67Ga SPECT/CT aids in the diagnosis of occult infected common iliac artery aneurysm

A 56-year-old woman, who had already suffered from systemic sclerosis and primary biliary cirrhosis, was presented with progressive pain at the right lower quadrant of abdomen, lower-grade fever, and leukocytosis for 4 days. Blood cultures did not yield pathogens. Abdominal ultrasonography revealed a right iliac artery aneurysm compressing the right kidney resulting in right hydronephrosis. 67Ga SPECT/CT demonstrated an intense hot area at the right common iliac artery, suggestive of an infected aneurysm. Contrast-enhanced CT showed concordant findings. This case illustrates the value of 67Ga SPECT/CT in discriminating pathologic uptake of the abdomen from physiologic activity of the bowels. Copyright ? 2013 Lippincott Williams & Wilkins.