Pulmonary Scintigraphic Patterns of Empyema following Pneumonia after Completely Clinical Recovery in Pediatrics

Received 10/14/2004; revised 3/14/2005; accepted 3/17/2005. For correspondence or reprints contact: Zen-Kong Dai, M.D., Department of Pediatrics, Kaohsiung Municipal Hsiao-Kang Hospital. 483 Shan-Ming Road, Hsiao-Kang District, Kaohsiung 812, Taiwan. Tel: (886)7-3121101 ext. 7153, Fax: (886)7-3117521, E-mail: [email protected] Background: In this study, we enrolled pediatric cases with history of pneumonia, resulting in empyema and evaluated the pulmonary function based on the ventilation and perfusion scintigraphy after complete clinical recovery. Methods: During 8 years period, twelve children (5 males and 7 females, aged 2to 14-year-old with the medium of 6-year-old) presenting with unilateral empyema following pneumonia were enrolled. Standard procedures of Tc-DTPA aerosol ventilation and TcMAA perfusion scintigraphy were performed in followup. Results: The scintigraphy revealed pathophysiological presentation of ventilation-perfusion (V/Q) matched or mismatched defects in the lung after critical disease process. V/Q matched defect, corresponding with prior pneumonia patch was a typical pattern at beginning after recovery. However, V/Q mismatched defect always resulted from the progressive repaired ventilation lesion via a period of time, except certain irreversible disease process. Conclusion: We consider that the ventilation-perfusion (V-P) scan is a high sensitive method to evaluate the pathophysiology of pulmonary functional status and has a value to become a follow-up procedure after recovery from empyema following pneumonia in pediatrics.