2001 Volume 12 Issue 1 Pages 89-93
A 71 year-old man transferred to our hospital because of acute respiratory dysfunction, hypotension and cyanosis. Several days before admission, he had suffered from frequent diarrhea. On admission, atrial fibrillation and hypoxia were noted and he was unconscious. He was immediately incubated and ventilated by a respiratory machine. And then he received transfusion therapy. Soon his general condition became stable, and we clinically considered that he had acute pulmonary thrombo embolism (PTE). Anticoagulant therapy was started but no thrombolytic therapy. He received an infusion of the Macroaggregates of 99mTC Albumin (99mTC-MAA) for a diagnosis of PTE. The lung scinti scan revealed no pulmonary blood flow in his left lung. To confirm thromboembolism, we scheduled a pulmonary arteriography for the next day. The pulmonary arteriogram showed that the left pulmonary artery was occluded only in A8 and A9. We expected improvement in the left pulmonary blood flow, but the second (on the 6th day after the first scinti scan) lung scinti scan revealed only slight recovery of the pulmonary blood flow. We wondered if the lung scinti scan by 99mTC-MAA could detect the pulmonary vascular lesions. In this paper, we considered that the different results of two examinations depended on the difference between the mechanisms of the two examinations.
