Published in:
01-01-2007 | Image of the month
MIBG-SPECT/CT-angiography with 3-D reconstruction of an extra-adrenal phaeochromocytoma with dissection of an aortic aneurysm
Authors:
Klaus Strobel, C. Burger, P. Schneider, M. Weber, Thomas F. Hany
Published in:
European Journal of Nuclear Medicine and Molecular Imaging
|
Issue 1/2007
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Excerpt
Phaeochromocytomas can cause severe complications like stroke, lung oedema, myocardial infarction or aortic dissection. Ten percent of phaeochromocytomas originate in extra-adrenal localisations and can be detected with
123I-MIBG scintigraphy [
1]. We report on a 50-year-old patient with weight loss, night sweating and increased urinary noradrenaline levels. SPECT with 358 MBq
123I-MIBG and additionally a dual-phase diagnostic CT were performed, showing increased MIBG uptake para-aortally on the left side (
a,
b,
arrow) corresponding to a hypervascularised lesion visible on CT (
b,
arrow) [
2]. Additionally, in CT a thoracic aneurysm with type B aortic dissection (
a,
b,
arrowheads) was detected. For surgical planning, CT-angiography and SPECT were combined in a fused 3D rendering using the PMOD 2.75 software (see figure). The paraganglioma was resected and 1 month later the aneurysm was successfully treated with a stent graft. There are some case reports in the literature about phaeochromocytomas associated with aortic or carotid dissections [
3‐
5]. SPECT/CT-angiography with fused 3D reconstruction requires appropriate software and some postprocessing time but provides the surgeon with important functional and morphological information for adequate therapy planning.
18F-DOPA PET/CT could be another interesting tool for imaging of such patients [
6].
…