摘要:

A characteristic image pattern of diminished radioaerosol penetration and reduced radioparticle perfusion has been observed in endobronchial obstruction. This reverse mismatch has a variety of etiologies, with the most common being mucus plugging. The regional hypoxia created by the obstruction causes the blood to shunt from the affected lung. Eleven patients from a group of 178 patients referred with a working diagnosis of pulmonary embolism showed the reversed mismatch. All presented with sudden dyspnea, chest pain and hypoxia. Bronchoscopy was recommended from the image results and nine patients demonstrated mucus plugs that were subsequently aspirated, one patient had a partially obstructing endobronchial carcinoma and one patient had a traumatic fractured bronchus that became occluded with healing granulation tissue. All improved following bronchoscopy. The incompleteness of the airway obstruction accounted for the variations of the perfusion images. Because of the radioaerosol's ability to sharply image the pulmonary airway distribution in contrast to the poor resolution of the radiogases such as xenon-133, it is recommended that radioaerosol lung imaging be substituted for radiogas ventilation imaging since it can accurately detect endobronchial obstruction as well as pulmonary embolism.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A new Tc-99m labeled carbon particle aerosol (“Technegas”) has been developed for lung ventilation scanning. This is the first reported clinical study of this agent in the United States. A total of 23 subjects were studied. Thirteen had comparative Xe-133 studies, and in seven patients pulmonary angiograms were available. The Technegas study agreed closely with the Xe-133 results in 10 out of 13 patients, while the pulmonary angiogram confirmed the Technegas and perfusion scan findings in seven out of seven cases. The Technegas scan was easily performed and well tolerated by all patients. If further clinical trials confirm these preliminary findings, Technegas may become the preferred agent for lung ventilation scanning.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A 35-year-old man was diagnosed in 1984 as having a synovial cell sarcoma of his right wrist without evidence of metastatic spread. The patient underwent regional hyperthermic chemoperfusion, wide-field excision, postoperative radiation therapy and systemic adjuvant chemotherapy. In 1986 and in 1987, because of new lesions found on chest radiographs, the patient underwent bilateral staging thoracotomies with resection of pulmonary metastases, followed by chemotherapy and radiotherapy. Later in 1987, a chest radiograph showed a large left hilar mass and multiple bilateral pulmonary nodules. Computerized tomography of the chest demonstrated a left hilar mass and two nodules in the right lower lung, raising the possibility of recurrent pulmonary metastatic cancer. As a diagnostic procedure, ln-111 labeled monoclonal antibody (Mab) 19-24, produced against a human malignant fibrous histiocytoma, was infused intravenously, and 48-hour images revealed focal areas of increased uptake corresponding to the lesions seen on CT. At surgery, the lesions were confirmed to be synovial cell sarcoma. Imaging with Mabs specific for sarcoma may be particularly useful in sarcoma patients in whom there is clinical uncertainty regarding the nature of pulmonary lesions. In this case, the Mab was useful in distinguishing tumor deposits from postsurgical scarring and helped to guide subsequent surgery and treatment.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Confusing a gallbladder or bile leak with duodenal activity is a common source of error in the interpretation of cholescintigrams. Techniques such as supplementary oblique views, delayed views, the “water test,” dynamic display and combined cholescintigraphy and ultrasound have been used with varying degrees of success. As illustrated in two cases, supplementary standing views provide a simple alternative method to differentiate gallbladder from small bowel activity.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Tc-99m DISIDA is widely used for studying a variety of biliary conditions. It is generally recognized that the spleen is normally visualized on DISIDA imaging only during the blood pool phase. Upon review of our experience with DISIDA, visualization of the spleen was found more common than generally acknowledged. All DISIDA examinations performed at our two institutions were retrospectively reviewed; 95 studies were performed at Institution #1 and 150 studies at Institution #2. There were 138 men and 107 women. Quality control to confirm radiochemical purity included sephadex gel column chromatography. Of 245 patient studies, persistent splenic visualization was identified in one patient (1.0%) at Institution #1 and in 11 patients (7.3%) at Institution #2. There was no correlation between age, sex or final diagnosis and persistent visualization of the spleen. It is suggested that persistent splenic visualization may be caused by an elevated concentration of reduced hydrolized technetium (colloid) in DISIDA.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Increased hepatic activity surrounding the gallbladder fossa during Tc-99m SC liver imaging was observed. Subsequent Tc-99m IDA biliary imaging showed similar findings in the face of nonvisualization of the gallbladder—the classic “rim sign.” Surgery confirmed the diagnosis of complicated acute cholecystitis. This case indicates that a rim sign may be seen with either Tc-99m SC or Tc-99m IDA imaging and may have the same diagnostic significance in both.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

This case report describes the use of cholescintigraphy in the preoperative evaluation of ventrally conjoined twin girls. Sonography and magnetic resonance imaging disclosed an anatomically conjoined heart and a single apparently fused liver. Cholescintigraphy demonstrated that the hepatic system functioned as two independent livers, gallbladders, and biliary drainage systems that were susceptible to separation.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Obstruction of the superior vena cava is commonly associated with the development of several collateral venous pathways. Right-to-left systemic to pulmonary venous shunting, however, rarely has been reported. This paper describes a case in which a previously unsuspected shunt, manifested by the striking visualization of myocardial and thyroid tissue in addition to other findings, was discovered on a routine lung perfusion scan. Imaging, as well as radiologic studies are presented in the investigation of this phenomenon.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A case in which there was a shunt between systemic veins and the left heart in superior vena cava syndrome due to lung cancer is reported. Superior vena cava syndrome developed one and a half years after right upper lobectomy with combined resection of thoracic wall. Radionuclide venography from the right antecubital vein showed immediate visualization of the left ventricle and aorta, before the right atrium and right ventricle were seen. In the superior vena cava syndrome due to a malignant tumor, this rare pathway as well as usual collaterals should be considered.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The bone scintigrams of 600 patients performed over a 12-month period were reviewed. Thirty-six demonstrated abnormalities of the urinary tract of which six cases of intense renal parenchymal activity (“Hot Kidneys”) were found. Two cases were related to treatment with the new antineoplastic agent mitoxantrone. In one patient it was related to treatment with calcitonin. Neither of these associations has been previously reported. Recognized causes of hypercalcemia and recent radiotherapy were present in two patients. No cause could be found in the final patient.

ISSN:0363-9762    

出版商:OVID    

年代:1990

数据来源: OVID