摘要:

Scintigraphy using Tc-99m has been shown to be highly sensitive in localizing abnormal parathyroid glands in patients with hyperparathyroidism. False-negative studies most often are attributed to glandular size or location. The authors report a case of negative parathyroid imaging using standard dual-phase technique, which was converted to a positive study by the addition of a pinhole view. During a 1-year period, the authors systematically added an anterior-pinhole image of the neck to all equivocal or negative Tc-99m studies. Five of 19 patient studies were pinhole-image positive and standard-image negative or equivocal. In selected patients undergoing Tc-99m scintigraphy for hyperparathyroidism, the addition of a pinhole view may enhance study sensitivity and the confidence in interpretation.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

We prospectively studied 26 patients with cold thyroid nodules (five malignant and 21 benign nodules) on Tc-99m pertechnetate scintigraphy to investigate the diagnostic value of Tc-99m tetrofosmin scintigraphy and color-Doppler sonography in differentiating malignant from benign thyroid nodules. In each patient, Tc-99m Tetrofosmin uptake in the nodule and intranodule vascularity were assessed semiquantatively. Both the uptake and vascularity were classified as low, Iso or high. Eight out of 26 nodules showed high Tc-99m tetrofosmin uptake; five of them were malignant. Eight (including four malignant tumors) out of 26 nodules showed increased vascularity compared with normal thyroid tissue on color-Doppler sonography. In six out of eight patients with high uptake of Tc99m-tetrofosmin, increased vascularity was observed. The sensitivity, specificity, negative predictive value, and positive predictive value of Tc-99m tetrofosmin scintigraphy and color-Doppler sonography were determined to be 100% and 80%, 85% and 80%, 62% and 50%, and 100% and 94%, respectively. We conclude that color-Doppler sonography seems to have limited value in the detection of malignant thyroid nodules. However, Tc-99m tetrofosmin scintigraphy is a sensitive method to use in diagnosing malignant nodules, although it is not specific for the detection of malignant nodules.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Eighteen bone marrow transplanted multiple myeloma patients had imaging studies on 24 occasions with radiography as well as bone and bone marrow scintigraphy within 2 months. Twelve of the radionuclide bone marrow studies were performed with Tc-99m human serum albumin colloid and 12 were performed with a Tc-99m tagged monoclonal antigranulocyte antibody. The total detection rate of bone marrow lesions increased by 5% when the findings on bone marrow scintigraphy were combined with the findings and at radiography bone scintigraphy. For lesions in the spine and sacrum, the increase was 25% and 33% respectively, including patients with focal radiotherapy. Peripheral red bone marrow expansion was noted in 17 patients. In a comparison of Mab and Tc-99m HSA colloid imaging, Mab resulted in a higher bone marrow to soft tissue uptake and to a much smaller part of the skeleton being obscured by liver and spleen uptake. It is concluded that bone marrow imaging is valuable for showing red bone marrow distribution. It thereby shows possible sites for malignant lesions; it also shows that Mab imaging is superior to Tc-99m HSA colloid imaging in bone marrow transplanted multiple myeloma patients.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Gastric duplication cysts are uncommon congenital anomalies, and examples imaged with scintigraphy are rarely reported in the literature. The authors report an infant with duplication of the stomach, which was extensively evaluated using scintigraphy, ultrasound, computed tomography, and upper gastrointestinal series. The role of multimodality imaging is discussed, and correlative surgical and histologic findings are presented.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors report two patients without coronary artery disease who experienced asystole during the IV infusion of dipyridamole on routine Tl-201 myocardial perfusion imaging and review the literature for possible explanations of this rare side effect. Until now, this side effect was only reported in patients with coronary artery disease or beta-blocker therapy. Yet, the cases lacked both concomitant factors and autonomic dysregulation is suggested as a cause for asystole

