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VQ Scan vs Spiral CT with Contract Dye - So Confused!
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VQ Scan vs Spiral CT with Contract Dye - So Confused!

Back in August I was diagnosed with Pulmonary Embolism via VQ Scan and put on Heparin & Coumidan. In September I went to another hospital and they did a Spiral CT that showed my lungs were clear with great circulation. Last week I went back to the same place thatdid the VQ Scan for a follow-up and the Radiologist said that "the clots have not changed from the August VQ Scan" Needless to say I was incredibly confused after the Spiral CT said I was clear. So, my Hemotologist (this is the 2nd one - the first was not a nice person)did a D-Dimer AND another spiral CT on Friday and the DDimer cameback normal and my CT came back perfect. Now I'm really confused. I
asked the Hemotologist what on earth the VQ scan could be picking upand he replied "very possibly false positives" FALSE POSITIVES?????? So realistically, there is a very
good chance I never had PE to begin with (I had NO PE Symptoms other than some very minimal pressure in my chest but I also had a cold at the time the PE was found by a fluke because a Ddimer was "slightly off"). For there to be "no change" after 4 months of coumidan therapy? Is this possible? Any information is sincerely appreciated.

Best regards,
Colleen
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The spiral CT and D dimer are reliable and definitive tests.  When these tests are clear and normal there would be no pulmonary embolism (PE).  You should ask your doctor what was meant by the D dimer being "slightly off."  However, VQ scans can be falsely positive.  This is almost always because of some type of chronic lung disease, such as asthma or COPD.  You should ask the CT radiologist to review the VQ scans.  If the diagnosis of PE was made only on the basis of an abnormal VQ scan, it is possible that diagnosis was incorrect.  On the other hand, clots present in the lungs in August could have dissolved by the time of the spiral CT in September.  However, that would not explain the unchanged VQ scan.
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