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Prat ML, Torres G, Fernandez A, Muniz R, Eiselle G, Martin-Comin J: [Detection of superior vena cava stenosis with superior vena cava-superior left pulmonary artery shunt and pulmonary hypertension. Rev Esp Med Nucl. 2003 Mar-Apr;22(2):100-4.
Detection by nuclear medicine study]. We present a 59 year old patient diagnosed of right superior lobe pulmonary carcinoma by CT scan. A ventilation/perfusion pulmonary scintigraphy quantified for study of pulmonary function after surgery was performed. The images show an abnormal pattern of the distribution of macroaggregate albumin (MAA) and extrapulmonary presence of tracer (right/left shunt). A first step dynamic study showed the existence of superior cava stenosis and passage of the tracer from the vena cava to the left pulmonary artery by collateral circulation (innominate vein) that not only explained the existence of the abnormal pattern of the MAA distribution but also what the cause of the right/left shunt was. After the resolution of the stenosis, the distribution pattern became normal and the extrapulmonary presence of MAA disappeared. |
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