作者: George Panoutsopoulos , Ioannis Ilias , Ioulia Christakopoulou
DOI: 10.1007/BF02987863
关键词: Perfusion scanning 、 Shunting 、 Intracardiac injection 、 Medicine 、 Angiography 、 Right-to-left shunt 、 Cardiology 、 Pulmonary embolism 、 Radiology 、 Shunt (medical) 、 Arteriovenous Anastomosis 、 Internal medicine
摘要: A 56-yr-old man, two months after an operation for acoustic neurinoma, gradually developed dyspnea. Massive pulmonary embolism (MPE), with a significant right-to-left (R-L) shunt, was seen in perfusion scan of the lungs Tc-99m MAA. Radioactivity noted thyroid, spleen, kidneys and brain. cardiac ultrasound study did not reveal intracardiac shunting. few days later, when patient’s condition improved, another show whereas subsequent digital subtraction angiographic confirmed diagnosis MPE but failed to cause shunt. In absence any possible pathophysiological mechanism, explain observed R-L we deduce that particles MAA might have passed through precapillary arteriovenous anastomoses and/or dilated capillaries, as result highly increased vascular pressure due MPE.