Pulmonary embolism

Case contributed by Dr Bruno Di Muzio

Presentation

Shortness of breath with chest tightness .

Patient Data

Age: 60-year-old
Gender: Male
X-ray

Posterior atelectasis in the left lower lobe, lungs and pleural space are otherwise clear. The heart is enlarged. No pneumothorax or subphrenic free gas.

Nuclear medicine

V/Q Study

RADIOPHARMACEUTICAL: 99mTc Gas, 40 MBq / 99mTc MAA, 173 MBq

TECHNICAL PROCEDURE AND RESULTS Routine SPECT ventilation and perfusion scans of the lungs were performed. Images were compared with chest x-ray. Segmental or subsegmental unmatched perfusion defects are seen within the right middle lobe/anterior segment of right upper lobe and the posterior basal segment of the right lower lobe. Subsegmental matched ventilation-perfusion defect is seen within the posterior basal segment of the left lower lobe, in keeping with bronchopulmonary disease, and correlating with similar findings on chest x- ray of atelectasis or consolidation at this site (best seen on the lateral view).

IMPRESSION Positive study for segmental or subsegmental pulmonary embolism situated within the right middle lobe/anterior segment of the right upper lobe and the posterior basal segment of the right lower lobe.

Case Discussion

This case illustrates an even distribution of radionuclide throughout the lung fields with multiple bilateral perfusion defects consistent with pulmonary embolism.

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Case information

rID: 48281
Case created: 28th Sep 2016
Last edited: 2nd May 2017
System: Chest
Tag: rmh
Inclusion in quiz mode: Included

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