Measurement of the Vital Capacity and Perfusion of Each Lung by Fluoroscopy and Macroaggregated Albumin Lung Scanning

Abstract

Measurement of the ventilation and perfusion of each lung may be important in the preop-erative evaluation of a patient with reduced pulmonary function facing resection of all or a portion of 1 lung. If the pulmonary tissue to be resected represents a significant amount of the functioning parenchyma, surgery might produce pulmonary insufficiency. Clinical fluoroscopy and 13lj MAA [Macroaggregated albumin] lung scan were used to estimate the ventilation and persusion of each lung. The results of these 2 methods were compared with ventilation and perfusion data obtained from bronchospirometry performed on the same patients. The percentage of pulmonary perfusion to each lung measured by MAA lung scan showed a mean difference of 4% from O2 uptake measured by bronchospirometry with a standard deviation of 4%. In 18 patients the vital capacity of each lung (an index of ventilation) was measured by bronchospirometry and estimated by fluoroscopy. The mean difference between the 2 methods was 8% of the total vital capacity with a standard deviation of 8%. The use of functional fluoroscopy combined with 131I MAA lung scan offers a practical alternative to the technique of bronchospirometry. The equipment required is available in most hospitals and hence could easily be part of a routine preoperative evaluation.