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Ventilation/Perfusion Mismatch Caused by Positive Pressure Ventilatory Support

Department of Radiology, Division of Nuclear Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania

Correspondence: For reprints contact: Chun K. Kim, MD, Andre Meyer Dept. of Physics/Nuclear Medicine, Box 1141, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029.

ABSTRACT

In a patient with lobar atelectasis who was on positive pressure ventilatory support, ventilation and perfusion images showed absent ventilation and normal perfusion (reverse mismatch) in the region of the atelectasis and normal ventilation and decreased perfusion (true mismatch) not caused by pulmonary embolism in another lung zone. We report this case to emphasize that the lung scan findings in patients on positive pressure ventilatory support be carefully interpreted for the diagnosis of pulmonary emboli.