摘要:

A patient with a chronic occult gastrointestinal bleeding site is described. Because an extensive examination failed to locate the site of bleeding, a heparin infusion was used in conjunction with a conventional Tc-99m labeled red cell bleeding study. A mid-jejunal ulcer was safely localized before elective surgery. A protocol for a heparin provocative bleeding study is proposed.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A retrospective study was conducted using 36 patients with gastrointestinal bleeding in whom the diagnosis was not directly apparent from first line diagnostic procedures. Final diagnosis was established by surgery, endoscopy, or postmortem examination in 20 patients. Scintigraphic examination with Tc-99m or in-111 labeled red blood cells yielded 24 positive and 18 negative results. Nine out of 13 positive scans (verified by other diagnostic procedures) accurately identified the site of bleeding. This was considered to be a satisfactory result in this group of difficult to diagnose patients. The lowest success rate was observed in patients taking drugs that interfered with coagulation, or in patients prone to diffuse blood loss because of coagulopathy. Late scans did not offer additional information and the use of in-111 for this purpose was not thought to be of benefit. Although the technique is rather noninvasive and simple, its application should be restricted to selected patients and its interpretation related to the results of other investigations.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SPECT imaging has been shown to identify additional defects when applied to Tc-99m DMSA scintigraphy. However, the nature of these defects is uncertain. They may be because of small scars or anatomical variants. The interrenicular septum (IRS) is a normal finding that may mimic a scar on ultrasound examination or tomography. In this study, it was found that the IRS may be identified on Tc-99m DMSA SPECT and that it was present in 32% of patients. Its characteristic appearance is a linear area of absent tracer uptake extending from the renal hilum into the parenchyma, usually anterosuperiorly. The preservation of renal cortical uptake differentiates it from a scar, which results in a defect in the rim of cortical Tc-99m DMSA accumulation.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

To clarify the clinical significance of TI-201 reverse redistribution (RR), 33 patients with chronic coronary artery disease (CAD) underwent stress-redistribution TI-201 cardiac imaging with rest reinjection, coronary arteriography, and 2D-echocardiography. Rest Tc-99m MIBI scintigraphy was also performed in 27 of the 33 patients. A total of 495 segments were analyzed for TI-201 scintigraphy (405 for Tc-99m MIBI). Each segment was assigned to one of the major coronary artery territories. Two patterns of RR were identified; 1) pattern A (RR-A) showed normal TI-201 uptake on stress images and lower than normal on redistribution images, and 2) pattern B (RR-B) showed lower than normal TI-201 uptake on stress images with further decrease on redistribution images. The RR phenomenon was found in 46 (9% of the total) segments; 25 with RR-A and 21 with RR-B. Reverse redistribution pattern A segments had lower Tc-99m MIBI uptake (84 ± 9% versus 92 ± 10%,P< 0.0001) and a higher percentage of stenosed coronary arteries (80% versus 49%,P< 0.05) compared to normal segments (n = 204, 41% of the total). No difference in wall motion was observed between RR-A and normal segments. Of the 25 segments with RR-A, 14 showed enhanced TI-201 uptake after reinjection (Re+) and 11 remained unchanged after reinjection (Re–). Segments that were Re– showed significantly (P< 0.05) lower Tc-99m MIBI uptake (79 ± 9%) compared to Re+ segments (87 ± 8%) and normal segments (92 ± 10%). No difference in wall motion was observed between Re+ and Re– segments. Normal and Re+ segments did not differ significantly in any of the variables considered. Reverse redistribution-pattern B segments did not significantly differ from those with reversible or irreversible TI-201 defects. These data suggests that in patients with chronic CAD segments with normal TI-201 uptake on stress images and decreased TI-201 uptake on redistribution images should not be considered normal segments. Thallium-201 reinjection at rest appears to be able to further stratify these segments, identifying those with enhanced TI-201 uptake after reinjection that show myocardial perfusion and coronary anatomy similar to normal segments.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Three hundred twenty-one separate acquisition dual-isotope myocardial perfusion scans were reviewed retrospectively. Studies performed in six patients demonstrated a relative improvement in Tc-99m sestamibi uptake during stress in segments that appeared abnormal on rest injected TI-201 images. All patients who demonstrated this pattern had a prior history of myocardial infarction and interventional revascularization. While many factors may contribute to this appearance, the authors favor the presence of a patent infarct-related artery as being the most significant.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Iodine-123 MIBG is a norepinephrine analog which can be used to image the sympathetic innervation of the heart. The authors report a patient with myotonic dystrophy whose I-123 MIBG SPECT revealed accelerated washout of I-123 MIBG from infero-posterior and a part of lateral wall, although TI-201 SPECT showed no abnormal finding. The authors conclude that I-123 MIBG can be more sensitive in detecting the cardiac abnormality than TI-201 SPECT in this disease.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Ventilation-perfusion lung scans are routinely performed using Tc-99m labeled MAA particles administered intravenously which are subsequently trapped in the pulmonary artery capillary bed. In the presence of a right-to-left shunt, activity may be seen in the systemic circulation. Right-to-left shunts may be worsened by inducing hypoxemia which causes pulmonary artery constriction, and also by increasing venous return to the heart. In this case, the authors used various maneuvers to increase right-to-left shunting and thereby demonstrated the presence of fixed pulmonary hypertension. These findings suggested that the patient's dyspnea on exertion was not primarily because of left ventricular dysfunction, and proposed coronary bypass surgery was deferred for medical management.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Severe coronary artery disease may occur early in the course of mucopolysaccharidosis. The authors present radiologic, scintigraphic, and pathologic findings in five patients with Hurler syndrome. Thallium-201 myocardial scintigraphy and selective coronary angiography obtained within 2 days to 6 months were correlated in five patients. Postmortem examination of the coronary arterles was obtained in one patient within hours of angiography. Interobserver agreement on grading of scintigraphic abnormalities was poor. Nonspecific findings on TI-201 studies included septal abnormalities in all five patients. Scintigraphic findings were corroborated by angiography and postmortem results in only 3 of 5 patients. Our findings suggest that resting TI-201 scintigraphy has limited value in the detection of coronary artery disease in patients with Hurler syndrome.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Reference values for splenic volume used in this study are based on necropsy measurements made in 1970. Because the volumes (measured by radionuclide tomography) seemed to be consistently greater than the necropsy values, the splenic volume in 35 healthy male volunteers ranging in age from 18–30 years (median age, 21 years) was studied. Their mean (SD) splenic volume was 281 (73) ml compared with 138 (34) ml in the reference group. The mean splenic volume in healthy volunteers seems to be significantly greater than in cadavers, and these results suggest that reference range for splenic volume in vivo should be revised.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Cholescintigraphy with morphine augmentation is used routinely to expedite the differential diagnosis of acute from chronic cholecystitis. A patient with hepatic dysfunction and an allergy to morphine received intravenous meperidine in conjunction with cholescintigraphy. The gallbladder was not visualized 30 minutes after administration of the drug. However, the activity accumulated in the initial photon deficient gallbladder at 4 hours after meperidine administration (6.5 hours after radiopharmaceutical administration.) These findings may be explained in part by prolongation of meperidine bioavailability because of impairment of hepatic function.

ISSN:0363-9762    

出版商:OVID    

年代:1994

数据来源: OVID