摘要:

Differential renal blood flow and parenchymal mass were compared in 50 pairs of scintigraphic studies performed on 44 patients. Background corrected total kidney counts were determined between 1 to 2 minutes following injection of 1-123 or 1-131 orthoiodohippurate (OIH), and at 1 to 2.5 hours after injection of Tc-99m glucoheptonate (GHA). The OIH and GHA differentials agreed within 5% in 36 studies (72%). When the OIH differentials were symmetric (45% to 55% in each kidney), agreement with the GHA results was complete (17 out of 17). By comparison, 42% (14 out of 33) of studies with asymmetric OIH differentials had a >5% disparity from the GHA split function. Serum creatinine was elevated at the time of 9 out of 14 studies (64%) with OIH/GHA disagreement and 18 out of 36 studies (50%) with OIH/GHA agreement. Of the 14 studies with disparate OIH/GHA differentials, the GHA differential was more symmetric in 10 (71%). When different scinitigraphic measures of differential renal flow and parenchymal mass disagree, this is most likely due to the effects of asymmetric renal impairment rather than to those of global renal dysfunction.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The efficacies of two scintigraphic and two sonographic techniques and resultant index values, as markers of renal allograft pathology, were assessed. Index values of 183 combined scintigraphic and sonographic examinations in 47 graft recipients were compared to the pathological diagnosis of transplant biopsies and subsequent clinical outcome. All recipients were studied with baseline imaging techniques postoperatively, again when indicated by predefined clinical criteria, and prior to graft biopsy. The scintigraphic technique involved the calculation of indices of thrombotic activity and cortical graft perfusion. Ultrasound involved determination of the Doppler resistance index of Pourcelot and estimations of graft volume from real time images. A decreased cortical perfusion index was, overall, the most sensitive index of acute or chronic graft pathology, but it lacked specificity. Increased thrombotic and resistance indices were 96% and 86% sensitive for acute vascular rejection and were 82% and 76% specific. Jointly increased thrombotic and resistance indices improved the specificity for acute vascular rejection to 98%. An increase in graft volume of more than 50% over stable values was 100% sensitive and 92% specific for acute interstitial rejection, and 95% specific when paired with a normal thrombotic index. A marked increase in the thrombotic index was 100% sensitive for cyclosporine-induced thrombotic microangiopathy, but only 49% specific. The specificity of a markedly increased thrombotic index for thrombotic microangiopathy improved to 93% when the Doppler resistance index remained normal or was only marginally elevated. None of the scintigraphic or ultrasound indices were helpful for the diagnosis of acute tubular necrosis, chronic rejection, recurrent glomerulopathy, or graft infection.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Radionuclide renal studies with quantitative measurements in patients confined to intensive care units usually require the use of a 10-inch field-of-view mobile gamma camera and a diverging collimator to image both kidneys simultaneously. The patient must frequently be in the lateral decubitus position so imaging can be performed in the posterior projection. Due to spatial distortion caused by the diverging collimator, variations in detector angulation and kidney depth produce different detection efficiencies for each kidney. Counts in regions of interest over the kidneys were compared as a function of detector angulation and patient position (prone and lateral decubitus). Substantial variations were observed comparing the diverging collimator data to 15-inch field-of view parallel hole acquisitions. Significant variation can also be obtained with parallel hole collimators when the patient's position is changed.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The utility of morphine-augmented cholescintigraphy was reviewed in 32 patients with suspected acute cholecystitis. All patients were administered 2 mg morphine sulfate intravenously when the gallbladder failed to visualize 30 minutes into the study, and imaging continued for up to 60 minutes. Sensitivity for detection of acute cholecystitis was 93% (13 out of 14). Specificity was 78% (14 out of 18). Three of four false-positives occurred in the setting of prolonged fasting and chronic cholecystitis. Cumulative experience suggests that the technique is diagnostically equivalent to imaging for up to 4 hours and that specificity remains incomplete in the setting of prolonged fasting, chronic cholecystitis and other conditions known to affect conventional cholescintigraphy.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

