Xe-133 ventilation images and Tc-99m MAA perfusion images
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View second image(xr). PA and lateral chest radiographs
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The perfusion images demonstrate complete absence of radiotracer within the right lung. There is a suggestion of moderate-sized perfusion defects in the apicoposterior and anterior segments of the left upper lobe. There is hypoperfusion of the mid and lower lung fields in the left lung. This hypoperfusion matches the retention on the ventilation images.
The chest radiographs demonstrate a paucity of bronchovascular markings particularly within the lower lobes bilaterally consistent with emphysematous changes due to patient's known Alpha -I antitrypsin deficiency. There is relative opacification of the upper lobes bilaterally, left greater than right which may represent sparing of the upper lobe lung parenchyma versus a focal infiltrate within the upper lobes bilaterally, left greater than right. No pneumothorax or pleural effusion is seen. The aorta is mildly tortuous. The cardiac size is within normal limits. Diffuse osteopenia is noted.
View followup image(ct). Axial CT images with contrast in pulmonary arteries are shown. The top row is more cranial than the bottom row.
Datz, Fredrick L. Gamuts in Nuclear Medicine. Salt Lake City, Utah. Mosby 3rd ed., p 188, 1995.
References and General Discussion of Ventilation Perfusion Scintigraphy (Anatomic field:Lung, Mediastinum, and Pleura, Category:Organ specific)
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