Author/Authors :
Mohammadzadeh Kosari, Hadis Nuclear Medicine Research Center - Mashhad University of Medical Sciences, Iran , Masoudifard, Alireza Nuclear Medicine Research Center - Mashhad University of Medical Sciences, Iran , Zakavi, Rasoul Nuclear Medicine Research Center - Mashhad University of Medical Sciences, Iran , Asl Zare, Mohammad Department Urology - Ghaem Hospital - Mashhad University of Medical Sciences, Iran , Soltani, Salman Department Urology - Imam Reza Hospital - Mashhad University of Medical Sciences, Iran , Akhavan Rezayat, Alireza Department Urology - Ghaem Hospital - Mashhad University of Medical Sciences, Iran , Aghaee, Atena Nuclear Medicine Research Center - Mashhad University of Medical Sciences, Iran
Abstract :
A 68-year-old male, known case of abdominal aortic dissection and recent aortic stent insertion, presented with gross
hematuria. The urologists suspected aoro-ureteric fistula and performed open surgery (ureterolysis). Tc-99m labeled red blood
cell (99mTc-RBC) scintigraphy was ordered to confirm the diagnosis and localize the possible aorto-ureteric fisula, Considering
sustained gross hematuria and ongoing anemia, and the fact that the patient had some degrees of renal insufficiency
consequently not a candidate for contrast Computed Tomography (CT) angiography, a 99mTc-RBC blood pool study was
requested instead. The dynamic planar images showed a zone of abnormal radiotracer accumulation in the left side of the aorta,
which remained till the end of study. SPECT images revealed a left aorto-ureteric fistula approximately 8cm above the aortic
bifurcation.
Keywords :
RBC scintigraphy , Aorto-ureteric fistula , Aortic dissection , Gross hematuria , SPECT
