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Nuclear Medicine and Molecular Imaging
Published in: Nuclear Medicine and Molecular Imaging 3/2016

01-09-2016 | Interesting Image

Vertebral Uptake of Tc-99m Macroaggregated Albumin (MAA) with SPECT/CT Occurring in Superior Vena Cava Obstruction

Authors: Shawn Karls, Hani Hassoun, Vilma Derbekyan

Published in: Nuclear Medicine and Molecular Imaging | Issue 3/2016

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Abstract

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.
Literature
1.
Brant WE, Helms C. Fundamentals of Diagnostic Radiology—4 Volume Set, Lippincott Williams & Wilkins, 2012, pp 1263–1279.
2.
Lasjaunias P, Berenstein A, ter Brugge K. Clinical Vascular Anatomy and Variations, Springer Science & Business Media, 2013, pp 159.
3.
Kapur S, Paik E, Rezaei A, Vu DN. Where there is blood, there is a way: unusual collateral vessels in superior and inferior vena cava obstruction. Radiographics. 2010;30:67–78.CrossRefPubMed
4.
Conway O, Lloyd S, Gruning T. Global hepatic uptake of (99m)Tc-MAA during VQ scintigraphy secondary to synchronous superior and inferior vena caval obstruction: a demonstration of trans-portal venous collateral pathways. Nucl Med Mol Imaging. 2013;47:291–3.CrossRefPubMedPubMedCentral
5.
Gale B, Chen C, Chun KJ, Lan J, Cynamon J, Freeman LM. Systemic to pulmonary venous shunting in superior vena cava obstruction. Unusual myocardial and thyroid visualization. Clin Nucl Med. 1990;15:246–50.CrossRefPubMed
6.
Kume N, Suga K, Uchisako H, Matsui M, Shimizu K, Matsunaga N. Abnormal extrapulmonary accumulation of 99mTc-MAA during lung perfusion scanning. Ann Nucl Med. 1995;9:179–84.CrossRefPubMed
7.
Marcus CS, Parker LS, Rose JG, Cullison RC, Grady PJ. Uptake of Tc-99m MAA by the liver during a thromboscintigram/lung scan. J Nucl Med. 1983;24:36–8.PubMed
8.
Yamada T, Takahashi K, Shuke N, Katada R, Mineta M, Nagasawa K, et al. Focal hepatic "hot spot" in superior vena cava obstruction: correlation between radiocolloid hepatic SPECT and contrast-enhanced CT. Clin Nucl Med. 1999;24:533–4.CrossRefPubMed
9.
Esser JP, Oei HY, de Bruin HG, Krenning EP. Liver and vertebral uptake of Tc-99m macroaggregated albumin (MAA). Clin Nucl Med. 2004;29:793–4.CrossRefPubMed
10.
Meristoudis G, Ilia I, Tsaroucha A, Giannakopoulos V, Christakopoulou J. Liver and vertebral visualization on lung perfusion scan. Rev Esp Med Nucl. 2008;27:369.CrossRefPubMed
11.
Rager O, Nkoulou R, Garibotto V, Boudabbous S, Arditi D. Spinal uptake mimicking metastasis in SPECT/CT bone scan in a patient with superior vena cava obstruction. Clin Nucl Med. 2013;38:908–9.CrossRefPubMed
12.
Kim YK, Sung YM, Hwang KH, Cho EK, Choi HY. Pseudopathologic vertebral body enhancement in the presence of superior vena cava obstruction on computed tomography. Spine J 2013.
Metadata
Title
Vertebral Uptake of Tc-99m Macroaggregated Albumin (MAA) with SPECT/CT Occurring in Superior Vena Cava Obstruction
Authors
Shawn Karls
Hani Hassoun
Vilma Derbekyan
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 3/2016
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-015-0372-y

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