Peters A M, Gordon I, Kaiser A M, Arnot R N, Lavender J P
Department of Paediatric Radiology, Hospital for Sick Children, London.
Br J Radiol. 1989 Jun;62(738):536-43. doi: 10.1259/0007-1285-62-738-536.
A defect seen in the perfusion scan in a region of lung that is normally ventilated is usually interpreted as indicating pulmonary vascular disease. Since the distribution of 99Tcm macro-aggregated albumin (MAA) represents the distribution of perfusion (Q) only at the time of MAA injection, the assumption is required that the distribution of ventilation (V) remains unchanged between MAA injection and the commencement of imaging. We report the V/Q scintigraphic findings in six patients (including four children), in whom this assumption could not be sustained. Thus ventilation imaged with 81Krm was seen to change during image acquisition in lobes that showed perfusion abnormalities. In some, but not all, views the appearances were typical for pulmonary vascular disease, which might easily have been misdiagnosed if the changes in the distribution of ventilation had not announced themselves by occurring during image acquisition. A ventilation image obtained immediately before injection of 99Tcm-MAA may be useful.
在正常通气的肺区域灌注扫描中出现的缺陷通常被解释为提示肺血管疾病。由于99锝标记的大聚合白蛋白（MAA）的分布仅代表MAA注射时的灌注（Q）分布，因此需要假设通气（V）分布在MAA注射与成像开始之间保持不变。我们报告了6例患者（包括4名儿童）的V/Q闪烁扫描结果，在这些患者中该假设无法成立。因此，用81氪成像的通气情况在显示灌注异常的肺叶图像采集过程中发生了变化。在某些（但不是所有）视图中，表现符合肺血管疾病，若通气分布的变化没有在图像采集过程中显现出来，很可能会被误诊。在注射99锝-MAA之前立即获得的通气图像可能会有帮助。
