Extensive Aortitis with Stanford Type B Intramural Hematoma and Renal Arteritis: A Nuclear Medicine Perspective on Infectious versus Inflammatory Aortitis

Authors

DOI:

https://doi.org/10.59667/sjoranm.v34i2.14

Keywords:

18F-FDG PET/CT, aortitis, Stanford type B intramural hematoma, giant cell arteritis, infectious aortitis, syphilis

Abstract

Aortitis associated with a Stanford type B intramural hematoma and aortic wall ulcerations requires prompt assessment because both inflammatory and infectious etiologies may produce overlapping imaging findings. We report a 78-year-old woman with poorly controlled hypertension who presented with pulsatile abdominal pain, dyspnea, and vomiting. Marked inflammatory activity was present. 18F-FDG PET/CT demonstrated intense large-vessel uptake, and subsequent CT angiography demonstrated post-isthmic descending aortitis with a Stanford type B intramural hematoma, aortic wall ulcerations, and right renal artery involvement. Treponemal serology was reactive, whereas RPR/VDRL was nonreactive, raising concern for a possible infectious contribution without establishing syphilitic aortitis. The patient subsequently deteriorated, required intensive care, and died shortly thereafter. This case illustrates that inflammatory and infectious aortitis may show overlapping patterns of vascular FDG uptake.

Author Biography

  • Amal Guensi, Centre Hospitalier Universitaire Ibn Rochd

    Head of Department of Nuclear Medicine Department , Faculty of Medicine and Pharmacy

References

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Published

2026-09-25

Data Availability Statement

All data relevant to this case report are contained within the article. No separate research dataset was generated.

Issue

Vol. 34 No. 2 (2026)

Section

Case reports

License

Copyright (c) 2026 Mohammed Amine Biyi, Zakaria Ouassafrar, Amal Guensi

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

This license requires that reusers give credit to the creator. It allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, even for commercial purposes.

How to Cite

Biyi, M. A., Ouassafrar, Z., & Guensi, A. (2026). Extensive Aortitis with Stanford Type B Intramural Hematoma and Renal Arteritis: A Nuclear Medicine Perspective on Infectious versus Inflammatory Aortitis. Swiss Journal of Radiology and Nuclear Medicine, 34(2), 1-5. https://doi.org/10.59667/sjoranm.v34i2.14

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