99mTc-MAA-Anreicherung in der Leber bei cavo-portalem Shunt über eine rekanalisierte Vena umbilicalis

An unusual phenomenon during lung scintigraphy is presented. Besides visualization of the lungs, accumulation of Tc-99m macroaggregated albumin (MAA) was seen in a small part of the liver and in and around several thoracic vertebrae. Contrast-enhanced radiographic computed tomography revealed extensive collateral pathways, which were caused by a partially obstructed superior vena cava. Shunting of systemic venous blood flow through chest wall veins to the portal system was responsible for accumulation of MAA in the liver. Retrograde blood flow through dilated thoracic vertebral veins resulted in visualization of the bone marrow.

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Periumbilical Uptake of Tc-99m MAA on Lung Perfusion Scanning in a Patient With Superior Vena Cava Obstruction

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Nabers²

2006

Clinical Nuclear Medicine

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A 25-year-old woman with severe parenchymal lung disease of unknown etiology and existing for more than a decade was referred for ventilation-perfusion scintigraphy because of suspicion of pulmonary embolism. Both ventilation and perfusion images showed, apart from perfusion defects from her severe lung disease, a left apical pneumothorax and signs of recurrent pneumonia of the left lower lobe. Noteworthy was the periumbilical uptake of the Tc-99m macroaggregated albumin (MAA). Her medical history revealed iatrogenic superior vena cava (SVC) obstruction. In this case, the main collateral pathway of portosystemic shunting is probably, after recanalization of the left umbilical vein, a network of smaller paraumbilical veins.

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99mTc-MAA-Anreicherung in der Leber bei cavo-portalem Shunt über eine rekanalisierte Vena umbilicalis

Cited by 3 publications

References 10 publications

Global Hepatic Uptake of 99mTc-MAA During VQ Scintigraphy Secondary to Synchronous Superior and Inferior Vena Caval Obstruction: a Demonstration of Trans-Portal Venous Collateral Pathways

Global Hepatic Uptake of 99mTc-MAA During VQ Scintigraphy Secondary to Synchronous Superior and Inferior Vena Caval Obstruction: a Demonstration of Trans-Portal Venous Collateral Pathways

Liver and Vertebral Uptake of Tc-99m Macroaggregated Albumin (MAA)

Periumbilical Uptake of Tc-99m MAA on Lung Perfusion Scanning in a Patient With Superior Vena Cava Obstruction

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