We present a patient with exercise induced right ventricular ischemia demonstrated on stress TI-201 myocardial scintiscan. The patient underwent cardiac catheterization, and subtotal occlusion was found at the proximal right coronary artery. Repeat stress TI-201 scan became normal following the successful percutaneous transluminal coronary angioplasty.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The hypoplastic left heart syndrome, which characteristically presents in the first few hours of life with cardiovascular collapse, is treated by reconstructive surgery (Norwood's procedure) beginning in the neonatal period. If untreated, more than 95% of infants with this malformation die within the first month of life. The case described involves the development of increasing cyanosis 7 weeks following bilateral superior vena caval-pulmonary artery (SVC-PA) anastomosis in an infant born with a hypoplastic left heart (including aortic and mitral valve stenosis) and an anatomic variant of bilateral superior vena cavae. The use of Tc-99m MAA proved efficacious in quantitating the differential perfusion to each lung, establishing the site of a postoperative stenosis in an anastomotic channel, and documenting systemic perfusion, thus confirming the right-to-left shunt from the superior vena cava to the systemic circulation that resulted in increasing cyanosis.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Catecholamine-induced cardiomyopathy associated with pheochromocytoma is a well-recognized but rare entity. Both hypertrophic and dilated variants have been described. We report a case of dilated cardiomyopathy associated with a benign pheochromocytoma that showed complete normalization of left ventricular systolic function following removal of the tumor. Serum noradrenaline and dopamine were significantly elevated without elevation in serum adrenaline levels. This may be the first report in which radionuclide ventriculography was used to document the time course of normalization in LVEF following removal of a pheochromocytoma.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

After an intravenous infusion of dipyridamole(0.56 mg/kg), we performed both echocardiography and thallium scintigraphy in 63 patients who were referred for known or suspected coronary artery disease. Of those patients, 25 returned for coronary arteriography within 1 month after the tests, thus forming the study group for this report. Sensitivity for detection of coronary artery disease, when analyzed region-by-region, was 80% for thallium scintigraphy and 57% for echocardiography, whereas specificity was 85% and 98%, respectively. When evaluating individual patients for the presence or absence of ischemia, we found a sensitivity of 95% for scintigraphy and 58% for echocardiography; corresponding specificities were 50% and 100%. By using arteriography as the gold standard for comparison, it appears that thallium scintigraphy has a significantly higher sensitivity but lower specificity for the detection of coronary artery disease than does echocardiography. Echocardiography may, however, be a useful adjunct to thallium scintigraphy in the evaluation of patients with coronary artery disease.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

An unusual distribution of Tc-99m MDP and Ga-67 citrate in several muscle groups is described in a 14-year-old boy with aplastic anemia and normal renal function at the time of imaging. Although the patient did not develop musculo-skeletal signs or symptoms, a subsequent autopsy revealed widespread muscle calcification.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

To evaluate the value of TI-201 thyroid imaging in differentiating benign from malignant thyroid nodules, 58 patients with histologically proven thyroid masses were studied. The nature of the thyroid tumor was initially assessed by Tc-99m scans. Early and delayed TI-201 thyroid imaging were performed in all patients, and thallium uptake and clearance in the cold nodules were assessed visually. Of the 20 patients with histologically proven malignant nodules, 19 showed increased TI-201 activity in both the early and delayed images, indicating a sensitivity of 95%. On the other hand, 35 out of the 38 patients with benign nodules showed no increased thallium activity in the nodules on the delayed images, indicating a specificity of 92%. When early thallium images were analyzed separately, the sensitivity was 100% but the specificity was only 37%. By combining early and delayed TI-201 images, differentiation between benign and malignant cold nodules is feasible. False-positive and false-negative cases will be discussed.

ISSN:0363-9762    

出版商:OVID    

年代:1991

数据来源: OVID