摘要:

A 51-year-old man with a malignant melanoma in his left forearm was studied to detect the sentinel lymph node and to assess the possibility of micrometastases in regional lymph nodes. Lymphoscintigraphy demonstrated two sentinel lymph nodes in the midarm. Two other nodes in the same location as well as in the left axilla were also observed. The exact location of the sentinel lymph nodes was identified with a gamma-ray detector. At the time of surgery, blue dye was injected around the primary lesion and the two sentinel lymph nodes on the inner side of the left arm were resected. Both lymph nodes were pigmented black. The histopathologic study demonstrated metastases from malignant melanoma in both nodes. This case reflects the main role of lymphoscintigraphy in identifying draining lymph nodes in unusual locations as observed in this patient.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Two patients with subacute cerebral infarction underwent benzodiazepine receptor imaging using I-123-iomazenil and cerebral perfusion imaging with Tc-99m HMPAO and Tc-99m ECD. Iomazenil early images resembled HMPAO images, which demonstrated increased uptake in a part of the infarcted site. Iomazenil delayed images and ECD images showed reduced accumulation in the same area. Crossed cerebellar diaschisis was observed in HMPAO, ECD, and iomazenil early images, but it was not remarkable in iomazenil delayed images. These cases suggest that sequential iomazenil images visualized increased uptake with relatively impaired viability in the infarcted site and hypoperfusion with preserved viability in the contralateral cerebellar hemisphere, which could not be recognized without using both HMPAO and ECD in the subacute phase of cerebral infarction.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Purpose:Cholelithiasis is a common disorder occurring in over 20 million people in the United States and resulting in approximately 600,000 cholecystectomies annually. Although over 95% of biliary tract disease is caused by gallstones, the vast majority (>80%) of cholelithiasis cases are asymptomatic. The purpose of this study is to evaluate the utility of quantitative cholescintigraphy in detecting symptomatic biliary tract disease and predicting clinical relief after cholecystectomy.Materials and Methods:Fifty-two patients with clinical symptoms of chronic cholecystitis were evaluated by cholescintigraphy with a gallbladder ejection fraction calculated after the intravenous administration of cholecystokinin. A gallbladder ejection fraction of ≥35% was considered a normal physiologic response. Forty-one of the patients subsequently underwent cholecystectomy, whereas the remaining 11 subjects were diagnosed and treated for non-biliary disorders that did not require cholecystectomies. After clinical follow-up including histopathological gallbladder findings, all subjects' final diagnoses were established and correlated with their quantitative cholescintigram study.Results:Twenty-six of twenty-eight patients who had an abnormal quantitative cholescintigram demonstrated evidence of chronic cholecystitis by histopathologic criteria after cholecystectomy. Furthermore, 27 of these 28 patients (96%) experienced complete relief of their clinical symptoms after surgery.Conclusion:Functional cholescintigraphy is a safe, accurate, and useful test for detecting symptomatic gallbladder disease, and appears reliable in predicting symptomatic relief after cholecystectomy.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Tc-99m MIBI imaging has been used in nuclear oncology, but its role in detecting lymphomas has not been widely investigated. In this study, 31 patients with lymphomas (20 non-Hodgkin's and 11 Hodgkin's) underwent Tc-99m MIBI whole-body imaging. A total of 74 tumor lesions were detected in 25 patients, while the remaining 6 patients were disease-free. The diagnostic accuracy of MIBI imaging for lesion detection was 85%. A total of 11 unknown tumor lesions in 3 patients were discovered on MIBI scans. Tumor size was significantly (p= 0.01) higher in lesions with increased MIBI uptake (3.5 ± 2.0 cm) compared with those with no uptake (1.8 ± 1.0 cm). No false positive MIBI findings were observed. The accuracy of MIBI scintigraphy in patients with Hodgkin's disease was lower (72%) compared to that of patients with non-Hodgkin's lymphomas (94%). However, this difference was not related to tumor type, but to lesion size. In fact, tumor size was significantly (p= 0.02) lower in lesions of patients with Hodgkin's disease (2.5 ± 1.3 cm) compared to those of patients with non-Hodgkin's lymphomas (3.7 ± 2.2 cm). MIBI imaging may be useful in patients with lymphomas for detecting tumor lesions and, hence, may be considered an alternative to gallium scanning, providing better imaging quality. However, the intense Sestamibi activity in the lower chest and abdomen as well as tumor size may limit the diagnostic sensitivity of this radionuclide technique in patients with lymphomas.