Ventilation/perfusion scintigraphy in patients with pulmonary vascular anomaly

Background

Although ventilation/perfusion (V/Q) scintigraphy is frequently used in the diagnosis of acute or chronic pulmonary embolism (PE), it also plays a significant role in diagnosing pulmonary vascular diseases. Additionally, in the presence of a mismatch defect on V/Q scintigraphy, pulmonary vascular anomalies should be considered as a possible alternative to PE. For this reason, we aimed to present three cases with Swyer–James–MacLeod syndrome (SJMS), one of which was also complicated by PE, and one case with pulmonary artery hypoplasia.

Case Presentation

Case 1: PE was diagnosed by V/Q scintigraphy in a patient with known SJMS. Case 2: SJMS was diagnosed by thoracic computed tomography (CT), flexible optical bronchoscopy (FOB) and V/Q scintigraphy. Case 3: V/Q scintigraphy revealed pulmonary artery hypoplasia in the differential diagnosis of PE when evaluated together with FOB and thoracic CT. Case 4: Diagnosed as SJMS by Thorax CT and V/Q scintigraphy in the presence of chronic lung disease.

Conclusions

V/Q scintigraphy is also used in the diagnosis of congenital/hereditary vascular and airway diseases. Thoracic CT should be performed together with evaluation to reach the diagnosis in this group of patients. In cases with mismatch defects, vascular anomalies should also be considered in the differential diagnosis.