LUNG SCANS WITH I¹³¹ LABELLED MACROAGGREGATED HUMAN SERUM ALBUMIN (MAA)

¹ From the Section of Nuclear Medicine, Departments of Radiology and Medicine, University of Colorado Medical Center, Denver, Colorado, and the Section of Nuclear Medicine, Departments of Medicine and Radiology, Fitzsimons General Hospital, Denver, Colorado

One hundred and fifty-three consecutive lung scans performed on 135 patients have been analyzed. There was no morbidity caused by the procedure. When requested

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for evaluation of acute pulmonary embolism, the scan was correct at least 74 per cent of the time. Although there was an incidence of 14 per cent false negative and 11 per cent false positive results based on the clinical diagnosis, in many of these the scan may actually have been correct and the clinical diagnosis wrong. Consolidation, fibrosis, bullae, emphysema, pleural fluid and altered pulmonary blood flow as in mitral stenosis may result in changes in the lung scan which interfere with the diagnosis of pulmonary embolism. The resolution time of changes secondary to pulmonary embolism is variable and may be short. Therefore, scanning must be performed as soon after clinical embolism as possible. In addition to being of value in the diagnosis of pulmonary embolism, lung scanning may be helpful in bronchogenic carcinoma and in evaluation of the subphrenic space, when combined with the liver scan. The patterns found in emphysema and mitral stenosis suggest the value of the lung scan in intrapulmonary shunts.

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