Abstract
Lung scintigraphy is an invaluable screening tool in the evaluation of the pulmonary hypertensive patient. The absence of perfusion defects is properly interpreted to exclude occlusive pulmonary vascular disease such as CTEPH. However, unmatched perfusion defects are due to a number of disease states, and as illustrated with this presented case, extensive precapillary, small vessel pulmonary vascular disease needs to be considered among the possibilities.
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Further Reading
Bailey CL, Channick RN, Auger WR, et al. High probability perfusion lung scans in pulmonary venoocclusive disease. Am J Respir Crit Care Med. 2000;162(5):1974–8.
Chan K, Ioannidis S, Coghlan JG, et al. Pulmonary arterial hypertension with abnormal V/Q single-photon emission computed tomography. JACC Cardiovasc Imaging. 2018;11(10):1487–93.
Fishman AJ, Moser KM, Fedullo PF. Perfusion lung scans vs pulmonary angiography in evaluation of suspected primary pulmonary hypertension. Chest. 1983;84(6):679–83.
Suigura T, Tanabe N, Matsuura Y, et al. Role of 320-slice CT imaging in the diagnostic workup of patients with chronic thromboembolic pulmonary hypertension. Chest. 2013;143:1070–7.
Worsley DF, Palevsky HI, Alavi A. Ventilation-perfusion lung scanning in the evaluation of pulmonary hypertension. J Nucl Med. 1994;35(5):793–6.
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Elwing, J.M., Gopalan, D., Auger, W.R. (2020). Case 17: Can Severe Pulmonary Arterial Pulmonary Hypertension Mimic CTEPH?. In: Auger, W., Gopalan, D. (eds) Clinical Cases in Chronic Thromboembolic Pulmonary Hypertension. Clinical Cases in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-17366-1_17
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DOI: https://doi.org/10.1007/978-3-030-17366-1_17
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