Correct!
4. Any of the above

The enlarged peripheral pulmonary vessels can be associated with conditions that produce right-to-left pulmonary shunting, and such shunting could explain the patient’s complaints. Measuring the shunt fraction using the 100% oxygen method, 99mTc-MAA scanning, and an echocardiographic bubble study are all methods that could be used to detect the presence of intrapulmonary right-to-left shunting.

The patient underwent 99mTc-MAA scanning (Figure 4).

Figure 4. 99mTc-Macro aggregated albumin scintigraphy.

Which of the following best describes the results of this examination?

1. Homogeneous lung perfusion indicates that the study is low probability for pulmonary embolism
2. The study is normal
3. Inhomogeneous lung perfusion suggests the possibility of pulmonary hypertension
4. The study shows systemic tracer embolization
5. 1 and 4
6. 3 and 4

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