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Suzuki K, Kamata N, Inokuma S, Terada H, Yokoyanma Y, Abi K, Mochizuki T, Kobayashi T: Clinical significance of ventilation/perfusion scans in collagen disease patients. Ann Nucl Med. 2000 Dec;14(6):405-13. The purpose of this study was to detect disturbances in pulmonary circulation in collagen disease patients by means of a non-invasive technique. METHODS: Ventilation/perfusion scans with 133Xe gas and 99mTc-macroaggregated albumin (MAA) were performed in 109 patients with various collagen diseases. Functional images of V, Vol, Q and V/Q ratio were obtained at total lung capacity. Wash-out time was calculated from the wash-out curve. Whole body scans were performed in 65 patients to evaluate intra-pulmonary shunts. RESULTS: Increased V/Q areas were observed in 74 patients (67.9%), suggesting some impairment of pulmonary perfusion. Decreased perfusion, probably due to vasculitis or intravascular microcoagulation, was observed often, even in patients without pulmonary fibrosis. Shunt ratios over 10% were observed in 8 of the 65 patients (12.3%), indicating formation of PA-PV shunts secondary to peripheral vascular impairment. Wash-out time was prolonged in 37 patients (33.9%), shortened in 18 (16.5%), and within the normal range in 54 (49.6%). The prolonged and normal wash-out times in the patients with pulmonary fibrosis may represent obstructive changes in the small airways superimposed on the fibrosis. CONCLUSION: Ventilation/perfusion scans are a very useful tool for evaluating collagen lung diseases, and they might contribute to treatment decisions for the patients. |
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