A ventilation/perfusion lung scan, also called a V/Q lung scan, is a type of medical

imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within a
patient's lungs,[1] in order to determine the ventilation/perfusion ratio. The ventilation part of the test
looks at the ability of air to reach all parts of the lungs, while the perfusion part evaluates how well
blood circulates within the lungs. As Q in physiology is the letter used to describe bloodflow the term
V/Q scan emerged.

Uses

This test is most commonly done in order to check for the presence of a blood clot or abnormal
blood flow inside the lungs (such as a pulmonary embolism or PE), although computed
tomography with radiocontrast is now more commonly used for this purpose.

Significance of results

V/Q Scan Interpretation

Result Interpretation Significance

Excludes pulmonary
Normal No perfusion deficit
thromboembolism

Perfusion deficit with matched ventilation

Low probability < 20% probability of PE
deficit

Intermediate Perfusion deficit that corresponds to

20% - 80% probability of PE
probability parenchymal abnormality on chest x-ray

Multiple segmental perfusion deficits with

High probability > 80% probability of PE
normal ventilation

Decreased uptake of the inhaled radioisotope may indicate an impaired ability to breathe, airway
obstruction, or possible pneumonia.

Decreased circulation of the injected MAA indicates a problem with blood flow into or within the
lungs. A localized area of decreased uptake, usually in a wedge shaped (or pie shaped)
configuration with normal ventilation images (mismatched defect) suggests a pulmonary embolus or
blood clot in the lungs, which leads to reduced perfusion.
Risks[edit]

Although this test uses radioactive materials, the total amount of radiation exposure is low. In order
to decrease the radiation exposure in pregnant patients, the total radioactive dose may be
decreased or the ventilation phase omitted. Computed tomography with radiocontrast can
alternatively be performed, although this can result in a greater radiation dose to the patient. [4] It has
been suggested that breastfeeding should be discontinued for 24 hours following use of
radiocontrast, however this is no longer considered necessary as such a limited quantity of
radiocontrast gets excreted into breastmilk.[5]

In respiratory physiology, the ventilation/perfusion ratio (VV/ QVratio or V/Q ratio) is a ratio used to
assess the efficiency and adequacy of the matching of two variables:[1]

VVor V ventilation the air that reaches the alveoli

QVor Q perfusion the blood that reaches the alveoli via the capillaries
The V/Q ratio can therefore be defined as the ratio of the amount of air reaching the alveoli per
minute to the amount of blood reaching the alveoli per minutea ratio of volumetric flow rates.
These two variables, V & Q, constitute the main determinants of the blood oxygen (O 2) and carbon
dioxide (CO2) concentration.
The V/Q ratio can be measured with a ventilation/perfusion scan.
A V/Q mismatch can cause a type 1 respiratory failure.

Ventilation[edit]
Gravity and lungs weight act on ventilation by increasing pleural pressure at the base (making it less
negative) and thus reducing the alveolar volume. The lowest part of the lung in relation to gravity is
called the dependent region.

Perfusion[edit]
The impact of gravity on pulmonary perfusion expresses itself as the hydrostatic pressure of the
blood passing through the branches of the pulmonary artery in order to reach the apical and basal
district of the lung, acting respectively against or synergistically with the pressure developed by the
right ventricle.

apex of lung higher

base of lung lower