Hanyu Taketo, Nishihori Masahiro, Izumi Takashi, Motomura Kazuya, Ohka Fumiharu, Goto Shunsaku, Araki Yoshio, Yokoyama Kinya, Uda Kenji, Saito Ryuta
Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Nagoya, Aichi, Japan.
NMC Case Rep J. 2022 Sep 15;9:289-294. doi: 10.2176/jns-nmc.2022-0055. eCollection 2022.
In this article, we report a case wherein a brain tumor was suspected based on computed tomography and magnetic resonance imaging findings. We made an initial diagnosis of malignant brain tumor based on methionine-positron emission tomography (PET) findings, but the correct diagnosis was dural arteriovenous fistula (DAVF). The patient was a 45-year-old man with DAVF who developed headache. Methionine-PET imaging showed high methionine uptake in the lesion. Although the tumor was strongly suspected from the findings of methionine-PET, the diagnosis of DAVF could be made correctly only by interpreting digital subtraction angiography and computed tomographic angiography. The findings of methionine-PET, which is considered useful in the diagnosis and denial of brain tumors, made the diagnosis of DAVF more difficult. The increased uptake of methionine-PET in DAVF is an important finding because, to our knowledge, this study is the first to report such finding. The results of this study might be useful for differential diagnoses when the diagnosis is uncertain.
在本文中，我们报告了一例基于计算机断层扫描和磁共振成像结果怀疑为脑肿瘤的病例。基于蛋氨酸正电子发射断层扫描（PET）结果，我们初步诊断为恶性脑肿瘤，但正确诊断为硬脑膜动静脉瘘（DAVF）。该患者为一名45岁患有DAVF的男性，出现了头痛症状。蛋氨酸PET成像显示病变部位蛋氨酸摄取增高。尽管从蛋氨酸PET结果强烈怀疑为肿瘤，但仅通过解读数字减影血管造影和计算机断层血管造影才能正确诊断为DAVF。被认为对脑肿瘤诊断和排除有用的蛋氨酸PET结果，使DAVF的诊断更加困难。DAVF中蛋氨酸PET摄取增加是一个重要发现，因为据我们所知，本研究是首个报告该发现的研究。当诊断不确定时，本研究结果可能对鉴别诊断有用。
