Interesting image
Appearance of thoracic aortic aneurysm on myocardial perfusion imaging
Aspecto de aneurisma de la aorta torácica en un estudio de perfusión miocárdica
Department of Nuclear Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey
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Caudal to the anterior and in a paravertebral localization, a nodule of 2.4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2.2<span class="elsevierStyleHsp" style=""></span>cm and a SUVmax of 15.7 may be observed. Right pleural effusion. In the abdominal region retroperitoneal accumulation was identified (arrow). No contrast is shown in the ureter in the CT image since the image was acquired in a phase adequate for the study of abdominal organs.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. González-Roiz, M. García-García-Esquinas, A. Prieto-Soriano, G. Salazar-Andía, M.N. Cabrera-Martín, J.L. Carreras-Delgado" "autores" => array:6 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "González-Roiz" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "García-García-Esquinas" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Prieto-Soriano" ] 3 => array:2 [ "nombre" => "G." 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No other active lesions suggestive of pathology were observed in the remainder of the study.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.M. Mena, A.C. Hernández, M. Gallego, T. Martínez, J.F. Contreras" "autores" => array:5 [ 0 => array:2 [ "nombre" => "L.M." "apellidos" => "Mena" ] 1 => array:2 [ "nombre" => "A.C." "apellidos" => "Hernández" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Gallego" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Martínez" ] 4 => array:2 [ "nombre" => "J.F." "apellidos" => "Contreras" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X12000923" "doi" => "10.1016/j.remn.2012.03.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X12000923?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808913000037?idApp=UINPBA00004N" "url" => "/22538089/0000003200000002/v1_201305061041/S2253808913000037/v1_201305061041/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting image</span>" "titulo" => "Appearance of thoracic aortic aneurysm on myocardial perfusion imaging" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "119" "paginaFinal" => "120" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Aydin, N. Ergul" "autores" => array:2 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Aydin" "email" => array:1 [ 0 => "m_aydin@yahoo.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "N." "apellidos" => "Ergul" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Department of Nuclear Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aspecto de aneurisma de la aorta torácica en un estudio de perfusión miocárdica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1698 "Ancho" => 2453 "Tamanyo" => 606266 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Myocardial perfusion imaging shows an irreversible hypoperfusion in the mid-ventricular portion of anteroseptal wall, and a suspicious reversible hypoperfusion in the apical slices of inferolateral wall. The review of the raw cine data demonstrates photon-deficient areas in the posterior region of the left hemithorax (arrows).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 65-year-old man with dyspnea and chest discomfort referred for dipyridamole myocardial perfusion scintigraphy. <span class="elsevierStyleSup">99m</span>Tc-sestamibi cardiac gated SPECT images showed an irreversible hypoperfusion in the mid-ventricular portion of anteroseptal wall, a suspicious reversible hypoperfusion in the apical slices of inferolateral wall, and left ventricle dilatation with a ejection fraction of 40%. In addition, a decreased radiotracer uptake was seen in the posterior region of the left hemithorax in the rotating (cine) images of the stress and rest myocardial perfusion SPECT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Also, the review of all the raw data demonstrated a photon-deficient area in the right anterior projection images. Subsequent thoracic CT demonstrated a fusiform thoracoabdominal aortic aneurysm apparently located in the regions of decreased radiotracer uptake in the cardiac scan (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A thoracic aortic aneurysm is a serious health problem because depending on its location and size, it may rupture or dissect, causing life-threatening by internal bleeding. While only half of those with thoracic aortic aneurysm complain of symptoms, possible warning signs include pain in the jaw, neck and upper back, chest or back pain, coughing, hoarseness, or difficulty in breathing. If a thoracic aortic aneurysm is suspected, chest X-ray, CT, MRI, echocardiography, and angiography demonstrate the disease.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Myocardial perfusion gated SPECT imaging is widely used to evaluate suspected or known coronary artery disease. Beside the knowledge of regional myocardial perfusion and left ventricular function and volumes, it also gives information about extracardiac diseases according to incidental findings of radiotracer distribution. In the literature, the causes of decreased extracardiac uptake in the thorax are given as follows; malfunctioning photomultiplier tubes, dilated pulmonary arteries and dilated left atrium, pacemakers, coins, defibrillators, pleural effusion and pericardial effusion.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> In short, it is recommended to review of cinematic projections in order to find extracardiac increased or decreased activities. According to our knowledge, this is the first case demonstrating decreased sestamibi uptake due to a thoracic aortic aneurysm in the literature.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-03-05" "fechaAceptado" => "2012-03-21" "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1698 "Ancho" => 2453 "Tamanyo" => 606266 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Myocardial perfusion imaging shows an irreversible hypoperfusion in the mid-ventricular portion of anteroseptal wall, and a suspicious reversible hypoperfusion in the apical slices of inferolateral wall. The review of the raw cine data demonstrates photon-deficient areas in the posterior region of the left hemithorax (arrows).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1535 "Ancho" => 2500 "Tamanyo" => 417927 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Coronal, sagittal and transaxial slices of thoracic computed tomography of the patient demonstrate a fusiform thoracoabdominal aortic aneurysm including ascending aortic, aortic arch, and descending aortic (arrows), and abdominal aortic (arrowheads) aneurysm that is apparently located in the regions of decreased radiotracer uptake in the myocardial perfusion SPECT.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and management issues in thoracic aortic aneurysm" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.M. Booher" 1 => "K.A. Eagle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ahj.2011.04.010" "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "2011" "volumen" => "162" "paginaInicial" => "38" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21742088" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unusual extracardiac findings detected on myocardial perfusion single photon emission computed tomography studies with Tc-99m sestamibi" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.K. Gedik" 1 => "E.L. Ergün" 2 => "M. Aslan" 3 => "B. Caner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0b013e318159661b" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2007" "volumen" => "32" "paginaInicial" => "920" "paginaFinal" => "926" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18030041" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unusual incidental findings by SPECT myocardial perfusion imaging and CT in the same patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Bhambhvani" 1 => "E. Dubovsky" 2 => "H. Nath" 3 => "J. Heo" 4 => "A. Iskandrian" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12350-010-9219-1" "Revista" => array:6 [ "tituloSerie" => "J Nucl Cardiol" "fecha" => "2010" "volumen" => "17" "paginaInicial" => "937" "paginaFinal" => "938" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20390393" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003200000002/v1_201305061041/S2253808913000219/v1_201305061041/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003200000002/v1_201305061041/S2253808913000219/v1_201305061041/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808913000219?idApp=UINPBA00004N" ]
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