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eFigure 9–19. Normal lung perfusion. A routine examination may include as many as eight views– anterior, posterior, right and left anterior and posterior obliques, and both right and left laterals (A to H). Some physicians prefer to omit the anterior obliques; others do not include the laterals. There is general agreement that the posterior obliques are the most valuable views. When the patient is injected in the supine position, the radioactive particles are evenly distributed throughout the lungs, with a gently increasing gradient of activity from the upper anterior to the lower posterior lung fields. The cardiac and mediastinal spaces between the lungs have a configuration in the combined anterior and posterior views similar to that of the respective area in the posteroanterior CXR. Cardiomegaly and mediastinal masses will cause distortions that are common to both examinations. An enlarged cardiac space may be caused by cardiomegaly and by effusions or other conditions of the pericardial sac and adjacent pleural cavity. If the patient is rotated, the lung images may override and cause a false defect, which will disappear when the patient is repositioned accurately. However, a true lesion is unlikely if seen in only one view of a complete study. (Reproduced, with permission, from Baum S et al. Atlas of Nuclear Medicine Imaging, 2nd ed. Originally published by Appleton & Lange. Copyright © 1992 by The McGraw-Hill Companies, Inc.) A normal lung perfusion scan shows normal perfusion in six different views of the lungs.

Current Medical Diagnosis & Treatment 2024 > Pulmonary Venous Thromboembolism

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