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Hyperparathyroidism (HPT) is one of the most prevalent endocrine diseases, for which the only effective treatment is surgery. The use of imaging techniques in the preoperative localization of the hyperfunctioning glands is the subject of controversy. The purpose of this paper is to assess the use of double-phase scintigraphy with Tc-99m sestamibi in the localization of lesions causing HPT.We used scintigraphy to preoperatively examine 41 patients, 31 of whom had primary HPT and 10 with secondary HPT. We acquired two anterior view planar images of the neck and chest 10 minutes and 3 hours after injection of Tc-99m sestamibi.Final diagnosis, determined with biopsy, was adenoma in 26 patients, 24 of whom had a positive scintigraphic study (sensitivity 92%), with only two false negative results. In the 14 cases of parathyroid hyperplasia, scintigraphy was also positive, and 62% (30/48) of the excised glands were identified by Tc-99m sestamibi. The radioisotope study was of particular interest in the six patients who previously had undergone surgery, since all the studies were positive; in two patients, additional diseased glands were located in the neck, and an ectopic adenoma was found in the remaining four patients. A fifth ectopic lesion was also sestamibi-positive and, in this case, the scintigraphic result was a direct indication for mediastinal surgery. There were no false positive results, even in patients with multinodular goiter.We conclude that, due to its high sensitivity and the ease with which it is performed, double-phase scintigraphy with Tc-99m sestamibi is the preferred technique for the preoperative localization of diseased glands in patients with HPT, especially in cases of parathyroid adenoma, including those with aberrant location. Its use is of particular interest in patients who previously have undergone surgery.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Somatostatin receptor imaging with In-111 pentetreotide has been validated for the diagnosis and staging of chest tumors with neuroendocrine differentiation such as bronchial carcinoid and small cell lung cancer. In-111 pentetreotide uptake is not specific for neuroendocrine tumors because somatostatin receptors are also expressed by white blood cells, leading to the in vivo visualization sites of infection sites or active inflammation. Pleural plaques may be due to asbestos exposure or tuberculosis. Presented here are three cases of In-111 pentetreotide uptake in pleural plaques. This uptake by benign lesions may be misleading in the diagnostic work-up of patients with lung tumors.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Purpose:Alcoholic foamy degeneration (AFD) is a liver disease causing temporary hepatocyte dysfunction. The prognosis is usually good, but liver biopsy is needed for diagnosis. We report the usefulness of liver-spleen scintigraphy with the radiocolloid Tc-99m phytate for the diagnosis of AFD.Patients and Methods:We used liver scintigraphy with Tc-99m phytate to study three patients with AFD diagnosed on the basis of findings from a liver biopsy.Results:Liver-spleen scintigraphy showed hepatomegaly and splenomegaly, and bone marrow was visible, but radioisotope uptake by the liver was uniform.Conclusions:This pattern of scintigraphic findings is different from that reported for patients with alcoholic fatty livers or severe alcoholic hepatitis, and seems to be specific for AFD.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Tc-99m tetrofosmin SPECT imaging of the head and neck was performed on 10 patients with nasopharyngeal carcinoma (NPC) and 10 controls. There was no abnormal nasopharyngeal uptake of tetrofosmin in the 10 controls. In the patients with NPC, 3/10 (30%) of the cases had no abnormal uptake and 7/10 (70%) had increased nasopharyngeal uptake. Considering our preliminary study, we find that Tc-99m tetrofosmin SPECT of the head and neck may be helpful in the detection of NPC. However, further study with a larger number of patients is needed to ascertain the value of Tc-99m tetrofosmin SPECT in such cases.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The purpose of this atlas is to present a review of the literature showing the advantages of SPECT brain perfusion imaging (BPI) in mild or moderate traumatic brain injury (TBI) over other morphologic imaging modalities such as x-ray CT or MRI. The authors also present the technical recommendations for SPECT brain perfusion currently practiced at their center. For the radiopharmaceutical of choice, a comparison between early and delayed images using Tc-99m HMPAO and Tc-99m ECD showed that Tc-99m HMPAO is more stable in the brain with no washout over time. Therefore, the authors feel that Tc-99m HMPAO is preferable to Tc-99m ECD. Recommendations regarding standardizing intravenous injection, the acquisition, processing parameters, and interpretation of scans using a ten grade color scale, and use of the cerebellum as the reference organ are presented.SPECT images of 228 patients (age range, 11 to 88; mean, 40.8 years) with mild or moderate TBI and no significant medical history that interfered with the results of the SPECT BP were reviewed. The etiology of the trauma was in the following order of frequency: motor vehicle accidents (45%) followed by blow to the head (36%) and a fall (19%). Frequency of the symptoms was headache (60.9%), memory problems (27.6%), dizziness (26.7%), and sleep disorders (8.7%). Comparison between patients imaged early (<3 months) versus those imaged delayed (>3 months) from the time of the accident, showed that early imaging detected more lesions (4.2 abnormal lesions per study compared to 2.7 in those imaged more than 3 months after the accident). Of 41 patients who had mild traumatic injury without loss of consciousness and had normal CT, 28 studies were abnormal. Focal areas of hypoperfusion were seen in 77% (176 patients, 612 lesions) of the group of 228 patients. The sites of abnormalities were in the following order: basal ganglia and thalami, 55.2%, frontal lobes, 23.8%, temporal lobes, 13%, parietal, 3.7%, insular and occipital lobes together, 4.6%.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A 52-year-old man with dilated cardiomyopathy, congestive heart failure, and a history of cardiovascular events, underwent a liver scan with Tc-99m-albumin colloid. There was diminished hepatic uptake, with a shift of activity to the spleen and bone marrow. In addition, accumulation in both kidneys was noted. Reports on renal uptake of the related compound Tc-99m-sulfur colloid were reviewed. A common mechanism of deposition may involve intravascular fibrin deposition.

ISSN:0363-9762    

出版商:OVID    

年代:1998

数据来源: OVID