Lung Ventilation-Perfusion Scan in COVID-19

Abstract

Although COVID-19 infection is associated with the increased risk of pulmonary thromboembolism (PTE), COVID-19 pulmonary lesions cause ventilation-perfusion (V/Q) patterns other than PTE. Although extensive research has been done to address different anatomical patterns of COVID-19, there is a knowledge gap in terms of V/Q lung scintigraphy in these patients. The purpose of this study is to demonstrate these patterns and to show how important it is to use SPECT/CT in addition to planar images to differentiate between these patterns from PTE. In the current collection, we presented various patterns of V/Q SPECT/CT abnormalities in COVID-19 patients.

Lung functional imaging

“…[44]. In contrast to the overall characterisation of the lungs obtained using MIGET, PET, MRI and SPECT imaging allow regional assessments of V ̇/Q ̇ratios and associated gas exchange parameters [24,28,45,46]. For example, V ̇/Q ̇imaging has provided insights into highly heterogeneous regional variations in ventilation and perfusion that can explain changes in arterial blood gases [28], estimates of alveolar O 2 and CO 2 partial pressures in ventilation defects (VDefs) during bronchoconstriction in asthma [47,48], regional O 2 and CO 2 transfer in asthma [49], the spatial distribution of alveolar dead space and its effects on gas exchange in early acute respiratory distress syndrome [50], and the effects of nitric oxide (NO) inhalation on regional perfusion and V ̇/Q ̇in pulmonary arterial hypertension [51].…”

“…99m Tc diethylene triamine pentaacetic acid (DTPA) or Technegas) deposited in the alveoli, or the gaseous xenon-133 ( 133 Xe) or 81-metastable-krypton ( 81m Kr). The typical clinical use of SPECT and scintigraphy ventilation imaging is as part of V ̇/Q ̇scans for the evaluation of pulmonary embolism [24].…”