Perfusion-ventilation lung scintigraphy with hybrid imaging in patient with lung fibrosis – case report

Summary

Introduction: Interstitial lung diseases (ILD, also fibrosing lung processes) are immunopatological processes in the lung interstitium, i.e. interalveolarly, in the alveoli and in peribonchium. They make difficult gas exchange in the alveolo-capillary membrane and cause respiratory insufficiency.

Case report: 59-y-old man was sent to our department to exclude pulmonary embolism. He was assessed by cardiologist due to lower extremities edema; it was concluded as a chronic venous insufficiency without heart role. Patient was followed for 19 years by pneumologist for ILD, type bronchiolitis obliterans. He suffers from chronical exertional dyspnea. There was neither pulmonary hypertension nor cor pulmonale on echocardiography.

There were quite homogenous perfusion and ventilation on lung scintigraphy, so we were able to exclude pulmonary embolism. We detected significant parenchymal changes with a mixed density and honeycomb character on a low dose nondiagnostic CT. So we can conclude the presence of interstitial damage in the lung without a significant changes of perfusion and ventilation, which explain clinical symptoms.

Conclusion: Hybrid lung scintigraphy in patients with interstitial lung diseases is able to explain the cause of dyspnea and simultaneously exclude pulmonary embolism by confirmation of parenchymal changes.

Keywords:

lung scintigraphy – SPECT/CT – lung fibrosis