From the Department of Nuclear Medicine, Medical Center - University of Freiburg.
University Heart Center Freiburg, Department of Cardiology and Angiology I.
Clin Nucl Med. 2021 Mar 1;46(3):238-239. doi: 10.1097/RLU.0000000000003462.
A 58-year-old man with progressive dyspnea and recurrent extensive left-sided pleural effusion underwent pulmonary ventilation/perfusion SPECT/CT, which showed a pronounced mismatched perfusion deficit of the entire, normally ventilated left lung. As unilateral perfusion deficits of an entire lobe are generally not due to pulmonary embolism, further CT angiography and cardiac MRI were conducted. These examinations revealed high-grade left pulmonary vein stenosis (PVS) caused by pulmonary vein isolation performed for atrial fibrillation 3 and 4 years earlier. Thus, in addition to, for example, neoplastic processes or pulmonary congenital vascular abnormalities, PVS must be considered as a differential diagnosis and possible pitfall in ventilation/perfusion SPECT/CT in dyspneic patients with prior pulmonary vein isolation.
一位 58 岁男性，进行性呼吸困难，反复出现广泛的左侧胸腔积液，行肺通气/灌注 SPECT/CT 检查，显示整个正常通气的左肺明显灌注不匹配缺陷。由于整个肺叶的单侧灌注缺陷通常不是由肺栓塞引起的，因此进一步进行 CT 血管造影和心脏 MRI 检查。这些检查显示，由于 3 至 4 年前进行的心房颤动肺静脉隔离术，导致左肺高级别静脉狭窄（PVS）。因此，除了例如肿瘤过程或肺先天性血管异常外，在因肺静脉隔离术而出现呼吸困难的患者的通气/灌注 SPECT/CT 中，必须考虑 PVS 作为鉴别诊断和可能的陷阱。
