Lung ventilation-perfusion (V/Q) scintigraphy.Perfusion Scintigraphy in Diagnosis and Management of Thromboembolic Pulmonary Hypertension

Nuclear Medicine

Perfusion Scintigraphy in Diagnosis and Management of Thromboembolic Pulmonary Hypertension

Farshad Moradi , Timothy A. Morris, Carl K. Hoh

Author Affiliations

• From the Department of Radiology, Division of Nuclear Medicine (F.M., C.K.H.); and Division of Pulmonary, Critical Care, and Sleep Medicine (T.A.M.), University of California, San Diego, San Diego, Calif.
• Address correspondence to F.M., Department of Radiology, Division of Nuclear Medicine, Stanford School of Medicine, 300 Pasteur Dr H-2226, MC 5281, Stanford, CA 94305 (e-mail: fmoradi@stanford.edu).

Published Online:Jan 8 2019https://doi.org/10.1148/rg.2019180074

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Abstract

Chronic thromboembolic pulmonary hypertension is reviewed, and the associated technical considerations and spectrum of scintigraphic findings encountered in diagnosis and management are described.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening complication of acute pulmonary embolism (PE). Because the treatment of CTEPH is markedly different from that of other types of pulmonary hypertension, lung ventilation-perfusion (V/Q) scintigraphy is recommended for the workup of patients with unexplained pulmonary hypertension. Lung V/Q scintigraphy is superior to CT pulmonary angiography for detecting CTEPH. Perfusion defect findings of CTEPH can be different from those of acute PE. Familiarity with the patterns of perfusion defects seen during the initial workup of CTEPH and the expected posttreatment changes seen at follow-up imaging is essential for accurate interpretation of V/Q scintigraphy findings.