Document Type: Case Report
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Urology Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Urology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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.