| Japanese |
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| Title | 核医学検査が病態把握に有用であった下大静脈・尿管通過障害をきたした炎症性腹部大動脈瘤の1例 |
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| Subtitle | 症例報告 |
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| Authors | 広瀬義晃*, 林田孝平*, 石田良雄*, 濱田星紀*, 高橋延和*, 高宮誠*, 安藤太三**, 西村恒彦*** |
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| Authors(kana) | |
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| Organization | *国立循環器病センター放射線診療部, **外科, ***大阪大学医学部トレーサ情報解析 |
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| Journal | 核医学 |
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| Volume | 31 |
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| Number | 9 |
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| Page | 1107-1111 |
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| Year/Month | 1994/9 |
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| Article | 報告 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」症例は48歳男性. 1年前に呼吸困難を訴え, 僧帽弁逆流, 解離性大動脈瘤と診断され, 僧帽弁形成術, 上行・弓部大動脈置換術が施行された. この時, 炎症性腹部大動脈瘤(IAAA)の併存が発見されたが, 経過観察となった. 今回, 腰痛, 発熱が出現し, IAAAの増悪が疑われ入院となった. 腹部造影CTでは腎下部に径5.5cmの大動脈瘤があり, その周囲には, enhanceされる厚い瘤壁が認められた. 99mTc-MAAによる腹部ベノグラムでは, 下大静脈が閉塞し, 側副血行路が明瞭に描出された. 123I-OIHによるレノグラムでは, 右腎は無機能型, 左腎は機能低下型であった. 67Gaシンチグラムでは, IAAAに一致する部位に淡い集積が疑われた. 人工血管置換術が施行され, 術中所見で, 大動脈瘤周囲の線維組織が下大静脈, 両側尿管, 十二指腸, 空腸と強く癒着していた. 術後, 腎機能は改善傾向にあり, 炎症の進行も認められていない. 本症の診断にはX線CTが有用であるが, 下大静脈閉塞の診断と側副血行路の描出, 分腎機能の評価に核医学検査が有用であった. |
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| Practice | 臨床医学：一般 |
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| Keywords | Inflammatory aortic aneurysm, Inferior vena cava obstruction, Ureteral obstruction, Radionuclide studies. |
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| English |
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| Title | A Case of Inflammatory Abdominal Aortic Aneurysm with Associated Inferior Vena Caval and Bilateral Ureteral Obstruction |
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| Authors | Yoshiaki HIROSE*, Kohei HAYASHIDA*, Yoshio ISHIDA*, Seiki HAMADA*, Nobukazu TAKAHASHI*, Makoto TAKAMIYA*, Motomi ANDO**, Tsunehiko NISHIMURA*** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, **Department of Surgery, National Cardiovascular Center, ***Department of Tracer Data Analysis, Biomedical Research Center, Osaka University Medical School |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 31 |
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| Number | 9 |
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| Page | 1107-1111 |
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| Year/Month | 1994/9 |
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| Article | Report |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] One year ago, a 48-year-old man complained of dyspnea, and was diagnosed as mitral valve regurgitation and aortic dissection. He underwent mitral valve replacement and aortic arch grafting. He was also pointed out to have an inflammatory aortic aneurysm (IAAA) in the infrarenal abdominal aorta, but did not undergo surgery. At this admission, he had lumbago and low grade fever probably due to deterioration of the IAAA. On the preoperative radionuclide studies, inferior vena caval obstruction and bilateral ureteral obstruction or severe stenosis were demonstrated by 99mTc-MAA venography and 123I-OIH renogram, respectively. 67Ga scan showed faint abnormal accumulation at the IAAA. He underwent surgery. IAAA had a thick wall in white and hard fibrotic tissue adhered closely to duodenum, jejunum, inferior vena cava and bilateral ureters. After surgery, his renal function was improved. In this case, radionuclide studies were useful for detecting the inferior vena caval obstruction, assessing renal function and inflammatory activity. |
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| Practice | Clinical medicine |
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| Keywords | Inflammatory aortic aneurysm, Inferior vena cava obstruction, Ureteral obstruction, Radionuclide studies. |
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