Mallin W H, Silberstein E B, Shipley R T, Vu D N, Alspaugh J P, Moulton J S
Deparmtent of Radiology, University of Cincinnati Medical Center, Ohio 45267-0577.
Clin Nucl Med. 1993 Jul;18(7):594-6. doi: 10.1097/00003072-199307000-00012.
An interesting case of fibrosing mediastinitis, which is a rare cause of total nonvisualization of one lung on pulmonary scintigraphy, is presented. Scintigraphy with Tc-99m MAA showed a severe deficit of perfusion in the right lung, with normal perfusion of the left lung. Ventilation images were normal. CT and MRI each demonstrated the mediastinal nodal enlargement and MRI demonstrated the "flow void" signal phenomenon in the right pulmonary artery indicating its patency. Confirmation of actual patency without pulmonary artery emboli and with poor venous opacification was documented with angiography. Multiple complementary imaging modalities were helpful in correctly diagnosing fibrosing mediastinitis from an extensive list of differential possibilities for unilateral non-visualization of the lung on perfusion scanning.
本文介绍了一例纤维化纵隔炎的有趣病例，这是肺部闪烁扫描中一侧肺完全不显影的罕见原因。用Tc-99m MAA进行的闪烁扫描显示右肺灌注严重不足，左肺灌注正常。通气图像正常。CT和MRI均显示纵隔淋巴结肿大，MRI显示右肺动脉有“血流空洞”信号现象，提示其通畅。血管造影证实无肺动脉栓塞且静脉显影不佳的情况下肺动脉实际通畅。多种辅助成像方式有助于从灌注扫描中一侧肺不显影的众多鉴别可能性中正确诊断纤维化纵隔炎。
