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A ventilation/perfusion lung scan, also called a V/Q lung scan, or ventilation/perfusion scintigraphy, is a type of medical imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within a patient's lungs, [1] [2] in order to determine the ventilation/perfusion ratio.
Ventilation/perfusion scans, sometimes called a VQ (V=Ventilation, Q=perfusion) scan, is a way of identifying mismatched areas of blood and air supply to the lungs. It is primarily used to detect a pulmonary embolus. The perfusion part of the study uses a radioisotope tagged to the blood which shows where in the lungs the blood is perfusing.
Using a small amount of inhaled or injected radioactive material called a tracer for visualization, a V/Q scan is a type of nuclear medical imaging that allows for localization and characterization of blood flow (perfusion scan) and measurement of airflow (ventilation scan) within the lungs. [2]
A pulmonary ventilation-perfusion scan (lung V/Q scan) can be used to diagnose the V/Q mismatch. A ventilation scan is used to measure airflow spread and a perfusion scan for blood flow distribution in the lungs. A radioactive tracer is used to scan the whole lung and the ventilation and perfusion function. [21]
A ventilation perfusion scan or lung scintigraphy can be used to diagnose areas of lungs being ventilated but not adequately perfused. This results in a raised Alveolar-arterial (A-a) gradient which is responsive to supplemental oxygen. In conditions with right to left shunts, there are also ventilation perfusion defects with high A-a gradients.
The ventilation/perfusion ratio (V/Q ratio) is higher in zone #1 (the apex of lung) when a person is standing than it is in zone #3 (the base of lung) because perfusion is nearly absent. However, ventilation and perfusion are highest in base of the lung, resulting in a comparatively lower V/Q ratio.
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CTPA was introduced in the 1990s as an alternative to ventilation/perfusion scanning (V/Q scan), which relies on radionuclide imaging of the blood vessels of the lung. It is regarded as a highly sensitive and specific test for pulmonary embolism. [1] CTPA is typically only requested if pulmonary embolism is suspected clinically.
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