Cook G J, Fogelman I
Department of Nuclear Medicine, Guys Hospital, London, United Kingdom.
J Nucl Med. 1996 Aug;37(8):1359-61.
Two children (aged 12 and 14 yr) with a history of complex congenital heart disease presented with symptoms and signs suggestive of pulmonary embolism. Initial ventilation-perfusion lung scans showed normal, approximately equal ventilation to both lungs. Global reduction of perfusion to the right lung was observed in one and was observed in the left lung in the other patient. It was not possible to exclude a large, central embolus in either case. Due to complex cardiac anatomy, however, which included bilateral cavopulmonary anastomoses in the first patient and SVC-right pulmonary artery and right atrial-pulmonary artery anastomoses in the second, repeat scans were performed within a short period in each case with different injection sites, including the contralateral arm and a leg injection, respectively. In both patients, these follow-up scans showed a different perfusion agent distribution to each lung when compared to the initial scans. These results demonstrated that there was no evidence of pulmonary embolism in either case.
两名患有复杂先天性心脏病史的儿童（年龄分别为12岁和14岁）出现了提示肺栓塞的症状和体征。最初的通气-灌注肺扫描显示正常，两肺通气大致相等。其中一名患者观察到右肺灌注整体减少，另一名患者则观察到左肺灌注整体减少。在这两种情况下都无法排除大的中央型栓子。然而，由于复杂的心脏解剖结构，第一名患者包括双侧腔肺吻合术，第二名患者包括上腔静脉-右肺动脉和右心房-肺动脉吻合术，因此在每种情况下均在短时间内分别在不同注射部位（包括对侧手臂和腿部注射）进行了重复扫描。与最初的扫描相比，两名患者的这些后续扫描均显示每个肺的灌注剂分布不同。这些结果表明，在这两种情况下均无肺栓塞的证据。
