Measurement of the Vital Capacity and Perfusion of Each Lung by Fluoroscopy and Macroaggregated Albumin Lung Scanning

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Abstract
Measurement of the ventilation and perfusion of each lung may be important in the preop-erative evaluation of a patient with reduced pulmonary function facing resection of all or a portion of 1 lung. If the pulmonary tissue to be resected represents a significant amount of the functioning parenchyma, surgery might produce pulmonary insufficiency. Clinical fluoroscopy and 13lj MAA [Macroaggregated albumin] lung scan were used to estimate the ventilation and persusion of each lung. The results of these 2 methods were compared with ventilation and perfusion data obtained from bronchospirometry performed on the same patients. The percentage of pulmonary perfusion to each lung measured by MAA lung scan showed a mean difference of 4% from O2 uptake measured by bronchospirometry with a standard deviation of 4%. In 18 patients the vital capacity of each lung (an index of ventilation) was measured by bronchospirometry and estimated by fluoroscopy. The mean difference between the 2 methods was 8% of the total vital capacity with a standard deviation of 8%. The use of functional fluoroscopy combined with 131I MAA lung scan offers a practical alternative to the technique of bronchospirometry. The equipment required is available in most hospitals and hence could easily be part of a routine preoperative evaluation.

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