Nucl Med Mol Imaging.  2016 Sep;50(3):266-269. 10.1007/s13139-015-0372-y.

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

• Karls S
• Hassoun H
• Derbekyan

• KMID: 2351653
• DOI: http://doi.org/10.1007/s13139-015-0372-y

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.

Keyword

Tc-99m-MAA; Nuclear medicine; SPECT; Pulmonary embolism; Superior vena cava obstruction; Collateral circulation

MeSH Terms

Aged
Collateral Circulation
Dyspnea
Embolism
Humans
Lung
Male
Nuclear Medicine
Perfusion
Phlebography
Pulmonary Embolism
Radionuclide Imaging
Superior Vena Cava Syndrome*
Technetium Tc 99m Aggregated Albumin
Thoracic Vertebrae
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
Vena Cava, Superior*
Ventilation
Technetium Tc 99m Aggregated Albumin