The stripe sign: a new sign for diagnosis of nonembolic defects on pulmonary perfusion scintigraphy.

Overview

A total of 47 patients who underwent both lung ventilation-perfusion scintigraphy and pulmonary arteriography were evaluated for presence on the scintigram of perfusion defects that did not extend to the lung edge, leaving a peripheral parenchymal stripe (PPS) of perfused lung between the defect and the adjacent pleural surface. Scans were scored both with and without regard for the PPS according to probability of pulmonary embolism; these predictions were then compared with the official lung scan report given initially to the referring physician. Predictions were then verified by pulmonary arteriography. Of the 13 patients who showed one or more PPSs, four reports would have been more accurate using the revised criteria that included the "stripe sign." In this study, visualization of a PPS in an area of defect on a perfusion lung scan was extremely accurate for predicting absence of pulmonary emboli in the specific area of the stripe. Further studies that would be needed to confirm this finding are discussed.