Systemic Artery to Pulmonary Artery Shunt Mimicking Acute Pulmonary Embolism, Unmasked by a Multimodality Imaging Approach Article Swipe

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Medicine Pulmonary embolism Pulmonary artery Radiology Shunt (medical) Perfusion Angiography Artery Pulmonary angiography Right pulmonary artery Perfusion scanning Cardiology Internal medicine

Brieg Dissaux , Pierre-Yves Le Floch , Romain Le Pennec , Cécile Tromeur , Pierre‐Yves Le Roux ·

YOU? · · 2022 · Open Access · · DOI: https://doi.org/10.3390/tomography8010014 · OA: W4205664912

In this report, we describe the functional imaging findings of systemic artery to pulmonary artery shunt in V/Q SPECT CT imaging. A 63-year-old man with small-cell lung cancer underwent CT pulmonary angiography (CTPA) for suspected acute pulmonary embolism (PE). The CTPA showed an isolated segmental filling defect in the right lower lobe, which was initially interpreted as positive for PE but was actually the consequence of a systemic artery to pulmonary artery shunt due to the recruitment of the bronchial arterial network by the adjacent tumor. A V/Q SPECT/CT scan was also performed, demonstrating a matched perfusion/ventilation defect in the right lower lobe.