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  1. #1
    SGUdroncall is offline Junior Member 510 points
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    In what situation is Spiral CT better than a V/Q Scan for PE?

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    Kaplan had a question and it said that if CXR shows atelectasis than Spiral CT is better. But is that really the right answer because I thought V/Q is the answer regardless of what the lungs look like.

    Please enlighten..anyone.

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    hunteradam07 is offline Permanently Banned 511 points
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    Quote Originally Posted by SGUdroncall View Post
    Kaplan had a question and it said that if CXR shows atelectasis than Spiral CT is better. But is that really the right answer because I thought V/Q is the answer regardless of what the lungs look like.

    Please enlighten..anyone.
    I think V/Q scan is good initial test for PE while Spiral CT is best diagnostic best for PE (high specific and sensitive). Furthermore, I remembered seeing a lot V/Q scan report during my rotation which said inconclusive. So think for intial test, it's good but if u still think it's PE better go w Spiral. I hope this help.

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    chenghbk is offline Newbie
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    Spiral CT is fast. When the patient is in acute distress, you don't want to postpond the procedures to long, and the patient can die. So, the best initial test is spiral CT. Once the diagnosis is confirmed, then you can go ahead to save a live.

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    hunteradam07 is offline Permanently Banned 511 points
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    I read and saw in the kaplan videos that V/Q scan is the best inital test and spiral ct is best test. Are they wrong?

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    hahaha is offline Newbie 510 points
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    If the CXR is completely normal a V/Q scan can be performed,but if any CXR abnormalities particularly which affect ventilation then CT is better

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    SGUdroncall is offline Junior Member 510 points
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    I think you are right...if the CXR does not show any ventilation defects like atelectasis than V/Q is best and remains the best for the initial test. But if there are venilation probs then go with spiral CT. At least that's what kaplan seemed to say.

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    hunteradam07 is offline Permanently Banned 511 points
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    Here is what UW saying:
    Pt with sx of PE next best step is V/Q scan,
    1. If it's +, then anticoag w heparin and warfin.
    2. If it's neg, R/O PE.
    3. If inconclusive, venous UTZ LEX or spiral CT. If venous UTZ is neg or CT neg, then still high risk of PE, CT-angiogram (invasive).

  8. #8
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    RussianJoo is offline Ultimate Member
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    isn't a spiral ct the gold standard for a PE?
    Hollywood Upstairs School of Medicology, Class of 2010
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    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Quote Originally Posted by RussianJoo View Post
    isn't a spiral ct the gold standard for a PE?
    Angiogram gold standard
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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    teratos is offline Jedi Moderator 658 points
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    With atelectasis, you will have a V/Q mismatch. V/Q is good if the x-*** is normal. G
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