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Based on the data by Armas et al, avascular necrosis, a not uncommon treatment-associated complication in patients with lymphoma, it should be easily distinguishable from osseous lymphomatous involvement in patients with Ga-67 avid lymphoma. In avascular necrosis, Ga-67 uptake will be either absent, decreased, or normal, whereas in lymphoma Ga-67 uptake will be increased. The authors present a patient with Hodgkin's disease who had new foci of simultaneously increased Ga-67 and Tc-99m MDP uptake because of avascular necrosis as proven by biopsy and long-term follow-up. The authors hypothesize that a possible explanation for the discrepancy between this patient report and the series by Armas et al may be that increased Ga-67 is a delayed phenomenon related to healing.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Paget's disease is occasionally found as an incidental finding on bone scans performed for the evaluation of metastatic disease, which causes a diagnostic and a subsequent therapeutic dilemma. We have previously described the “Mouse Face” appearance of vertebrae on bone scans (increased uptake in the vertebral body, posterior elements, and the spinous process), which was fairly specific for Paget's disease in a small series. This retrospective study was undertaken to determine if this observation holds true in a larger series. Bone scans performed in 2,881 patients were randomly selected, and were reviewed by 2 physicians. Thirty-nine cases with a “Mouse Face” appearance were identified. Diagnosis was established in 30 of the 39 patients by correlative radiographic studies and/or clinical follow-up. Twenty patients were referred for the evaluation of possible metastases, and 7 were found to have metastases at the sites of “Mouse Face.” The other 13 had Paget's disease. However, 6 of the 7 patients with metastases had extravertebral findings compatible with multiple metastases, and the remaining patient had a “Mouse Face” lesion only, with a question of metastases. Ten patients were evaluated for Paget's disease or others, and none of them had metastases at the site of the “Mouse Face.” The “Mouse Face” appearance is more suggestive of Paget's disease than metastases even in patients with cancer. These patients should be assumed unlikely to have vertebral metastases, unless proven by another correlative radiologic study.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The authors studied the clinical courses and immunologic aspects in 15 patients (age range, 32-69 years old; 14 women) with clinical features that were similar to subacute thyroiditis (SAT). In 2 patients (group A) whose thyrotropin-binding inhibitory immunoglobulins (TBII) and thyroid stimulating antibody (TSAb) showed strongly positive activity at the initial visit, Tc-99m pertechnetate thyroid uptake (Tc-99m uptake) was elevated (5.6% and 3.8%, respectively, normal; 0.7-3.0%). In 6 (group B) of 13 other patients, Tc-99m uptake was not completely suppressed (2 normal, 4 near normal) and imaging showed uptake in one lobe. In 7 (group C), however, there was no evidence of uptake in either lobe. Inflammatory process was localized in one lobe in all group B patients, and was in both lobes in all group C patients but one. Serum TSH levels were detectable in at least 4 patients (2 group B, 2 group C) low in all. There were no patients in both groups B and C in whom TBII and/or TSAb were detected at the initial visit.In SAT, marked suppression of Tc-99m uptake may be ascribed mainly to inflammatory follicular cell damage, but it is not always suppressed, owing to an association similar to Graves' disease and other unknown mechanism(s).

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The scintigraphic findings in a rare case of a unilateral matched ventilation perfusion defect, Swyer-James (Macleod's) syndrome, are presented. A 40-year-old man underwent ventilation/perfusion imaging for acute onset of dyspnea. The scan showed markedly diminished ventilation, vascular flow, and perfusion unilaterally on the left hemithorax. Chest radiography showed hyperlucency of the left lung. Pulmonary angiography showed left-sided hypovascularity, and the CT scan of the chest showed apical bullae and peribronchial thickening of the left lung. Ventilation/perfusion imaging and other radiologic assessment, along with the patient's medical history, confirmed the diagnosis of the Swyer-James syndrome. This condition should be considered as a differential diagnosis in a patient with unilaterally matched ventilation/perfusion deficits without an obvious etiology.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A 29-year-old right-handed female nurse presented with complex, focal epilepsy and secondary MRI generalized seizures. Magnetic resonance imaging showed symmetrical bilateral periventricular nodular heterotopia, caused by an ontogenic migration disorder. Glucose consumption of these aberrant gray-matter structures measured using PET with F-18 (FDG) was of the same magnitude as that of the cortical gray matter. This further illustrates that PET-FDG may detect cortical heterotopia, which supplements differential diagnostic work-up of migration disorders.

ISSN:0363-9762    

出版商:OVID    

年代:1997

数据来源: OVID