摘要:

PurposeMorphine sulfate causes spasm of the sphincter of Oddi. Conversely, the cholecystagogue sincalide produces relaxation of the sphincter and contraction of the gallbladder. This prospective study evaluated whether sincalide could produce normal gallbladder emptying after low-dose morphine sulfate (0.04 mg/kg).MethodsThirty to 120 minutes (mean, 51 minutes) after morphine sulfate–augmented gallbladder visualization, 25 gallbladder ejection fractions in 24 patients were measured. One patient was studied twice, 2 weeks apart. Gallbladder ejection fractions were calculated after controlled 30-minute infusions of sincalide (0.02 &mgr;g/kg).ResultsFourteen gallbladder ejection fractions were normal (mean, 63%; range, 45% to 80%) and 11 gallbladder ejection fractions were abnormal (mean, 12%; range, 5% to 19%;P< 0.001).ConclusionsNormal gallbladder ejection fractions can be obtained as early as 30 minutes after administration of low-dose morphine sulfate. Potential applications of post–morphine sulfate sincalide challenge would include, for example, to support true-negative morphine sulfate–augmented gallbladder visualization in a patient with a high clinically indicated potential of having acute cholecystitis.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

PurposeThe influence of patient posture on the incidence and severity of gastroesophageal reflux is well known. Scintigraphic imaging, however, is routinely performed with the patient lying in the supine position, because current gamma camera designs do not allow for changes to the angle of the patient table.MethodsTo overcome this difficulty and to increase the diagnostic sensitivity of scintigraphy, we used an alternative patient position. Twenty-seven adult patients (eight men, 19 women; mean age, 47.5±11.5 years) with gastroesophageal reflux disease were prospectively studied consecutively using two body positions, the supine and the knee–chest positions. Each consisted of dynamic acquisition of 450 seconds. An entire study for each patient required only 15 minutes. Images were interpreted qualitatively by three observers.ResultsAlthough gastroesophageal reflux was positively identified in only 9 of 27 (33%) patients using the supine position, 20 of 27 (74%) patients were shown to have gastroesophageal reflux in the knee–chest position (P< 0.05). No reflux was detected in seven patients using both positions. In five patients, whose study results were positive using both positions, the number of reflux episodes was greater in the knee–chest position compared with the supine position.ConclusionThe knee–chest position increases the diagnostic efficiency of gastroesophageal reflux scintigraphy.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A 45-year-old man, seropositive for hepatitis C, was examined because his liver was palpable well below the costal margin. A CT examination revealed multiple nodules within the liver and also several sites of ectopic tissue. The patient had a splenectomy 25 years before. A radiocolloid study showed uptake, consistent with splenosis, in the thorax, abdomen, pelvis, and possibly the left arm. The magnitude of the ectopic tissue, and its multiple locations, indicated the ability of splenic cells to grow in a variety of body sites.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A 2-month-old infant had jaundice that began 3 days after birth. The clinical features were suggestive of biliary obstruction. Tc-99m mebrofenin hepatobiliary imaging confirmed the diagnosis of spontaneous perforation of the common bile duct, and surgical intervention resulted in progressive recovery.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We present a case of increased I-131 uptake in a patient with papillary thyroid carcinoma with local recurrence and distant metastases after a second treatment with retinoic acid as a sign of redifferentiation of the tumor cells. When fine-needle aspiration cytology before and after a second course of retinoic acid treatment were compared, signs of tumor cell redifferentiation were found. This was accompanied by biochemical reexpression of thyroid marker proteins.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Strontium-89 is effective in the palliation of bone pain caused by skeletal metastases. Its primary side effect is mild thrombocytopenia that typically recovers in 3 or 4 months. Subclinical disseminated intravascular coagulation is reported to be present in approximately 10% to 20% of patients with advanced prostate cancer. These patients may be at increased risk for severe marrow depression after radionuclide therapy for bone pain palliation. This report describes a patient with painful bony metastases resulting from prostate carcinoma. He had a normal platelet count and no clinical evidence of a coagulation disorder at the time of strontium-89 therapy, and a severe disseminated intravascular coagulation developed and lead to death after treatment. A normal platelet count before strontium-89 therapy does not preclude subsequent disseminated intravascular coagulation, and we support the Society of Nuclear Medicine’s bone pain treatment procedure guideline that patients referred for bone palliation should be screened for disseminated intravascular coagulation before therapy.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Radiolabeled leukocyte scintigraphy is a well-established technique for the diagnosis of inflammation and infection with a typical presentation of a hot spot within the abnormal areas. However, in some cases of osteomyelitis of the axial skeleton, a cold defect pattern has been described. Tc-99m ciprofloxacin is a new agent claimed to be specific for imaging sites containing viable bacteria. In this report, we present three cases of proved bacterial infection of the axial skeleton with a mismatch pattern between Tc-99m ciprofloxin and tagged leukocytes. Although Tc-99m–labeled leukocyte scanning showed a cold defect, probably caused by bone marrow replacement, the Tc-99m ciprofloxacin consecutively revealed a hot spot at the site of infection. These data suggest that Tc-99m ciprofloxacin should be a better agent than radiolabeled leukocytes for detecting osteomyelitis of the axial skeleton.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

