PATTERNS OF PULMONARY PERFUSION SCANS IN NORMAL SUBJECTS

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Abstract
A vital factor conditioning the usage of the pulmonary perfusion (Q) scan in the evaluation of patients suspected of pulmonary embolism is the prevalence of abnormal Q scans in subjects free of cardiopulmonary disease. Because this prevalence has not been well defined, Q scans were performed in 80 nonsmoking subjects 18-29 yr of age having no known active cardiopulmonary disease. Each subject underwent a history, physical examination, ECG, spirometry and chest roentgenogram, followed by a 6-view Q scan. Two subjects in whom a Q defect was suspected underwent a 133Xe equilibrium-washout ventilation (V) scan. All Q scans were interpreted blindly and independently by 2 experienced readers; 79 of the 80 Q scans were read as normal. No subject demonstrated a lobar or segmental defect. One of the 80 subjects, who had a mild pectus excavatum, had left upper lobe subsegmental defect, which was not seen on the V scan. Based on the statistical analysis of these data, no more than 3.68% of normal nonsmoking persons in this age group may have a lobar or segmental Q scan defect and no more than 6.77% may have a subsegmental defect (with 95% confidence). Q scan defects, particularly lobar or segmental, apparently are rarely present among normal nonsmokers in this age group.

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