Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jun;36(6):1005-8.
doi: 10.1007/s00259-008-1056-y. Epub 2009 Feb 4.

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

Paloma Pifarré  1 , Isabel Roca, Iñaki Irastorza, Marc Simó, Susan Hill, Lorenzo Biassoni, Isky Gordon
Affiliations

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

Paloma Pifarré et al. Eur J Nucl Med Mol Imaging. 2009 Jun.

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.

PubMed Disclaimer

References

    1. J Pediatr (Rio J). 2005 Mar-Apr;81(2):155-61 - PubMed
    1. Arch Pathol Lab Med. 1990 Feb;114(2):142-4 - PubMed
    1. Am J Forensic Med Pathol. 2002 Sep;23(3):257-9 - PubMed
    1. J Pediatr Hematol Oncol. 1998 Nov-Dec;20(6):570-3 - PubMed
    1. Cardiol Rev. 2001 May-Jun;9(3):173-82 - PubMed

Publication types