Abstract:

Aim. Pulmonary embolism (PE) is a cardiovascular disease that the diagnosis is needed urgent recognition or exclusion, since the PE has high risk of death and anticoagulant treatment starting with suspicion of PE has high risk of bleeding. Ventilation/perfusion(V/P) scintigraphy is one of the widely used tests in suspect of PE. D-dimer is a product of fibrin degradation. However, it is not specific for acute thrombosis. The purpose of this study was to investigate the relation between number of the defect in the ventilation/perfusion scintigraphy and D-dimer levels. Method. In our study, the relation between D-dimer levels of 100 cases followed-up with PE pre-diagnosis and their V/P scintigraphy was investigated. Scintigraphic findings of the patients were divided into six groups regarding the perfusion detect as; “no involvement”, “subsegmenter-involvement”, “onesegment involvement”, “two-segments involvement”, “three-segments involvement”, “more than three-segments involvement” and also divided into four groups regarding the possibility of pulmonary as; “no pulmonary embolism”, “low-probability”, “intermediate-probability” and “high-probability”. The reference range of D-dimer level was 0.00-0.50 µg/mL. Results. Of the 100 patients studied on, 52 were male and 48 were female. In 65 patients without pulmonary embolism D-dimer: 4.39 ± 9 µg/mL; in 20 patients with low-probability D-dimer: 4.57 ± 4 µg/mL;in 9 patients with intermediate-probability D-dimer: 6.38 ± 6 µg/mL and, in 6 patients with high-probability D-dimer:8.0 ± 8 µg/mL (p>0.05). Regarding the number of segment monitored perfusion defect; in 22 patients without perfusion defect D-dimer: 3.01 ± 4 µg/mL;in 8 patients with subsegmental defect D-dimer: 3.62 ± 3 µg/mL; in 14 patients with one segment defect Ddimer:10.7 ± 18 µg/mL; in 11 patients with 2 segments defect D-dimer: 3.16 ± 2 µg/mL; in 10 patients with 3 segments defect D-dimer: 3.86 ± 3 µg/mL, in 35 patients with more than 3 segments defect D-dimer: 4.66 ± 4 µg/mL (p<0.05). Conclusion. In consequence of our study that we researched relations between D-dimer levels and scintigraphic findings in ventilation/perfusion scintigraphy; D-dimer level was found high in the group with perfusion defect in one segment, but however it was found lower at the group in more than three segments defects. This situation makes us think that the cases with one segment defect are ones coherent with real acute PE, and the cases with more segment defects are the cases who rather has chronic diseases.

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