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Respiratory System

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Synopsis of Pathophysiology in Nuclear Medicine
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Abstract

The pulmonary system consists of the lungs, airways, pulmonary and bronchial circulation, and chest wall. The lungs consist of lobes, three in the right (upper, middle, and lower) and two in the left lung (upper and lower). Each lobe is again divided into segments and lobules (Fig. 11.1). The airway system consists of upper airways (nasopharynx and oropharynx) and lower airways (trachea, bronchi, bronchioles, and alveolar ducts) connected by the larynx (Fig. 11.2).

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References

  1. Brashers BL, Davey SS (1998) Structure and function of the pulmonary system. In: McCance KL, Huether SE (eds) Pathophysiology, the biologic basis for disease in adults and children, 3rd edn. Mosby, St Louis, pp 1101–1157

    Google Scholar 

  2. Thibodeau GA, Patton KI (1996) Anatomy and physiology, 3rd edn. Mosby, St Louis

    Google Scholar 

  3. De Nardo GL, De Nardo SJ (1984) The lungs. In: Freeman LM, Johnson PM (eds) Clinical radionuclide imaging, 3rd edn. Grune and Stratton, Orlando, pp 1051–1109

    Google Scholar 

  4. Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT, Weg JG (1991) Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 100:598–603

    Article  CAS  PubMed  Google Scholar 

  5. Frieman DG, Suyemoto J, Wessler S (1965) Frequency of pulmonary thromboembolism in man. N Engl J Med 272:1278–1280

    Article  Google Scholar 

  6. McLachlin J, Patterson JC (1961) Some basic observations on venous thrombosis and pulmonary embolism. Surg Gynecol Obstet 93:1–8

    Google Scholar 

  7. Moser KM (1990) Venous thromboembolism: state-of-the-art. Am Rev Respir Dis 141:235–249

    Article  CAS  PubMed  Google Scholar 

  8. Palevsky HI, Alavi A (1991) Noninvasive strategy for management of patients suspected of pulmonary embolism. Semin Nucl Med 21:325–331

    Article  CAS  PubMed  Google Scholar 

  9. Kamel E, Mckee T, Calcagni M, Schmidt S, Markl S, Bischof Delaloye A (2005) Occult lung infarction may induce false interpretation of F19 FDG PET in primary staging of pulmonary malignancies. Eur J Nucl Med Mol Imaging 32:641–646

    Article  PubMed  Google Scholar 

  10. Manny J, Hechtman HB (1985) Vasoactive humoral factors. In: Goldhaber SZ (ed) Pulmonary embolism and deep venous thrombosis. Saunders, Philadelphia, p 283

    Google Scholar 

  11. Dass H, Hcekscher T, Anthonisen NR (1967) Regional pulmonary gas exchange in patients with pulmonary embolism. Clin Sci 33:355–364

    Google Scholar 

  12. Smith R, Alderson PO (1987) Ventilation perfusion scintigraphy in pulmonary embolism in pulmonary nuclear medicine. In: Loken MK (ed) Pulmonary nuclear medicine. Appleton and Lange, Norwalk, pp 51–79

    Google Scholar 

  13. Wolfe MW, Skibo LK, Goldhaber SZ (1993) Pulmonary embolic disease: diagnosis, pathophysiologic aspects and treatment with thrombolytic therapy. Curr Probl Cardiol XVIII:587–633

    Google Scholar 

  14. Wiener RS, Schwartz LM, Woloshin S (2013) When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. BMJ 347:3368

    Article  Google Scholar 

  15. National Heart, Lung and Blood Institute (1970) Urokinase pulmonary embolism trial – phase I results. JAMA 214:2163–2172

    Article  Google Scholar 

  16. National Heart, Lung and Blood Institute (1974) Urokinase pulmonary embolism trial – phase II results. JAMA 229:1606–1610

    Article  Google Scholar 

  17. Klok FA, Mos IC, van Kralingen KW, Vahl JE, Huisman MV (2012) Chronic pulmonary embolism and pulmonary hypertension. Semin Respir Crit Care Med 33:199–204

    Article  PubMed  Google Scholar 

  18. Hoeper MM, Mayer E, Simonneau G, Rubin LJ (2006) Chronic thromboembolic pulmonary hypertension. Circulation 110:2011–2020

    Article  Google Scholar 

  19. Elgazzar AH, Jobalia R, Subramanian P, Ryan J, Hughes JA (1994) Multiple ventilation and perfusion (V/Q) scans in patients with and without pulmonary emboli (PE). J Nucl Med 35:239

    Google Scholar 

  20. PIOPED investigators (1990) Value of the ventilation/perfusion scan in acute pulmonary embolism: results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA 263:2753–2759

    Article  Google Scholar 

  21. Carson JL, Kelley MA, Duff A, Weg JG, Fulkerson WJ, Palevsky HI, Schwartz JS, Thompson BT, Popovich J Jr, Hobbins TE et al (1992) The clinical course of pulmonary embolism. N Engl J Med 326:1240–1245

