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Hello, I have some difficult time to understand the report from VQ Scan. I have chronically narrowed pulmonary arterial branches in the upper right lobe according to cat scan chest iv few weeks. Today I took VQ Scan and have difficult time to understand the report. Here it is and hopefully someone can help me to understand it. I will have CTA for heart and then cardiac cauterization soon. 

Impression 

Single large perfusion defect without changes in aeration of the right upper lobe consistent with intermediate probability for pulmonary embolus. Given the absent pulmonary veins and hypoplastic pulmonary arterial vasculature in this region better visualized on prior CTA 01/06/2017, however, this finding can represent chronic poor perfusion by the pulmonary vasculature rather than pulmonary embolus. Because radiotracer is trapped in the lungs on first pass circulation, uptake would be diminished if this region is perfused primarily by the bronchial arteries. 

FINDINGS: 
There is a large perfusion defect involving the entire right upper lobe. There is increased right upper lobe atelectasis and interlobular septal thickening compared to 01/06/2017. Absence of the right upper lobe pulmonary veins is again noted. 

The remainder of both lungs are clear and demonstrate heterogeneous perfusion within normal limits. 

A small amount debris is noted within the midesophagus. Status post cholecystectomy. Sternotomy wires are intact.

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