What is the role of ventilation-perfusion scanning for the workup of pulmonary arterial hypertension (PAH)?

Updated: Apr 25, 2018
  • Author: Kristin E Schwab, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Ventilation-perfusion scanning should be performed to exclude CTEPH. A high- or low-probability scan result is most useful, whereas intermediate-probability results should lead to the performance of pulmonary angiography.

Diffuse mottled perfusion can be observed in patients with pulmonary arterial hypertension (PAH), as opposed to the segmental or subsegmental mismatched defects observed in patients with CTEPH (see the image below).

Ventilation-perfusion scan of bilateral mismatched Ventilation-perfusion scan of bilateral mismatched segmental and subsegmental defects, suggesting chronic thromboembolic hypertension.

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