    Article  CAS  PubMed  Google Scholar 

  22. Schober B (1980) Do pulmonary emboli lodge preferentially in prior foci? J Nucl Med 21:659–661

    CAS  PubMed  Google Scholar 

  23. Worsley DF, Palesky HI, Alavi A (1994) Ventilation-perfusion lung scanning in the evaluation of pulmonary hypertension. J Nucl Med 35:793–796

    CAS  PubMed  Google Scholar 

  24. Wazir JF, Ansari NA (2004) Pneumocystis carinii infection: update and review. Arch Pathol Lab Med 128:1023–1027

    PubMed  Google Scholar 

  25. Feldman C (2005) Pneumonia associated with HIV infection. Curr Opin Infect Dis 18:165–170

    Article  PubMed  Google Scholar 

  26. Medrano FJ, Montes-Cano M, Conde M, de la Horra C, Respaldiza N, Gasch A, Perez-Lozano MJ, Varela JM, Calderon EJ (2005) Pneumocystis jirovecii in general population. Emerg Infect Dis 11:245–250

    Article  PubMed Central  PubMed  Google Scholar 

  27. Kramer EL, Sanger JJ (1989) Detection of thoracic infections by nuclear medicine techniques in the acquired immunodeficiency syndrome. Radiol Clin North Am 27:1067–1075

    CAS  PubMed  Google Scholar 

  28. Woolfenden JM, Carrasquillo JA, Larson SM, Simmons JT, Masur H, Smith PD, Shelhamer JH, Ognibene FP (1987) Acquired immunodeficiency syndrome: Ga-67 citrate imaging. Radiology 162:383–387

    CAS  PubMed  Google Scholar 

  29. Noble PW, Homer RJ (2004) Idiopathic pulmonary fibrosis: new insights into pathogenesis. Clin Chest Med 25:749–758

    Article  PubMed  Google Scholar 

  30. Line BR, Fulmer JD, Reynolds HY, Roberts WC, Jones AE, Harris EK, Crystal RG (1978) Gallium-67 citrate scanning in the staging of idiopathic pulmonary fibrosis: correlation with physiologic and morphologic features and bronchoalveolar lavage. Am Rev Respir Dis 118:355–365

    CAS  PubMed  Google Scholar 

  31. Elgazzar AH (1997) Scintigraphic diagnosis of pulmonary embolism: unraveling the confusion seven years after PIOPED. In: Freeman LM (ed), Nucl Med Ann. Lippincott, Raven pp 69–101.

    Google Scholar 

  32. Stein PD, Athanasoulis C, Alavi A, Greenspan RH, Hales CA, Saltzman HA, Vreim CE, Terrin ML, Weg JG (1992) Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation 85:462–468

    Article  CAS  PubMed  Google Scholar 

  33. Schoepf UJ, Goldhaber SZ, Costello P (2004) Spiral computed tomography for acute pulmonary embolism. Circulation 109:2160–2167

    Article  PubMed  Google Scholar 

  34. Radan L, Mor M, Gips S, Schlang-Eisenberg D, Lurie Y, Dickstein K, Bitterman H, Ben-Haim S (2004) The added value of spiral computed tomographic angiography after lung scintigraphy for the diagnosis of pulmonary embolism. Clin Nucl Med 26:255–261

    Article  Google Scholar 

  35. Aviram G, Levy G, Fishman JE, Blank A, Graif M (2004) Pitfalls in the diagnosis of acute pulmonary embolism on spiral computed tomography. Curr Probl Diagn Radiol 33:74–84

    Article  PubMed  Google Scholar 

  36. Ranji SR, Shajania KG, Trowbridge RL, Auerbach AD (2011) Impact of reliance on CT angiography on diagnosis of palmonary embolism. A bayesiam analysis. Journal of Hospital Medicine 1:81–87

    Google Scholar 

  37. Perrier A, Nendaz MR, Sarasin FP, Howarth NM, Bounameaux H (2003) Cost effectiveness analysis of diagnostic strategies for suspected pulmonary embolism including helical computed tomography. Am J Respir Crit Care Med 167:39–44

    Article  PubMed  Google Scholar 

  38. Kanne JP, Lalani TA (2004) Role of computed tomography and Magnetic resonance imaging for deep venous thrombosis and pulmonary embolism. Circulation 109(1):115–121, Supplement

    Google Scholar 

  39. Mitchell AM, Kline JA (2007) Contrast nephropathy following computed tomography angiography of the chest for pulmonary embolism in the emergency department. J Thromb Haemost 5:50–54

    Article  CAS  PubMed  Google Scholar 

  40. Smith-Bindman R, Lipson J, Marcus R et al (2009) Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 169:2078–2086

    Article  PubMed  Google Scholar 

  41. Altes TA, Mai VM, Munger TM, Brookeman JR, Hagspiel KD (2005) Pulmonary embolism: comprehensive evaluation with MR ventilation and perfusion scanning with hyperpolarized helium-3, arterial spin tagging, and contrast-enhanced MRA. J Vasc Interv Radiol 16:999–1005

