Modified PIOPED criteria for diagnosis of PE
Dr Yuranga Weerakkody and Radswiki et al.
The modified PIOPED criteria for diagnosis of PE determine the probability of PE following a VQ scan :
Levels of probability
High probability
- 2 or more large mismatched segmental defects or equivalent moderate/large defects with a normal x-ray
- any perfusion defect substantially larger than radiographic abnormality
Intermediate probability
- multiple perfusion defects with associated radiographic opacities
- greater than 25% of a segment and less than 2 mismatched segmental perfusion defects with:
- normal radiograph
- one moderate segmental
- one large or two moderate segmental
- one large and one moderate segmental
- three moderate segmental
- triple match : solitary moderate-large matching segmental defect with matching radiograph
- difficult to characterize as high probability or low probability
Low probability
- nonsegmental defects-small effusion blunting costophrenic angle, cardiomegaly, elevated diaphragm, ectatic aorta
- any perfusion defect with substantially larger radiographic abnormality
- matched ventilation and perfusion defects with normal chest radiograph
- small subsegmental perfusion defects
Normal scan
- no perfusion defects
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