Clinical ventilation-perfusion scintigraphy

Ventilation-perfusion scintigraphy is an established procedure for the investigation of lung disease. Perfusion scans are commonly obtained with a gamma-camera following injection of 99mTc-labelled microspheres. For the assessment of regional lung ventilation, a number of techniques are now being employed, i.e. 133Xe and 127Xe single breath/washout studies, continuous inhalation of 81mKr and inhalation of radioactive aerosols. The latter two methods are now gaining consideration in clinical practice. Lung perfusion scanning is highly sensitive for detection of regional abnormalities of blood flow; the diagnosis of pulmonary embolism remains the most important clinical application of the technique. In this context, the use of a ventilation scan is required in order to increase the specificity of the procedure. In general, lung ventilation-perfusion scintigraphy is of great value for the management of patients with both primary lung disease and heart disease, by providing pathophysiological information of importance for the diagnosis, follow up and the functional evaluation of the patient.