Related Experiment Videos
Tc-99m MAA lung perfusion scintigraphy performed before and after pulmonary embolectomy for saddle-type pulmonary
W J Shih1, M C Robinson, C Huber
1Division of Nuclear Medicine, Veterans Affairs Medical Center, Lexington, KY 40511, USA.
Abstract:
A 58-year-old man had shortness of breath, hypotension, and decreased partial pressure of oxygen (PO2) on the eighteenth day after undergoing craniotomy for a meningioma. Tc-99m MAA pulmonary perfusion scintigraphy showed little perfusion to the right lung and left lower lung and multiple perfusion defects in the left upper lung. Although the results of concurrent chest radiography were negative for pulmonary infiltrates, pulmonary angiography demonstrated a saddle-type embolism. The patient underwent emergency pulmonary artery embolectomy to remove blood clots and organized thromboemboli from the main pulmonary artery and the right and left pulmonary arteries. The patient's postoperative course was uneventful, and a second Tc-99m MAA lung perfusion scan demonstrated marked improvement in lung perfusion.
Insights
A patient developed pulmonary embolism after brain surgery. Prompt diagnosis with lung scans and angiography led to successful embolectomy and improved lung perfusion.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Post-craniotomy complications can include thromboembolic events.
- Pulmonary embolism (PE) presents with diverse symptoms, including respiratory and hemodynamic compromise.
- Meningioma surgery carries a risk of secondary complications.
Observation:
- A 58-year-old male presented with hypoxia and hypotension 18 days post-craniotomy for meningioma.
- Tc-99m MAA pulmonary perfusion scintigraphy revealed significant perfusion defects.
- Pulmonary angiography confirmed a saddle-type pulmonary embolism despite negative chest X-ray.
Findings:
- Saddle pulmonary embolism was diagnosed in a post-craniotomy patient.
- Emergency pulmonary artery embolectomy successfully removed thromboemboli.
- Post-operative lung perfusion scans showed significant improvement.
Implications:
- Early diagnosis and intervention are crucial for managing post-operative pulmonary embolism.
- Pulmonary perfusion scintigraphy is valuable in diagnosing PE in complex surgical cases.
- Aggressive surgical management can lead to favorable outcomes in saddle PE.