1. Vertebral Uptake of Tc-99m Macroaggregated Albumin (MAA) with SPECT/CT Occurring in Superior Vena Cava Obstruction
- Author
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Shawn Karls, Hani Hassoun, and Vilma Derbekyan
- Subjects
medicine.medical_specialty ,Lung ,medicine.diagnostic_test ,business.industry ,Venography ,medicine.disease ,Collateral circulation ,Scintigraphy ,030218 nuclear medicine & medical imaging ,Pulmonary embolism ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Superior vena cava ,Thoracic vertebrae ,medicine ,Radiology, Nuclear Medicine and imaging ,Interesting Image ,Radiology ,business ,Perfusion ,030217 neurology & neurosurgery - 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.
- Published
- 2015