Xenon Ventilation Images
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View second image(vq). Perfusion Images
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Full history/Diagnosis is available below
Perfusion: Perfusion images demonstrate hypoperfusion to the left lung base in a pattern matching the ventilation abnormality. In addition, perfusion images demonstrate a vertical-band of activity extending along the medial aspect of the right lung on anterior and posterior views. The RPO view demonstrates the anterior-posterior extent of perfusion within the right lung. No focal, large, segmental, wedge-shaped perfusion defects are noted in the left middle and upper lung fields. Overall, perfusion is slightly better to the right lung lung, when compared with the same area on the ventilation images.
CXR: Standard chest radiograph obtained after worrysome findings on the ventilation/perfusion scans demonstrate a large, secondary pneumothorax, with marked collapse of the entire right lung.
Secondary pnuemothorax may occur iatrogenically with procedures or may be secondarily associated with lung or pleural-based masses, especially in individuals with underlying cardiopulmonary diseases, such as asthma, COPD, etc.
When evaluating a ventilation/perfusion scan for pulmonary embolism, one should have a recent, standard chest radiograph. The chest radiograph should be within 24 hours of the acute event and prior to performing the V/Q scan. A significant change in the respiratory status or acute symptoms would dictate obtaining a more recent chest radiograph, even if a chest radiograph had already been obtained within 24 hours. A recent chest radiograph is required to interpret the V/Q scan; however, more importantly, it may identify other etiologies responsible for the patient's symptoms, such as pnuemothorax.
References and General Discussion of Ventilation Perfusion Scintigraphy (Anatomic field:Lung, Mediastinum, and Pleura, Category:Organ specific)
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