摘要:

PurposeSingle photon emission computed tomography (SPECT) bone scans of the lumbar spine were evaluated in the management of patients with low back pain and suspected spondylolysis.Materials and MethodsThirty-three patients (mean age, 30 years) with high clinical suspicion of pars interarticularis defects were included in the study. The results of lumbar radiographs and SPECT bone scintigraphy were compared and the influence of these results on patient management was evaluated.ResultsTwenty-six of the 33 patients had abnormal results of lumbar radiographs. Of the 21 patients with radiographs indicating spondylolysis, six had abnormal uptake in the pars regions on bone scintigraphy. One patient with normal results of lumbar radiographs had a SPECT bone scan showing uptake in the region of the pars interarticularis.ConclusionsSPECT bone scanning of the lumbar spine has a role in the treatment of patients with symptomatic spondylolysis.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

PurposeTo investigate the feasibility of using a dual-energy X-ray absorphometry (DEXA) scan to predict long-term force-transmission patterns in wrists.Material andMethodsBoth wrists of a man with morbid Kienböck stage IIIa disease of his left wrist (avascular necrosis of the lunate) were examined by a DEXA scan to determine the differences in bone density in the distal radius.ResultsIn the distal radius of the injured wrist, a shift in bone density was seen toward the scaphoid fossa, which resembles the shift in force-transmission pattern described in force-transmission studies of the wrist.ConclusionsThese differences can be interpreted as a result of an altered force-transmission pattern in the injured wrist.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

PurposeWhole-body fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scanning has been useful in the management of breast cancer. However, F-18 FDG uptake sometimes has been associated with benign breast disease. Four cases are reported of F-18 FDG breast uptake caused by infectious or inflammatory mastitis that mimics malignant disease.Methods and ResultsTwo women had F-18 FDG whole-body scans for the evaluation of a large breast mass after inconlusive results of ultrasonography. In both cases, intense focal F-18 FDG breast uptake was noted that mimicked breast cancer. Histologic examination showed, in one patient, chronic granulomatous infiltration that likely represented tuberculous mastitis, because she showed a good clinical response to empirical anti-tuberculous treatment. The second patient had lactational changes associated with acute inflammation, and the culture grewStaphylococcus aureus. The breast mass completely disappeared 3 weeks after a course of antibiotic treatment. The other two patients had staging F-18 FDG PET scans 1 and 12 months after lumpectomy for breast carcinoma to detect residual, recurrent, or metastatic disease. Both scans showed a ring-like uptake in the involved breast, with superimposed intense focal uptake suggesting tumor necrosis centrally and malignant foci peripherally. In both cases, histologic examination revealed hemorrhagic inflammation secondary to postsurgical hematomas and no evidence of malignancy.ConclusionAcute or chronic infectious mastitis and postsurgical hemorrhagic inflammatory mastitis should be considered in patients who have a breast mass, especially those with a history of tenderness or surgery.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A case of chest wall recurrence of breast cancer detected by scintimammography is presented. A 63-year-old woman who had a right mastectomy for breast carcinoma 24 years earlier was evaluated for left axillary adenopathy. Although it was suspected that a second primary malignancy had developed in the left breast, results of mammography and magnetic resonance imaging of that breast were negative. Scintimammography performed with Tc-99m sestamibi confirmed a normal left breast but revealed a lesion in the right chest wall at the site of the previous mastectomy. This was surgically confirmed as recurrent breast carcinoma, which subsequently altered patient management.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

A 5-year-old girl with biliary atresia and a subsequent Kasai procedure is described. She had clinical symptoms suggestive of rejection after a recent orthotopic liver transplant. A hepatobiliary scan showed partial hepatic infarction and a biloma in the infarcted area.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

