Unexpected Vertebral Bodies Trapping of 99mTc-Macroaggregated Albumin During Lung Perfusion Scintigraphy in a Patient With Collateral Paravertebral Venous System

A 35-year-old woman was referred to our nuclear medicine center for a ventilation and perfusion (VQ) pulmonary scintigraphy to detect pulmonary embolism. She was treated with low-molecular-weight heparin following a proximal venous thrombosis of the right upper limb and had a previous history of an infiltrating ductal carcinoma of the right breast. Surprisingly, the VQ scintigraphy showed uptake of Tc-99m-MAA in several superior vertebrae. A contrast-enhanced CT scan revealed a dilated collateral paravertebral venous system due to the deep vein thrombosis extended from superior vena cava to brachiocephalic trunk. Tc-99m-MAA was trapped through the dilated vertebral venous system.

Automated summary

A 35-year-old woman underwent a VQ pulmonary scintigraphy for suspected pulmonary embolism, but unexpectedly showed uptake of Tc-99m-MAA in several superior vertebrae. CT scan revealed a dilated collateral paravertebral venous system due to deep vein thrombosis, where Tc-99m-MAA was trapped.