Deep Vein Thrombosis Presenting on Pulmonary Ventilation and Perfusion Scintigraphy

作者：Itani Malak; Fair Joanna; Hillman Zachary; Behnia Fatemeh; Elojeimy Saeed^*

来源：Clinical Nuclear Medicine, 2016, 41(10): e462-e464.

DOI：10.1097/RLU.0000000000001337

• Tc-99m-DTPA
• Tc-99m-MAA
• incidental findings
• deep vein thrombosis
• ventilation perfusion scan

A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with Tc-99m-DTPA [diethylene triamine pentaacetic acid aerosol] and Tc-99m-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little Tc-99m-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal Tc-99m-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound. Careful attention to relative radiotracer count rates on VQ scans is crucial to ensure diagnostic utility. In addition, abnormal low perfusion radiotracer counts may unveil other pathology with important clinical implications.

• 出版日期2016-10