PurposeMyocardial perfusion and functional information during the same study is now feasible. A new assessment of regional ejection fraction at rest and peak exercise by first-pass radionuclide angiography using a “normal” database file has been developed.ObjectiveThis study was performed to assess the relation between this new method of quantitative regional ejection fraction and myocardial perfusion abnormalities and to compare this new technique with visual analysis of regional wall motion.MethodsConsecutive patients (n = 126) with simultaneous first-pass radionuclide angiography and perfusion SPECT imaging were studied at rest and peak exercise using a same-day protocol. The area under the receiver-operator characteristic curve (C index) was used to assess the concordance probability between perfusion and functional measurements, and logistic regression models were used to examine the ability of functional variables to predict perfusion results.ResultsA high concordance was found between the visual analysis of wall motion and perfusion abnormalities (C index = 0.796), and also between regional ejection fraction and perfusion defects (C index = 0.784). The maximal predictive power of functional variables was obtained by combining wall motion analysis and regional ejection fraction (C index = 0.859). Regional ejection fraction contributed, with 20% more information than provided by wall motion analysis alone (&khgr;2= 9.2,P= 0.0025).ConclusionsQuantitative regional ejection fraction using a normal database file has a strong relation to perfusion abnormalities and provides incremental information to regional wall motion analysis for predicting perfusion abnormalities. This new technique should be regarded as a potential adjunct to functional studies to evaluate patients with ischemic heart disease.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

PurposePancreatic islet cell tumors are potentially malignant tumors and are often difficult to detect with current imaging modalities. Positron emission tomography (PET) using fluorine-18–labeled fluorodeoxyglucose (FDG) is an imaging technique with high sensitivity for malignant tumors. The aim of this study was to assess the feasibility of FDG PET to detect pancreatic islet cell tumors.MethodsNineteen lesions of histologically proved islet cell tumors were evaluated in 12 patients (5 men, 7 women; ages 22 to 77 years). FDG uptake was analyzed semiquantitatively as a standardized uptake value. The diagnostic accuracy of PET was compared with that of US, CT, and MRI.ResultsOf 19 lesions, 8 showed positive PET results (standardized uptake value > 2.3), and localization was indicated in 2 lesions. In nine tumors that were not detected by PET, seven were small tumors ranging from 1.5 to 8 mm in diameter and were not identified by other imaging methods. The sensitivity rate of PET was 53%, whereas those of US, CT, and MRI were 53%, 50%, and 53%, respectively.ConclusionOur data suggest that FDG PET has a limitation in that it does not detect some small-sized islet cell tumors, mainly depending on their size, but it has potential utility as a complementary modality for other imaging techniques.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Glucagonomas, like other neuroendocrine tumors, express somatostatin receptors in more than 80% of cases. Unfortunately, because of the rarity of these tumors, the sensitivity and specificity of somatostatin analog (octreotide) imaging have not been established. Nonetheless, there have been limited reports in the literature supporting the use of indium In-111 DTPA N-terminal D-phenylalanine (D-PHE1) octreotide for glucogonoma imaging and may be most beneficial as an adjuvant to conventional imaging for tumor staging and therapeutic decision making. Current therapeutic applications of octreotide focus on stabilization of disease in tumors expressing somatostatin receptors, and tumor destruction, using &bgr;-emitting isotopes. In this report, imaging of a glucagonoma with In-111 DTPA-D-PHE1 octreotide scintigraphy is described in a 51-year-old woman examined for a large palpable abdominal mass.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Bowel transit in two women with protracted constipation was evaluated after oral administration of In-111 DTPA in water. Serial abdominal images were obtained for as long as 96 hours to assess transit through the stomach, small bowel, and colon. In both patients, large bowel transit was delayed. A pattern of colonic inertia was observed in one patient, whereas retention in the distal colon was seen in the other patient. Both patients underwent total colectomy with marked symptomatic relief. Colonic transit studies of these patients are presented, and the literature is reviewed.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

PurposeThis was a radioisotope study of nasal mucociliary clearance of total and subtotal nasal obstruction.MethodsRhinoscintigraphy was performed by insufflating 1.85 MBq (69 mCi) Tc-99m MAA in 20 patients. Six cases were regarded as the control group, because the presence of small spurs does not affect nasal patency. The remaining 14 patients had various rhinopathic conditions. Two regions of interest were selected, one in the nasal cavity and one in the pharynx. Mucociliary transport speed was calculated.ResultsThis parameter appeared to be a sensitive index for the assessment of the degree of mucociliary alteration. It showed that polyposis impairs mucociliary transport most severely, thus confirming the results of other published studies.ConclusionsRhinoscintigraphy proved to be a reliable, easily reproducible, and harmless method, so it may be used for follow-up examinations in patients who have had surgery of the nose and paranasal sinuses, and for drug therapy of rhinopathic conditions.

ISSN:0363-9762    

出版商:OVID    

年代:2000

数据来源: OVID