V/Q ventilation-perfusion lung scans

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Introduction

  • patients with airway infections are generally not permitted to have the ventilation phase
  • a recent CXR preferably with past 24hrs is required for the interpretation of these images as per PIOPED protocols
    • CXR findings such as COPD, cardiomegaly, pleural effusion, consolidation may change the interpretation of the scan
    • patients with COPD commonly have matched V/Q abnormalities due to hypoxic vasoconstriction
  • only 15% of patients with a PE have a high probability scan
  • a VQ interpreted as being high probability for PE will 90% probability of having a PE
  • around half of patients with a PE will have an indeterminate scan as there is both reduced ventilation and reduced perfusion and may need CTPA to confirm
  • a negative V/Q scan essentially rules out a PE