Radionuclide Lung Imaging
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Questions and Answers

What is the main purpose of lung scintigraphy?

  • Assessing pulmonary perfusion and ventilation
  • Evaluating lung cancer surgery
  • Assessing pulmonary anatomy
  • Diagnosing pulmonary embolism noninvasively (correct)
  • Which imaging modality is considered the standard for evaluating pulmonary embolism?

  • X-ray
  • MRI
  • Lung scintigraphy
  • Computed tomography pulmonary angiography (correct)
  • What is the function of the pores of Kohn and the canals of Lambert in the lungs?

  • Expelling carbon dioxide
  • Preventing collapse of obstructed lung segments (correct)
  • Supplying oxygen to alveoli
  • Aiding in lung ventilation
  • In which part of the trachea do the mainstem bronchi divide into lobar bronchi?

    <p>Intrathoracic region</p> Signup and view all the answers

    Why are lobes and segments crucial for interpreting pulmonary images?

    <p>To localize lung pathology</p> Signup and view all the answers

    What is the role of bronchial arteries in the lungs?

    <p>Connect to the pulmonary circulation</p> Signup and view all the answers

    What is the main difference in ventilation between the upper and lower lungs in the upright position?

    <p>Ventilation is greater in the lower lungs.</p> Signup and view all the answers

    Where is perfusion maximal in the lungs when in the upright position?

    <p>In the lower third of the lungs</p> Signup and view all the answers

    Which position results in more even ventilation and perfusion throughout the lungs?

    <p>Supine position</p> Signup and view all the answers

    What happens to the V/Q ratio from the base to the apex of the lung?

    <p>It decreases</p> Signup and view all the answers

    What percentage of capillaries are blocked by technetium-99m macroaggregated albumin (MAA)?

    <p>Less than 0.1%</p> Signup and view all the answers

    What is recommended for injection to ensure good statistical distribution of MAA in adults for perfusion imaging?

    <p>Between 200,000 and 700,000 particles</p> Signup and view all the answers

    What is the biologic half-life of MAA in the lung?

    <p>2 to 4 hours</p> Signup and view all the answers

    Why is it important to inject technetium-99m MAA during quiet respiration with the patient supine?

    <p>To decrease perfusion gradient</p> Signup and view all the answers

    What is crucial for diagnosing pulmonary emboli?

    <p>Understanding clinical presentation and risk factors</p> Signup and view all the answers

    Which imaging technique demonstrates higher sensitivity in distinguishing chronic thromboembolic pulmonary hypertension from other types?

    <p>V/Q scanning</p> Signup and view all the answers

    What do matched V/Q abnormalities suggest in the context of lung diseases?

    <p>Airway disease</p> Signup and view all the answers

    Which lung condition may show distinct V/Q scan patterns with lower lung involvement?

    <p>Cystic fibrosis</p> Signup and view all the answers

    What do ventilation-perfusion (V/Q) scans help differentiate from pulmonary emboli based on bronchodilator response and clinical history?

    <p>Asthma</p> Signup and view all the answers

    What can cause nonsegmental perfusion defects in lung scanning?

    <p>Inflammatory diseases</p> Signup and view all the answers

    Which imaging technique is preferred for staging and response evaluation in lung cancer?

    <p>CT and PET/CT scans</p> Signup and view all the answers

    What do V/Q scans assist in differentiating from other conditions like pulmonary emboli in lung imaging?

    <p>Pneumonitis</p> Signup and view all the answers

    What can cause diffuse or scattered nonsegmental perfusion defects in lung scanning?

    <p>Pleural effusions</p> Signup and view all the answers

    What is a leading cause of death during pregnancy in the developed world?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is the most important use of a V/Q lung scan?

    <p>Monitoring pulmonary emboli</p> Signup and view all the answers

    In a ventilation scan, why can xenon be seen longer at the lung bases?

    <p>Larger lung volume</p> Signup and view all the answers

    What is a characteristic of normal DTPA aerosol ventilation images?

    <p>Homogeneous deposition from base to apex</p> Signup and view all the answers

    Why is accurate diagnosis crucial before starting anticoagulation and thrombolytic therapies?

    <p>To minimize the risk of morbidity</p> Signup and view all the answers

    Which imaging technique categorizes the probability of pulmonary emboli based on specific interpretive criteria like PIOPED?

    <p>V/Q scans</p> Signup and view all the answers

    Why are V/Q scans particularly recommended for follow-up in diagnosed cases?

    <p>To evaluate regional pulmonary function</p> Signup and view all the answers

    What is a challenge associated with CTPA as a diagnostic tool for pulmonary emboli?

    <p>Overdiagnosis leading to unnecessary treatment</p> Signup and view all the answers

    Why do small pulmonary emboli present a diagnostic challenge?

    <p>Less than 25% of patients exhibit classic symptoms</p> Signup and view all the answers

    Why is poor-quality portable supine film a concern when interpreting lung scans?

    <p>It may cause misinterpretations</p> Signup and view all the answers

    What is a distinguishing feature between aerosol scans and perfusion scans?

    <p>Visualized trachea and bronchi in aerosol scans</p> Signup and view all the answers

    What is the mean diameter of the aerosols administered to the patient?

    <p>0.5 μm</p> Signup and view all the answers

    In which type of patients is central deposition of larger particles common?

    <p>Patients with COPD</p> Signup and view all the answers

    Why is Xenon-133 used for evaluating ventilation and perfusion?

    <p>To assess regional ventilation</p> Signup and view all the answers

    What is required from the patient during a ventilation study using Xenon-133?

    <p>Cooperation for breathing on a closed spirometer system</p> Signup and view all the answers

    Which technique can be used along with SPECT for improved lung scan accuracy?

    <p><strong>CT angiography</strong></p> Signup and view all the answers

    What is the main limitation mentioned in using 99mTc-DTPA aerosols?

    <p>Small amount of activity delivered to the patient</p> Signup and view all the answers

    Why is it recommended to adjust the doses of 99mTc-MAA and 99mTc-DTPA aerosol when performing sequential imaging of ventilation and perfusion?

    <p>To prevent interference between the two agents</p> Signup and view all the answers

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