Abstract
Lung perfusion imaging with Tc-99m MAA was performed in a patient thought to have pulmonary embolism. The dynamic flow images obtained before static lung perfusion imaging showed delayed drainage of the tracer into the right brachiocephalic vein and superior vena cava, and unusual demonstration of the right lateral thoracic and intercostal veins as collateral pathways. It was thought that coughing at the time of bolus injection of the tracer into a right antecubital vein caused an increase of intrathoracic pressure and consequently disturbed the venous return to the thorax.
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