Resolution of Pulmonary Cement Embolism After Treatment of Rivaroxaban on Ventilation/Perfusion SPECT Image

Abstract

A 73-year-old woman took a chest radiography for medical check-up, and pulmonary cement embolism was diagnosed. She had undergone percutaneous vertebroplasty. Ventilation-perfusion imaging revealed V/Q mismatched perfusion defect on the lung. Then, she has taken rivaroxaban (orally active direct factor Xa inhibitor) for 6 months and took follow-up V/Q scan. It revealed the disappearance of previous 2 of 3 moderate V/Q mismatches. There are controversies in the role of anticoagulation in treatment of pulmonary cement embolism, and this case shows functional recovery through the perfusion scan after anticoagulation treatment.