Lung ventilation-perfusion scintigraphy in children on long-term parenteral nutrition

Paloma Pifarré, Isabel Roca, Iñaki Irastorza, Marc Simó, Susan Hill, Lorenzo Biassoni, Isky Gordon

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    8 Citations (Scopus)

    Abstract

    Purpose: Pulmonary emboli (PE) are one of the major complications associated with total parenteral nutrition (TPN). Ventilation-perfusion scintigraphy (V/Q) remains the most used test for the diagnosis of PE and follow-up of patients on TPN. The aim of our study was to demonstrate the high prevalence of undiagnosed PE in children on TPN. Methods: The medical and imaging files of 64 patients on TPN who underwent V/Q examinations covering the period of 1986-2004 were reviewed. Children were aged between 3.18 months and 21.6 years. TPN was started at birth (range 0-15 years). All children had a normal chest radiograph and no symptoms at the time of the V/Q scan. A comparative analysis between the prevalence of PE and risk factors (number of days per week with lipophilic content of the TPN, bowel inflammation and thrombophilic factors (protein C and S) was performed. Results: Of the 64 patients, 25 (39%) had an abnormal V/Q scan. A total of 29 PE episodes were diagnosed in all patients. Two children had three episodes of PE. The median age at PE diagnosis was 4.6 years. In 17 patients (68%) diagnosis was achieved on the first V/Q scan performed. PE was bilateral in 56% and unilateral in 44%. PE was the main cause of 2 out 15 recorded deaths. All risk factors were associated with an increase in PE prevalence by statistical analysis. Conclusion: PE is underdiagnosed in children on long-term TPN. Lung V/Q scintigraphy is useful in the diagnosis of PE in children with a low pretest probability. © 2009 Springer-Verlag.
    Original languageEnglish
    Pages (from-to)1005-1008
    JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
    Volume36
    Issue number6
    DOIs
    Publication statusPublished - 1 Jun 2009

    Keywords

    • Lung
    • Paediatrics
    • V/Q

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