Stripe Sign on V/Q Scan

The stripe sign is a band of normally perfused lung interposed between a perfusion defect and adjacent pleural surface. In the absence of other perfusion defects, it indicates a low probability for pulmonary embolism. In cases of an otherwise intermediate or low-probability V/Q scans, the stripe sign can move the diagnosis to a lower probability.

If the patient has an otherwise high-probability V/Q scan, the presence of a stripe sign does not change the diagnosis and may indicate the reperfusion of an embolic segment.

The stripe sign is most commonly seen in patients with emphysema. The stripe sign may be mimicked by shine-through of normally perfused tissue adjacent to a wedge-shaped perfusion defect in cases when only limited numbers of perfusion images are obtained. Increasing the number of projections or acquiring SPECT images may be helpful in such cases.

References

Ergün EL, Volkan B, Caner B. Stripe sign in pulmonary embolism: a review of the causes. Ann Nucl Med. 2003 Apr;17(2):145-8.