PurposeTo apply postprocessing techniques to register three-dimensional Tl-201 bone SPECT datasets with MRI. This may provide more accurate anatomic-functional correlation when localizing active tumors.Materials and MethodsThree-dimensional datasets were constructed from previously acquired MRIs using routine imaging protocols. Registration software was used to coregister the Tl-201 SPECT studies and the MRIs in three dimensions.ResultsAdequate Tl-201 uptake in muscles and soft tissues along with relatively low accumulation in tendons and joint spaces provided adequate landmarks for visually aligning SPECT and MRI datasets. MR abnormalities were more extensive because of surrounding reactive tissue, and more focal Tl-201 uptake could be demonstrated within the region of MR signal abnormality, allowing the focal metabolically active tissue to be distinguished from adjacent edema.ConclusionsImage registration of SPECT and anatomic imaging (CT or MRI) is used routinely to evaluate functional abnormalities within the brain. This technique has now been applied to the combination of Tl-201 SPECT and MR data for evaluating bone lesions and may provide additional anatomic information for localizing functional abnormalities. This may be valuable for defining targets for biopsy, planning surgical treatment, and using minimally invasive therapies.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Antigranulocyte immunoscintigraphy is indicated for diagnostic imaging to determine the location and extent of infection. We present a case of a focal cold lesion in a vertebra of a patient thought to have a septic focal lesion. Whole-body scanning and dorsal spine SPECT revealed no focal increased uptake. CT and MR studies revealed the presence of a vertebral angioma. Conditions associated with a defect of uptake in immunoscintigraphy are discussed.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

PurposeWe describe a new method for measuring brain tumor uptake of Tl-201 and Tc-99m sestamibi (MIBI) that permits the semiquantitative comparison of tracer uptake to yield comparable “tumor bulk” ratios. We tested this method in patients treated recently and remotely with chemotherapy to determine if this method could identify differences between these two patient groups.ResultsThe mean Tc-99m MIBI to Tl-201 tumor bulk ratio was 1.03 (range, 0.81 to 1.12) in four patients who had recently received chemotherapy. The mean Tc-99m MIBI to Tl-201 tumor bulk ratio was 1.55 (range, 1.46 to 1.64) in seven patients who had remote therapy. The difference in the Tc-99m MIBI to Tl-201 tumor bulk ratio between the two groups was significant (P= 0.0001). Patients who received recent chemotherapy had relatively lower Tc-99m MIBI uptake compared with Tl-201. In remotely treated patients, uptake of the Tc-99m MIBI was greater compared with Tl-201.ConclusionThis method allows semiquantitative comparison of different tracer uptake values independent of tracer dose and reduces the variability in drawing a region of interest when measuring tumor uptake. Among the patients studied, those who had recent chemotherapy showed a low Tc-99m MIBI to Tl-201 ratio. This method of measuring “tumor bulk” can provide a useful index of viable tumor size in evaluating early tumor response and during ongoing chemotherapy.

ISSN:0363-9762    

出版商:OVID    

年代:1999

数据来源: OVID