Pochis W T, Krasnow A Z, Collier B D, Mewissen M W, Almagro U A, Hellman R S, Isitman A T
Department of Radiology, Medical College of Wisconsin, Milwaukee.
Clin Nucl Med. 1990 May;15(5):321-3.
A case of idiopathic pulmonary fibrosis with multiple areas of mismatch on ventilation-perfusion lung imaging in the absence of pulmonary embolism is presented. Idiopathic pulmonary fibrosis is one of the few nonembolic diseases producing a pulmonary ventilation-perfusion mismatch. In this condition, chest radiographs may not detect the full extent of disease, and xenon-133 ventilation imaging may be relatively insensitive to morbid changes in small airways. Thus, when examining patients with idiopathic pulmonary fibrosis, one should be aware that abnormal perfusion imaging patterns without matching ventilation abnormalities are not always due to embolism. In this setting, contrast pulmonary angiography is often needed for accurate differential diagnosis.
本文报告一例特发性肺纤维化患者，其通气-灌注肺显像存在多个不匹配区域，且无肺栓塞。特发性肺纤维化是少数可导致肺通气-灌注不匹配的非栓塞性疾病之一。在此情况下，胸部X线片可能无法检测到疾病的全部范围，而氙-133通气显像对小气道的病变可能相对不敏感。因此，在检查特发性肺纤维化患者时，应意识到灌注显像异常而通气无匹配异常并不总是由栓塞引起的。在这种情况下，通常需要进行对比剂肺血管造影以进行准确的鉴别诊断。