    Article  PubMed  Google Scholar 

  42. Mudge CS, Healey TT, Atalay MK, Pezzullo JA (2013) Feasibility of detecting pulmonary embolism using noncontrast MRI. Radiology 2013:1–5

    Google Scholar 

  43. Biello DR, Mattar AG, McKnight RC, Siegel BA (1979) Ventilation-perfusion studies in suspected pulmonary embolism. AJR Am J Roentgenol 103:1033–1037

    Article  Google Scholar 

  44. Hull RD, Hirsh J, Carter CJ, Jay RM, Dodd PE, Ockelford PA, Coates G, Gill GJ, Turpie AG, Doyle DJ, Buller HR, Raskob GE (1983) Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 98:891–899

    Article  CAS  PubMed  Google Scholar 

  45. Onyedika C, Glaser JE, Freeman LM (2010) Pulmonary embolism: role of ventilation-perfusion scintigraphy. Semin Nucl Med 2:82–87

    Google Scholar 

  46. Freeman LM, Glaser JE, Haramati LB (2012) Planar V/Q imaging for pulmonary embolism: the case for “outcomes” medicine. Semin Nucl Med 42(1):3–10

    Article  PubMed  Google Scholar 

  47. Burns SK, Haramati LB (2012) Diagnostic imaging and risk stratification of patients with acute pulmonary embolism. Cardiol Rev 20:15–24

    Google Scholar 

  48. Stein PD, Coleman ER, Gottscalk A, Saltzman H, Terrin ML, Weg JG (1991) Diagnostic utility of ventilation/perfusion lung scans in acute pulmonary embolism is not diminished by pre-existing cardiac or pulmonary disease. Chest 100:604–606

    Article  CAS  PubMed  Google Scholar 

  49. Harris B, Bailey D, Miles S, Bailey E, Rogers K, Roach P, Thomas P, Hensley M, King GG (2007) Objective analysis of tomographic ventilation–perfusion scintigraphy in pulmonary embolism. Am J Respir Crit Care Med 175:1173–1180

    Article  PubMed  Google Scholar 

  50. Bajc M, Neilly JB, Miniati M, Schuemichen C, Meignan M, Jonson B (2009) EANM guidelines for ventilation/perfusion scintigraphy. Part 1. Pulmonary imaging with ventilation/perfusion single photon emission tomography. Eur J Nucl Med Mol Imaging 36:1056–1070

    Article  Google Scholar 

  51. Glaser JE, Chamarthy M, Haramati LB, Esses D, Freeman LM (2011) Successful and safe implementation of a trinary interpretation and reporting strategy for V/Q lung scintigraphy. J Nucl Med 52:1508–1512

    Article  PubMed  Google Scholar 

  52. Sostman HD, Pistolesi M (2011) Scintigraphy for pulmonary embolism: too old to rock ‘n’ roll, too young to die? Nucl Med 52:11A–12A

    Article  Google Scholar 

  53. Bhargavan M, Sunshine JH, Lewis RS, Jha S, Owen JB, Vializ J (2010) Frequency of use of imaging tests in the diagnosis of pulmonary embolism: effects of physician specialty, patient characteristics, and region. AJR Am J Roentgenol 194:1018–1026

    Article  PubMed  Google Scholar 

  54. The Task Force for the Diagnosis and Management (2008) Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2008(29):2276–2315

    Google Scholar 

  55. Baughman RP (2004) Pulmonary sarcoidosis. Clin Chest Med 25:521–530

    Article  PubMed  Google Scholar 

  56. Mandel J, Weinberger SE (2001) Clinical insights and basic science correlates in sarcoidosis. Am J Med Sci 321:99–107

    Article  CAS  PubMed  Google Scholar 

  57. Gupta RG, Beckerman C, Silcian L et al (1982) Gallium citrate scanning and serum angiotensin converting enzyme levels in sarcoidosis. Radiology 144:895–899

    CAS  PubMed  Google Scholar 

  58. Prabhakar HB, Rabinowitz CB, Gibbons FK, O’Donnell WJ, Shepard JAO, Aquino SL (2008) Imaging features of sarcoidosis on MDCT, FDG PET, and PET/CT. AJR Am J Roentgenol 190:s1–s6

    Article  PubMed  Google Scholar 

  59. Elgazzar AH, Silberstien EB, Hughes J (1995) Perfusion and ventilation scans in patients with diffuse obstructive airway disease: utility of single breath (wash in) xenon-103. J Nucl Med 36:64–67

    CAS  PubMed  Google Scholar 

  60. Tümkaya E, Büyükdereli G (2013) The role of F-18- FDG PET and PET/CT in lung cancer. Arch Med Rev J 22:470–485

    Google Scholar 

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Elgazzar, A.H. (2014). Respiratory System. In: Synopsis of Pathophysiology in Nuclear Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-03458-4_11

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  • DOI: https://doi.org/10.1007/978-3-319-03458-4_11

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