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Key Image

Ventilation-Perfusion Scintigraphy. Perfusion images obtained after administration of Technetium 99-m via IV injection (image 1). Ventilation images obtained after administration of Xenon via inhalation (image 2).

Key Findings

There is a large mismatched perfusion defect in the right middle and lower lobes. No ventilation defect. No pleural effusion or focal airspace consolidation on the chest radiograph. CT interpretation in case #14.

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Diagnosis

High Probability for Pulmonary Embolism

Discussion

Companion case for this study is case 014, the contrast enhanced CT chest, available in the case menu.

References / Resources

Additional Information:

1. Dahnert*: 533, V/Q: 1119
2. Primer*: V/Q: 639-641, 674. CT: 5, 47
3. Related Article:

   Sostman, HD. "Acute Pulmonary Embolism: Sens and Spec of Ven-Perf Scintigraphy in PIOPED II Study." Radiology Jan 2008, 246:941-946.

   Stein, PD. "Contrast enhanced multidetector spiral CT of the chest and lower extremities in the suspected acute pulmonary embolism: results of the PIOPED II." NEJM 2006, 354:2317-2327.

   The PIOPED Investigators. "Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the Pulmonary Embolism Diagonsis(PIOPED)". JAMA 1990, 263: 2753-2759.

   Wittram C. "How I do it: CT pulmonary angiography." AJR 2007, 188: 1255-1261.

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