Unusual Visualization of the Ilium in Lower-Extremity Radionuclide Venography With 99mTc MAA

Area of Science:

• Nuclear medicine
• Cardiology
• Radiology

Background:

• A 60-year-old male presented with symptoms of dilated cardiomyopathy, right-sided heart failure, and significant ascites.
• Radionuclide venography using Technetium-99m labeled macroaggregated albumin was employed to assess circulatory dynamics.

Observation:

• The venography demonstrated stagnated radiotracer within the heart chambers.
• Reduced radiotracer uptake was observed in the lungs, indicating impaired pulmonary perfusion.
• Elevated radiotracer concentrations were noted in the main renal veins and the hepatic vein.

Findings:

• An unexpected finding was the accumulation of radioactivity in the ilium on delayed imaging.
• This pattern suggests aberrant tracer distribution beyond the expected cardiovascular and major venous pathways.

Implications:

• The abnormal tracer distribution, particularly the ilium uptake, may indicate complex pathophysiological processes in advanced heart failure.
• Further investigation is warranted to understand the clinical significance of ilium radiotracer accumulation in this context.
• This case highlights the potential for radionuclide venography to reveal unexpected findings relevant to systemic circulatory dysfunction.