No further evaluation was required. The image below shows a prone patient undergoing needle biopsy of a malignant hilar mass, which proved to be bronchogenic carcinoma. The biopsy was done with local anesthesia, and required only four hours of post-procedure observation. The two image display windows show the needle in the soft tissues and in the lung. Needle pierces visceral pleura, and when removed, air leaks from lung.
PE is potentially lethal, treatable, but with morbid treatment, accurate diagnosis is essential.
The presence of several large focal perfusion defects not matched by ventilation defects indicates a high probability of pulmonary embolism. A normal scan basically excludes PE and indicates search for alternative explanations for the patient's condition. A high probability scan is usually sufficient to begin treatment. May do Angiogram if clinical picture complicated. An low probability scan can be used to withhold treatment, but if clinical signs are compelling then Angiogram is indicated.