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Comprehensive Guide to V/Q Scintigraphy in Pulmonary Imaging

Explore the uses and findings of V/Q scintigraphy in pulmonary imaging, including segmental defects, occlusions, and matching/mismatching patterns. Learn about the lung network model, dynamic inhalation scintigraphy, and clearance rates.

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Comprehensive Guide to V/Q Scintigraphy in Pulmonary Imaging

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  1. Ventilation – perfusion (V/Q) scintigraphy Segmental defect • Occlusion of a branch of a branch of the pulmonary artery • Wedge shape and pleural based • Conforms to segmental anatomy of the lung • Large (>75%), moderate (25~75%), small (<25%) A branching lung network model (MRI-based)

  2. Ventilation – perfusionscintigraphy V / Q match • Both scintigrams are abnormal in the same area, defects of equal size V / Q mismatch • Abnormal perfusion in the area of normal ventilation or much larger perfusion abnormality than ventilation defect

  3. V/Q scan Normal 99mTc-MAA perfusion & 81mKr ventillation Matching perfusion & ventillation defect Scintigraphic image of pulmonary embolism

  4. Perfusion Scintigraphyplanar technique

  5. Perfusion Scintigraphyplanar technique

  6. Perfusion ScintigraphySPECT technique

  7. Lung uptake ratio before plannedpulmonectomy

  8. Ventilation Scintigraphyplanar technique

  9. Pulmonary artery agenesia

  10. Dynamic inhalation lung scintigraphy (DIS) Normal DTPA clearance Faster DTPA clearance Enhanced 99mTc DTPA clearance: • smoking (reversible) • alveolitis • sarcoidosis • pneumonitis • flame inhalation • interstitial pneumonia • lung manifestations of immunological diseases

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