10 research outputs found
V/P scan in diagnosis and follow-up of pulmonary embolism in 15-25-year-old females in relation to hormonal contraception use
Background: An analysis of medical records of young females
who were examined in our department during a five-year period
(2005-2009) on suspicion of pulmonary embolism (PE) in relation
to hormonal contraception (HC).
Material and methods: The patient sample included 86 young
females aged 15–25 (mean 21) years who underwent a ventilation/
perfusion scintigraphy (V/P scan). Seventeen of them were
examined repeatedly. Altogether, 114 scintigraphic examinations
were performed. Lung perfusion scintigraphy was performed using
a planar gamma camera (Mediso MB 9200) in 4 projections
following 100 MBq 99mTc — MAA i.v. application with 81 mKr
ventilation scintigraphy concurrently.
Results: 1. Among 57/86 (66%) patients on HC, 24 (42%) had
scintigraphic signs of PE. 2. 11/57 (19%) of them had clinical
signs of deep venous system thrombosis of the lower limbs
that were confirmed by sonography. 3. Leiden mutation was
found in 9/24 (37%) patients with PE. 4. Among 29/86 (34%)
females not taking HC, PE was detected in only 3 patients (10%).
5. 10/17 (59%) repeatedly examined females had permanent
post-embolic residual changes of lung perfusion.
Conclusions: In our group of patients who underwent a P/V scan,
42% of those on HC were diagnosed with PE on scintigraphy,
compared to 10% of those not taking HC. Among the patients
with PE, there were 10/24 (42%) young females with persistent
post-embolic changes. Our study indicates that the well-known
risk of venous thromboembolism related to the use of HC needs
to be considered as a cause of PE even among very young
females. In our experience, prevention of these life-threatening
conditions in patients with a family history of venous thromboembolism
consists of timely examination of their thrombotic profile
and selection of appropriate contraception.
Nuclear Med Rev 2011; 14, 2: 63–6