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Title: Ventilation-perfusion imaging in pulmonary papillomatosis

Abstract

Three children with laryngeal papillomas involving the lungs had serial ventilation-perfusion scintigrams to assess results of therapy designed to reduce the bronchial involvement. Different imaging patterns were observed depending on size, number, and location of lesions. In early parenchymal involvement a ventilation-perfusion mismatch was seen. The initial and follow-up studies correlated well with clinical and radiographic findings. This noninvasive procedure is helpful in evaluating ventilatory and perfusion impairment in these patients as well as their response to treatment.

Authors:
; ; ;
Publication Date:
Research Org.:
Johns Hopkins Medical Institutions, Baltimore, MD
OSTI Identifier:
5393489
Resource Type:
Journal Article
Resource Relation:
Journal Name: J. Nucl. Med.; (United States); Journal Volume: 22:11
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 59 BASIC BIOLOGICAL SCIENCES; EPITHELIOMAS; PATHOLOGY; LUNGS; SCINTISCANNING; CHILDREN; EVALUATION; IMAGES; INHALATION; PATIENTS; PEDIATRICS; PERFUSED TISSUES; RADIOPHARMACEUTICALS; RESPIRATION; THERAPY; AGE GROUPS; ANIMAL TISSUES; BODY; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; INTAKE; LABELLED COMPOUNDS; MEDICINE; NEOPLASMS; ORGANS; RADIOISOTOPE SCANNING; RESPIRATORY SYSTEM; TISSUES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics; 550901 - Pathology- Tracer Techniques; 551001 - Physiological Systems- Tracer Techniques

Citation Formats

Espinola, D., Rupani, H., Camargo, E.E., and Wagner, H.N. Jr. Ventilation-perfusion imaging in pulmonary papillomatosis. United States: N. p., 1981. Web.
Espinola, D., Rupani, H., Camargo, E.E., & Wagner, H.N. Jr. Ventilation-perfusion imaging in pulmonary papillomatosis. United States.
Espinola, D., Rupani, H., Camargo, E.E., and Wagner, H.N. Jr. 1981. "Ventilation-perfusion imaging in pulmonary papillomatosis". United States. doi:.
@article{osti_5393489,
title = {Ventilation-perfusion imaging in pulmonary papillomatosis},
author = {Espinola, D. and Rupani, H. and Camargo, E.E. and Wagner, H.N. Jr.},
abstractNote = {Three children with laryngeal papillomas involving the lungs had serial ventilation-perfusion scintigrams to assess results of therapy designed to reduce the bronchial involvement. Different imaging patterns were observed depending on size, number, and location of lesions. In early parenchymal involvement a ventilation-perfusion mismatch was seen. The initial and follow-up studies correlated well with clinical and radiographic findings. This noninvasive procedure is helpful in evaluating ventilatory and perfusion impairment in these patients as well as their response to treatment.},
doi = {},
journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 22:11,
place = {United States},
year = 1981,
month =
}
  • To determine the accuracy and limitations of Xe-133 ventilation and Tc-99m perfusion lung images (V-P images) in detecting pulmonary emboli (PE), these studies were performed in 23 dogs after experimental production of PE by a modified Wessler technique. Fourteen of the animals also underwent selective pulmonary angiography. Xenon-133 abnormalities were seen immediately after embolization in two of the 23 animals (8.7 percent). Perfusion images revealed the location of 83 percent of emboli that completely obstructed pulmonary vessels, but only 26 percent of those that partially obstructed flow. Defects were seen with 97 percent of emboli that completely occluded vessels largermore » than 2.0 mm in diameter, but in only 66 percent of those occluding smaller vessels. Oblique perfusion images provided the only evidence of the perfusion defect associated with five of 88 (5.7 percent) angiographically proven emboli. V-P imaging is a sensitive technique for detecting PE unless the emboli lodge in very small vessels or incompletely obstruct a vessel. Xenon-133 abnormalities occur infrequently following PE, and should not be a common cause for a false-negative V-P match in clinical practice.« less
  • The hospital and departmental records of the University of Virginia Medical Center from 1976 to 1980 show an increasing frequency of ventilation studies relative to perfusion studies and a decrease in frequency of ventilation-perfusion diagnosis of pulmonary embolus. Pulmonary angiograms have increased from one per 68 nuclear studies to one per 14. A review of 70 patients with correlating angiography or autopsy shows that 89% of nuclear studies were accurate. We have revised our interpretation criteria and indications for pulmonary angiography.
  • Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated withmore » a poor prognosis.« less
  • We have described a patient with paralysis of the diaphragm, in whom dyspnea, hypoxemia, and hypercapnia increased when he changed from the upright to the supine position. Ventilation (V) and perfusion (P) images of the right lung appeared to be normal and remained nearly the same in the upright and supine positions. In contrast, V and P images of the left lung were smaller than those of the right lung in the upright position and decreased further in the supine position. In addition, the ventilation image of the left lung was much smaller than the perfusion image in both positions.
  • Two patients with pneumothorax had ventilation-perfusion studies to rule out the possibility of pulmonary embolism; the presence of air in the pleural space was not known to the authors when the study was analyzed. A typical ventilatory pattern characterized by small volume difference at total lung capacity followed by disproportionately greater decrease of the volume of the affected lung at tidal breathing was observed. In one case, the routine chest radiograph failed to demonstrate air in the pleural space. A similar volume difference between the two lungs was noted on the perfusion images.