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Case Reports
. 2021 Aug 25;16(11):3157-3161.
doi: 10.1016/j.radcr.2021.07.076. eCollection 2021 Nov.

Common hepatic artery aneurysm detected by 18F-FDG PET/CT Imaging

Janata F  1 , Fezoulidis N  1 , Barachini O  1 , Mirzaei S  2 , Hergan K  3 , Zandieh S  1   3
Affiliations
Case Reports

Common hepatic artery aneurysm detected by 18F-FDG PET/CT Imaging

Janata F et al. Radiol Case Rep. .

Abstract

Hepatic artery aneurysm (HAA) is a rare, yet clinically important, condition. While the causes of HAA are poorly understood, it is estimated that mortality following spontaneous rupture is as high as 40%. We discuss the case of a 77-year-old man who presented to our hospital due to a 10 mm pulmonary lesion in the left lower lung lobe, which was identified by a computed tomography scan of the lung at another institution. An examination with 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in our department, but no significant uptake of 18F-fluorodeoxyglucose was found in the lung, and HAA was diagnosed only incidentally. A magnetic resonance imaging angiography supported the differential diagnosis of HAA, and the aneurysm was confirmed by targeted angiography. It was located in the common hepatic artery and was coiled during an intervention session. HAA accounts for 20% of all visceral aneurysms and, with a poorly understood natural history, is difficult to diagnose clinically, but early detection and treatment of HAA can improve prognosis.

Keywords: 18F-FDG PET/CT; CT, computed tomography; FDG, 18F-fluorodeoxyglucose; HAA, hepatic artery aneurysm; Hepatic artery aneurysm; MRI; MRI, magnetic resonance imaging; PET, positron emission tomography.

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Figures

Fig 1
Fig. 1
The 18F-FDG PET/CT images showed a 3.5 cm mass adjacent to the pancreas, which exhibited partial, marginal, and mild 18F-FDG uptake. The unenhanced scan showed a large, hypodense, and well-demarcated mass with marginal calcified walls.
Fig 2
Fig. 2
After intravenous administration of a 50-60 ml bolus of contrast medium, marked enhancement of the lesion was noted along the course of the hepatic artery.
Fig 3
Fig. 3
CT-reconstructed images showed the presence of a mass arising from the hepatic artery in the extrahepatic region. The arrow in the maximum intensity projection image shows the aneurysm.
Fig 4
Fig. 4
Contrast-enhanced MRI was also conducted. Dynamic contrast-enhanced MRI angiography was performed as an additional vascular imaging method for preoperative evaluation of the HAA. In the contrast-enhanced MRI image, clear enhancement of the mass, which was isointense to the arteries and had contact with the common hepatic artery, was observed in the arterial dynamic phase. In the T2 weighting, the mass showed a hypointense signal.
Fig 5
Fig. 5
The aneurysm was confirmed by targeted angiography. The angiography image showed that the aneurysm was located in the common hepatic artery.
Fig 6
Fig. 6
The aneurysm was coiled during the intervention session.
See this image and copyright information in PMC

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