The diagnosis of pneumothorax by ventilation-perfusion imaging

Two patients with pneumothorax had ventilation-perfusion studies to rule out the possibility of pulmonary embolism; the presence of air in the pleural space was not known to the authors when the study was analyzed. A typical ventilatory pattern characterized by small volume difference at total lung capacity followed by disproportionately greater decrease of the volume of the affected lung at tidal breathing was observed. In one case, the routine chest radiograph failed to demonstrate air in the pleural space. A similar volume difference between the two lungs was noted on the perfusion images.