Author/Authors :
Izadyar, S. Department of Nuclear Medicine - Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran , Abtahi, H. R Department of Pulmonology - Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran, Iran , Saber, S. Department of Pulmonology - Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran, Iran , Abbasi, M. Department of Nuclear Medicine - Shariati Hospital - Tehran University of Medical Sciences, Tehran, Iran
Abstract :
Quantitative pulmonary perfusion scintigraphy (QPPS) has few indications for evaluation of
pre- and post-lung transplantation. QPPS is useful for preoperative regional assessment of
pulmonary function. Post-transplantation lung scintigraphy has a prognostic value in detecting
chronic rejection. Here we report the clinical implication of QPPS in a 36-year-old man
with post-alveolar microlithiasis complicated lung-transplantation. The pulmonary function
tests and repeat thoracotomy excluded corresponding ventilatory problems and surgical
complications. Doppler echocardiography suggested elevated pulmonary artery (PA) pressure.
QPPS revealed decreased perfusion of transplanted lung (geometric mean: 46.8%) compared
to contra-lateral lung affected by severe alveolar microlithiasis indicating post-transplant
pulmonary artery stenosis; the diagnosis was confirmed by pulmonary CT-angiography. The
patient underwent a successful balloon angioplasty. Post-revascularization perfusion scintigraphy
documented increasing graft blood flow (geometric mean; 51%). We conclude that
QPPS may play a significant role in the assessment and follow-up of patients with complicated
lung transplantation, including pulmonary artery stenosis.
Keywords :
Lung Transplantation , Alveolar Microlithiasis , Quantitative Evaluation , Radionuclide Imaging
