Pulmonary perfusion imaging (eg, particulate)
CPT4 code
Name of the Procedure:
Pulmonary Perfusion Imaging (e.g., Particulate), also known as a Lung Perfusion Scan, Ventilation-Perfusion (V/Q) Scan.
Summary
Pulmonary perfusion imaging is a medical test that uses a small amount of radioactive material to examine blood flow in the lungs. It helps to detect any blockages or abnormalities in lung blood circulation.
Purpose
This procedure is primarily used to diagnose or rule out pulmonary embolism (a blockage in one of the pulmonary arteries in the lungs). Additionally, it can be used to evaluate lung function, especially before lung surgery, and to assess the effectiveness of treatment for conditions affecting lung blood flow.
Indications
- Sudden onset of shortness of breath or chest pain suggestive of pulmonary embolism.
- Unexplained low oxygen levels.
- Preoperative assessment before lung surgery.
- Monitoring of chronic lung conditions such as chronic obstructive pulmonary disease (COPD).
Preparation
- The patient may be instructed to avoid eating or drinking for a few hours before the procedure.
- Inform the healthcare provider of all medications you are taking, especially blood thinners.
- Diagnostic tests such as a recent chest X-ray or CT scan may be required beforehand.
Procedure Description
- The patient lies down on a table.
- A small intravenous (IV) line is inserted into a vein, usually in the arm.
- A radioactive tracer is injected through the IV. This tracer travels to the lungs and highlights areas of blood flow.
- The patient is moved under a special camera that takes images of the lungs as the tracer circulates.
- Sometimes, a ventilation scan is also performed where the patient inhales a radioactive gas, allowing visualization of air flow in the lungs.
- The imaging process typically involves the patient changing positions to capture different views.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
Pulmonary perfusion imaging is usually performed in a hospital's nuclear medicine department or an outpatient imaging center.
Personnel
- Nuclear medicine technologist
- Radiologist or nuclear medicine specialist
- Medical support staff
Risks and Complications
- Exposure to a small amount of radiation.
- Rarely, allergic reactions to the radioactive tracer.
- Minor discomfort at the injection site.
- Complications are generally rare and manageable.
Benefits
- Accurate diagnosis of pulmonary embolism and other lung conditions.
- Non-invasive procedure with minimal discomfort.
- Helps guide treatment decisions and surgical planning.
Recovery
- Most patients can resume normal activities immediately after the procedure.
- Drink plenty of fluids to help flush the radioactive tracer from your body.
- Follow-up appointments may be necessary depending on the results.
Alternatives
- CT pulmonary angiography: Provides detailed images of the lung arteries but involves higher radiation exposure.
- Doppler ultrasound: Limited to evaluating blood flow in veins of the legs rather than directly in the lungs.
- D-dimer blood test: Used to rule out blood clots but not specific for lung issues.
Patient Experience
Patients might feel a slight sting from the IV insertion and a mild sensation as the tracer is injected. There is generally no significant pain during the imaging process. Post-procedural discomfort is minimal, and pain management is rarely required.