Pulmonary Emphysema
Kagawa Medical College, Dept. Radiology; Drs: Isao Sato, Kazue Takahashi, Yoshihiro Nishiyama, Masatada Tanabe
59 yo male complaining of coughs and sputum of 10 years duration. Brinkman index 800; VC 94.6%; FEV1 65%;RV/TLC 43.6%.
Radiological Examinations
The plain CXR shows no apparent abnormality. High Resolutin CT shows disseminated regions of low absorption ranging from a few mm to 1cm in diameter throughout both lungs.
Tc-99m-MAA perfusion scintigraphy
Perfusion scintigrahpy shows inhomogenous distribution of perfusion threoughout the lungs with both apices most prominant. Band-like perfusion defects are seen along the interlobar fissures(fissure sign).
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Clinical Point: PFT and clinical symptoms suggest COPD, but chest radiography and CT appear normal. |
Technegas planar scintigraphy
Technegas SPECT
General Comments: The inhaled Technegas is distributed inhomogenously throughout both lungs. both apioces show a decreased deposition of Technegas.
SPECT images indicate "hot spots" and defects in both lungs.
HRCT suggests mild pulmonary emphysema predominantly in both upper lobes, but when compared with the CT findings, inhalation and perfusion scintigraphy show more marked changes consistent with COPD in the upper lobes of both lungs.
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