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KMID : 1148920160500030266
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Nuclear Medicine and Molecular Imaging
2016 Volume.50 No. 3 p.266 ~ p.269
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Vertebral Uptake of Tc-99m Macroaggregated Albumin (MAA) with SPECT/CT Occurring in Superior Vena Cava Obstruction
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Karls Shawn
Hassoun Hani
Derbekyan Vilma
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Abstract
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A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus. SPECT/CT differentiated residual esophageal/tracheal ventilation activity, a clinically insignificant finding, from vertebral uptake indicative of SVC obstruction, a potentially life-threatening condition.
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KEYWORD
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Tc-99m-MAA, Nuclear medicine, SPECT, Pulmonary embolism, Superior vena cava obstruction, Collateral circulation
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