What is the role of nuclear imaging in the diagnosis of cor pulmonale?

Updated: Dec 15, 2017
  • Author: Derek Leong, MD; Chief Editor: Henry H Ooi, MD, MRCPI  more...
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Radionuclide ventriculography can noninvasively determine right ventricular ejection fraction. Myocardial perfusion may also show a permanent increase in brightness of the right ventricle. [20]

Ventilation/perfusion (V/Q) scanning can be particularly useful in evaluating patients with cor pulmonale, especially if pulmonary hypertension is due to chronic thromboembolic pulmonary hypertension (CTEPH). V/Q scans are performed by having the patient inhale a radionucleotide (typically xenon or technetium) to assess ventilation, whereas perfusion is evaluated by the intravenous injection of another radionucleotide. The two images are then analyzed to determine if there are any mismatched perfusion defects, which is suggestive of a pulmonary embolism.

V/Q scans are typically interpreted as being normal, or having a high, intermediate, or low probability for pulmonary embolism. In CTEPH, the V/Q scan typically demonstrates having a high probability for pulmonary embolism as well as having multiple mismatched perfusion defects which can be visualized.

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