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Unilateral Absence of Right-Lung Perfusion with Normal Ventilation on Radionuclide Lung Scan as a Sign of Aortic Dissection

Departments of Diagnostic Radiology and Pulmonary and Critical Care Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts

Correspondence: For correspondence and reprints contact: David W. Seldin, MD, Department of Radiology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805.

ABSTRACT

A case of aortic dissection with unilateral absence of right-lung perfusion and normal ventilation on radionuclide ventilation/perfusion (V/Q) lung scan is presented with a review of the literature. Anticoagulation or thrombolytic therapy for presumed pulmonary embolism may be catastrophic if the clinical syndrome and V/Q scan appearance are instead due to aortic dissection. With this V/Q scan appearance, these therapies should not be instituted unless pulmonary embolism is diagnosed by pulmonary arteriography.

Key Words: aortic dissection • ventilation/perfusion lung scan • pulmonary embolism