An Unusual Presentation of Abdominal Aortic Aneurysm on Static Renal Tc-99m DMSA Scintigraphy

Raman, Venkatesh K.; Kapse, N; Karugaba, Robin; Sharp, D G; Stirling, S; Hall, Michael R.; Clarke, Sem

doi:10.1097/01.rlu.0000259336.06347.16

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…Extrarenal accumulation of 99m Tc-DMSA is an uncommon finding, and there are a few reports regarding abnormal uptake such as bone metastasis, infantile hemangioma, splenic amyloidosis, renal pelvic diverticulum, and abdominal aortic aneurysm. [2][3][4][5][6][7] In an in vitro study, blood clot uptake of DMSA was explained as partially nonspecific and partially mechanical trapping. 8 There is only 1 study reporting 2 cases of abnormal focal 99m Tc-DMSA uptake in the lung without structural alteration.…”

Section: Figurementioning

confidence: 99%

Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT

Nursal

Reyhan²,

Yapar³

2015

Clinical Nuclear Medicine

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Section: Figurementioning

confidence: 99%

Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT

Nursal

Reyhan²,

Yapar³

2015

Clinical Nuclear Medicine

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“…Two hours after intravenous injection, more than 50% of the injected 99mTc-DMSA is found mainly in the renal cortex, whereas there is only minimal background activity [7]. Extrarenal localization of 99mTc-DMSA is a rare finding and there are just some limited reports about abnormal uptake in splenic amyloidosis, bone metastases, renal pelvic diverticulum, infantile hemangioma and abdominal aortic aneurysm [2,3,5,6,8,9]. This finding has been attributed to the presence of free 99mTc, high percentage of pentavalent DMSA (V-DMSA), hypervascularity of the lesions and high blood pool activity.…”

Section: Case Reportmentioning

confidence: 99%

“…Renal scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) is one modality used to distinguish pyelonephritis (APN) and renal parenchymal scars [1]. Extrarenal uptake of 99mTc-DMSA is a rare finding, which has been described in some unusual conditions as bone metastasis, aortic aneurysm and hemangioma [2][3][4][5][6]. The purpose of this report is to present two cases of an abnormal 99mTc-DMSA uptake in the lung, which remained unexplained even after radiologic assessment.…”

Section: Introductionmentioning

confidence: 99%

Abnormal focal 99mTc-DMSA uptake in the lung — report of two cases

Pirayesh

Amoui²,

Asl³

et al. 2014

Nucl. Med. Rev.

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“…Duplex Ultrasonography is the most common modality to detect AA and CT angiography is the fi rst choice of imaging studies to defi ne the diameter of the aorta and suspected renal artery involvement in a patient with AA [4]. The scintigraphic fi rst pass (blood fl ow) or blood pool studies may show unusual abdominal or thoracic features suggestive of aneurysm as an incidental fi nding [5][6][7][8][9]. Detecting aortic aneurysm with Tc-99m MAG3 renal scintigraphy is not at all common and has been previously reported in literature in only one diagnosed case [5].…”

Section: Figurementioning

confidence: 99%

An incidental detection of aortic aneurysm on Tc-99m MAG3 renal scintigraphy

Sadic

Demirel²,

Koca³

et al. 2013

Nucl. Med. Rev.

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A 71-year-old man with newly diagnosed hypertension was Figure 1Tc-99m MAG3 renal scintigraphic images. Camera parameters: posterior position, 15% window centered at 140 keV using 64 × 64 matrix. Acquisition was started with bolus injection of 185 MBq (5 mCi) Tc-99m MAG3 and dynamic imaging was performed at 2 seconds/frame for 16 frames and then 2 minutes/frame for 19 frames. Dynamic vascular phase imaging of renal fl ow scintigraphy with Tc-99m MAG3 demonstrated abnormal radiotracer accumulation that was suspicious for abdominal AA and decreased left renal blood fl ow (A, B, black arrows). The entire 40-minute dynamic posterior imaging demonstrated diminished extraction and excretion functions in the left kidney (B). According to these images, CT angiography was performed to confi rm the suspected AA and to delineate the relationship of the aneurysm to the renal arteries.Abdominal aortic aneurysm, defi ned as a permanent dilatation of the abdominal aorta to a size 50% greater than the normal segment, is thought to be a degenerative change of alteration in elastin and collagen and enzymatic degradation in the aortic wall [1, 2]. Increased age, smoking, male sex and family history are the major risk factors for developing AA [3,4]. Duplex Ultrasonography is the most common modality to detect AA and CT angiography is the fi rst choice of imaging studies to defi ne the diameter of the aorta and suspected renal artery involvement in a patient with AA [4]. The scintigraphic fi rst pass (blood fl ow) or blood pool studies may show unusual abdominal or thoracic features suggestive of aneurysm as an incidental fi nding [5][6][7][8][9]. Figure 2CT angiography examination of thoracoabdominal aorta. A. Three dimensional reconstruction image demonstrating fusiform aneurysmatic dilatation beginning from the ascending aorta extending to the iliac bifurcation, including the abdominal aorta; B. Sagittal view of AA; C. narrowed left renal artery (white arrow); D. Normal right renal artery (white arrow). Figure 3Corresponding contrast-enhanced computed tomography (CT) examination of the thoracoabdomen demonstrating a 69 × 64 mm measured aortic aneurysm (A, upper arrowheads) with kyphoscoliosis, normal pelvicalyceal system and asymmetry in renal size with a smaller left kidney (A, left arrow) and normal right kidney (A, right arrow). CT transaxial scans at the renal level showed a large abdominal AA with a lumen of 48 × 35 mm with a mural thrombus (B, C, arrowheads).Detecting aortic aneurysm with Tc-99m MAG3 renal scintigraphy is not at all common and has been previously reported in literature in only one diagnosed case [5]. To the best of our knowledge, the case reported here is the fi rst presentation of incidental aortic aneurysm detected with Tc-99m MAG3 which started from the ascending aorta and extended to the iliac bifurcation. The CT angiography fi ndings (aortic aneurysm and mural thrombus) disclosed the renal scintigraphic features of suspected AA and decreased cortical

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An Unusual Presentation of Abdominal Aortic Aneurysm on Static Renal Tc-99m DMSA Scintigraphy

Cited by 4 publications

References 3 publications

Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT

Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT

Abnormal focal 99mTc-DMSA uptake in the lung — report of two cases

An incidental detection of aortic aneurysm on Tc-99m MAG3 renal scintigraphy

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