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Definition:

A pulmonary ventilation/perfusion scan is a pair of nuclear scan tests. These tests use inhaled and injected radioactive material (radioisotopes) to measure breathing (ventilation) and circulation (perfusion) in all areas of the lungs.



Alternative Names:

V/Q scan; Ventilation/perfusion scan; Lung ventilation/perfusion scan



How the test is performed:

A pulmonary ventilation/perfusion scan is actually two tests. These tests may be performed separately or together.

During the perfusion scan, a health care provider injects radioactive albumin into your vein. You are placed on a movable table that is under the arm of a scanner. The machine scans your lungs as blood flows through them to find the location of the radioactive particles.

During the ventilation scan, you breathe in radioactive gas through a mask while you are sitting or lying on a table under the scanner arm.



How to prepare for the test:

You do not need to stop eating (fast), eat a special diet, or take any medications before the test.

A chest x-ray is usually done before or after a ventilation and perfusion scan.

You will sign a consent form and wear a hospital gown or comfortable clothing that does not have metal fasteners.



How the test will feel:

The table may feel hard or cold. You may feel a sharp prick while the material is injected into the vein for the perfusion part of the scan.

The mask used during the ventilation scan may make you feel nervous about being in a small space (claustrophobia). You must lie still during the scan.

The radioisotope injection usually does not cause discomfort.



Why the test is performed:

The ventilation scan is used to see how well air reaches all parts of the lungs. The perfusion scan measures the blood supply through the lungs.

A ventilation and perfusion scan is most often done to detect a pulmonary embolus . It is also used to:

  • Detect abnormal circulation (shunts) in the blood vessels of the lungs (pulmonary vessels)
  • Test lung function in people with advanced pulmonary disease , such as COPD


Normal Values:

The health care provider should take a ventilation and perfusion scan and then evaluate it with a chest x-ray. All parts of both lungs should take up the radioisotope evenly.



What abnormal results mean:

If the lungs take up lower-than-normal amounts of radioisotope during a ventilation or perfusion scan, it may be due to:

  • Airway obstruction
  • A problem with blood flow (such as occlusion of the pulmonary arteries)
  • Damage from chronic smoking or COPD
  • Pneumonia
  • Pneumonitis
  • Pulmonary embolus
  • Reduced breathing and ventilation ability


What the risks are:

Risks are about the same as for x-rays (radiation) and needle pricks.

No radiation is released from the scanner. Instead, it detects radiation and converts it into an image.

There is a small exposure to radiation from the radioisotope. The radioisotopes used during scans are short-lived. All of the radiation leaves the body in a few days. However, as with any radiation exposure, caution is advised for pregnant or breast-feeding women.

There is a slight risk for infection or bleeding at the site where the needle is inserted. The risk with perfusion scan is the same as with inserting an intravenous needle for any other purpose.

In rare cases, a person may develop an allergy to the radioisotope. This may include a serious anaphylactic reaction .



Special considerations:

A pulmonary ventilation and perfusion scan may be a lower-risk alternative to pulmonary angiography for evaluating disorders of the lung blood supply.

This test may not provide an absolute diagnosis, especially in people with lung disease. Other tests may be needed to confirm or rule out the findings of a pulmonary ventilation and perfusion scan.



References:

Piccini JP, Nilsson K. The Osler Medical Handbook. 2nd ed. Philadelphia, Pa:Saunders; 2006.

Patz EF, Coleman RE. Nuclear Medicine Techniques. In: Mason RJ, Murray J, Broaddus VC, Nadel J, eds. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 21.




Review Date: 9/13/2008
Reviewed By: Benjamin Medoff, MD, Assistant Professor of Medicine, Harvard Medical School, Pulmonary and Critical Care Unit, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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