Abstract
A 67-year-old woman, who presented with a 2 month history of dyspnea, had a ventilation and perfusion lung scan that showed absent perfusion of the entire right lung with normal ventilation, as well as a rounded matched defect in the left lower lung adjacent to midline, suspicious for an aortic aneurysm or dissection. CT pulmonary angiography revealed a massive descending aortic aneurysm compressing the right pulmonary artery as well as the left lung parenchyma, accounting for the bilateral perfusion scan defects. We present the Xe-133 ventilation, Tc-99m MAA perfusion and CT pulmonary angiography imaging findings of this rare case.
References
White Jr RI, James Jr AE, Wagner Jr HN. The significance of unilateral absence of pulmonary artery perfusion by lung scanning. AJR Am J Roentgenol. 1971;111:501–9.
Sutter CW, Stadalnik RC. Unilateral absence or near absence of pulmonary perfusion on lung scanning. Semin Nucl Med. 1995;25:72–4.
Lisbona R, Derbekyan V, Novales-Diaz JA. Hemitruncus anomaly as a cause of unilateral absent lung perfusion with normal ventilation on radionuclide lung scan. Clin Nucl Med. 1996;21:655–6.
Hung GU, Tsai SC, Fu YC, Kao CH. Unilateral ventilation-perfusion mismatch on pulmonary scintigraphy caused by anomalous origin of a pulmonary artery from the innominate artery. Clin Nucl Med. 2001;26:719–20.
Armas RR. False positive V/Q scan mimicking massive pulmonary embolism. Clin Nucl Med. 1992;17:34–5.
Worsley DF, Coupland DB, Lentle BC, Chipperfield P, Marsh JI. Ascending aortic dissection causing unilateral absence of perfusion on lung scanning. Clin Nucl Med. 1993;18:941–4.
Slonim SM, Molgaard CP, Khawaja IT, Seldin DW. Unilateral absence of right lung perfusion with normal ventilation on radionuclide lung scan as a sign of aortic dissection. J Nucl Med. 1994;35:1044–7.
Miroult L, McCandless B, Tublin M, Cooper J. Obstruction of the left pulmonary artery by aortic arch aneurysm. Clin Nucl Med. 1996;21:984–6.
Cramer M, Foley WD, Palmer TE, Werner PH, Ollinger G, Thorsen MK, et al. Compression of the right pulmonary artery by aortic aneurysms: CT demonstration. J Comput Assist Tomogr. 1985;9:310–4.
Conflict of Interest Statement
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is a case report. There was no financial support for this research paper.
Rights and permissions
About this article
Cite this article
Makis, W., Derbekyan, V. Compression of the Right Pulmonary Artery by a Massive Descending Aortic Aneurysm Causing Bilateral Perfusion Defects on Pulmonary Scintigraphy. Nucl Med Mol Imaging 46, 65–68 (2012). https://doi.org/10.1007/s13139-011-0098-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13139-011-0098-4