copd? - where Spiral CT is definitely the first test
Go with approaches in Dr.Red notes, they are most accurate

You can also check this link at
http://www.radiologynotebook.com/pe.html

usually, you will not have both v/q and spiral CT in choices. If you have both, one of the above clues will help in deciding the best initial test

[ArchivalUser]

Good discussion!