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Comprehensive Ventilation/Perfusion SPECT

Departments of Radiation Physics and Clinical Physiology, Lund University Hospital, Lund, Sweden

View larger version (36K): [in a new window]   FIGURE 1. Procedure overview. SPET = single photon emission tomography; MAA = macroaggregated albumin.

View larger version (41K): [in a new window]   FIGURE 2. Hot spot removal. (A) Transverse slice shows central deposition of aerosol. (B) Transverse slice after automatic hot spot removal.

View larger version (35K): [in a new window]   FIGURE 3. Patient 11. (A) Planar images. Basal perfusion defect in right lung is well delineated. RPO = right posterior oblique; LPO = left posterior oblique. (B) Tomograms. Large basal perfusion defect is clearly visible on frontal slices from anterior to posterior even without display of V/P quotient. A smaller basal defect is also seen in left lung. Detection of small perfusion defects is enhanced by V/P quotient (a, b). (C) Sagittal slices of right lung, from lateral to medial. These clarify location of small mismatches (a, b) on V/P quotient images. Post = posterior; Ant = anterior.

View larger version (21K): [in a new window]   FIGURE 4. Patient 2. (A) Planar images. Ventilation: central deposition of aerosol. Perfusion appears to match ventilation. RPO = right posterior oblique; LPO = left posterior oblique. (B) Tomograms. Perfusion defects are visible on frontal slices but fact that these are mismatches is apparent only from V/P quotient (a, b). (C) Sagittal slices clarify location and extension of mismatches (a, b) on V/P quotient images. Post = posterior; Ant = anterior.

View larger version (45K): [in a new window]   FIGURE 5. Patient 10. (A) Planar images. Inhomogeneous distribution of activity on ventilation and perfusion images. RPO = right posterior oblique; LPO = left posterior oblique. (B) Tomograms. Ventilation and perfusion show clear redistribution on sagittal slices from basal and posterior region to apical and anterior region (arrows), typical for heart incompensation. Post = posterior; Ant = anterior.