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COPD (Chronic Obstructive Pulmonary Disease)

VQ scan and emphysema

05/02/2008

Question:

When I started being short of breath last year I was sent from my hospital to another hospital for a vq scan, this was due to a history of blood clots in our family because of an inhereted blood disorder. I was allowed to return straight back to the other hospital because thankfully it was not one. The specialist said I could go home but come back for a pft at a later date, it was at the pft or at least due to the results from the pft I was told I had emphysema. My question is, well one half is, would the radiographer have picked up the emphysema on the vq scan i.e. the holes it makes and have reported it on the results sheet or would he only have reported what he was asked to look for,i.e. the pulmonary embolism . The other part of my question is that I also suffer from achalasia and had a dilation a number of years ago, which needs to be re done as it is playing up quite a bit. I have noticed that when this is active my breathing seems to get worse. Would this have had any effect on my pft, cos I was thinking of asking for another done when my achalasia was less active. Surely achalasia wouldnt have any effect on the results of the emphysema diagnosis as regards the TLCO SB of 47% and air trapping maybe on the FEV1 and FVC What are your thoughts? thankyou so much for your time and anticipation of an answer

Answer:

The radiologist interpreting your VQ scan could very well have been focused on whether or not you had a blood clot. Emphysema can cause an abnormal VQ scan, but the findings are non-specific; a diagnosis of emphysema cannot be made on the VQ scan. Your achalasia could also have impacted your PFT's, depending on how active it was at the time of your tests. It is possible the achalasia could have contributed to constriction of your bronchiole tubes, which could affect the FEV1 as well as air-trapping.

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Response by:

Mahasti   Rittinger, RRT Mahasti Rittinger, RRT
Clinical Program Manager of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University

Phillip T Diaz, MD Phillip T Diaz, MD
Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University