A. Isotope V/Q lung scan
B. PET scan of Thorax
C. High resolution CT scan thorax
D. MRI scan Thorax
E. CT pulmonary angiogram
F. Ultrasound scan of Thorax
G. Ultrasound Doppler scan of Leg
H. Contrast venogram of the leg
From the list above please select the single most appropriate imaging test to make a diagnosis in each of the following patients – assume they have already had a Chest XRay [aside from patient #3]:
1. A 50 year old, non-smoking female on HRT presents with progressive breathlessness on exertion. Her BP is 140/80, she has a left parasternal heave, and bilateral ankle oedema. He has SaO2 90%, DLCO 60%
2. A 70 ear old, non-smoking man is on the orthopaedic ward following a total hip replacement. At 11 o’clock at night, he becomes acutely breathless with BP 70/50, raised JVP, centrally cyanosed, SaO2 75%, ECG shows signs of acute right heart strain
3. A 25 year old, non-smoking woman who is 20 weeks pregnant develops acute pleuritic chest pain. She also has a swollen red tender calf, a BP of 130/80, and a pleural rub; her ECG is normal.
