摘要:

The evaluation of gastrointestinal hemorrhage may include a Meckel's scan, particularly in children. Typically, a Meckel's diverticulum shows discrete, focal uptake in the right lower abdomen. The authors describe an adult whose bleeding Meckel's diverticulum manifested as brisk, intermittent intraluminal tracer extravasation.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Drug related false-positive hepatobiliary imaging is uncommon. The authors present a case of a 54-year-old woman who was treated with intravenous ceftriaxone for bacterial meningitis. Symptoms of acute cholecystitis subsequently developed and a sonogram revealed a gallstone. A Tc-99m DISIDA hepatobiliary study was positive for cystic duct obstruction. After discontinuation of ceftriaxone, the patient's clinical condition improved and, 2 weeks later, a repeat hepatobiliary scan was normal. High doses of ceftriaxone and prolonged administration may lead to formation of pseudocholelithiasis and signs of acute cholecystitis. Although this condition is usually benign and reversible, discontinuation of the drug is warranted when symptoms of acute cholecystitis are accompanied by a positive hepatobiliary scan.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

An uncommon case of hepatocellular adenoma is presented. In this case, the tumor was Tc-99m SC avid rather than the typical pattern of no uptake. Liver scintigraphy was able to demonstrate that the tumor originated from the liver correlating with ultrasound and computed tomography. Background information on hepatocellular adenomas, a differential diagnosis, and a logical approach to similar liver lesions is discussed.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors encountered a renal transplant patient in whom tubular stasis permitted sufficient time to perform SPECT using Tc-99m MAG3. SPECT revealed a defect that was not apparent on the planar study. Renal biopsy showed acute vascular rejection. On a subsequent Tc-99m MAG3 SPECT study the defect had resolved.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The effectiveness of low-dose intravenous insulin boluses to improve study quality in F-18 FDG myocardial scans is investigated. Seventeen patients were imaged using a protocol in which only diabetic patients with fasting blood glucose levels > 8 mmol/l were given insulin. Fifty-three patients were imaged using a protocol in which all patients were given 1-3 IU intravenously of insulin immediately before F-18 FDG injection, based on fasting blood glucose levels. Scan quality was rated as poor, good, or excellent. Using the conventional protocol, 29% of the scans were poor quality (uninterpretable), 47% were good, and 23% were excellent. Using the low-dose intravenous insulin boluses protocol, 2% were poor, 53% were good, and 45% were excellent (P= 0.01). There were no significant differences in the proportion of diabetic patients, age, or fasting blood glucose levels. Low-dose intravenous insulin bolus is an easy and safe method of improving myocardial F-18 FDG scan quality in nondiabetic and diabetic patients.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The case of a 56-year-old woman who was admitted with an acute anteroseptal myocardial infarction showed severely decreased left ventricular function and regional wall motion abnormalities on planar Tc-99m gated blood pool imaging. Tc-99m sestamibi stress SPECT imaging demonstrated residual peri-infarct ischemia. At angiography, a solitary severe proximal left anterior descending stenosis was successfully dilated. Later, because of recurrent chest pain, a second Tc-99m sestamibi stressrest SPECT was performed to exclude restenosis. Because the question of viability within the infarct region had also been asked, a gated protocol was applied and compared to Tl-201 rest-redistribution SPECT. Both tests pointed to the existence of tissue viability in the septal region, without evidence for stress ischemia. The patient was then medically treated. One year later, because of angina, Tc-99m gated SPECT blood pool imaging showed a spectacular increase in left ventricular function and a dramatic improvement in regional wall motion. Angiographic data confirmed these findings and there was no significant restenosis. Thus, Tc-99m sestamibi gated SPECT may be helpful in predicting viability and recovery of function in patients with severely impaired left ventricular regional wall motion after acute myocardial infarction.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Uptake of Tc-99m MDP tracer was noted within prostatic calcifications in a 48-year-old man with no known malignancy who underwent a three-phase bone scan for left knee and thigh pain. Routine anterior and posterior views of the pelvis demonstrated focal tracer uptake within the right public bone, which mimicked a metastatic lesion. Additional imaging showed the uptake to be extraosseous and localized within the prostate in a distribution similar to the extensive prostatic calcifications seen on the corresponding plain film and computed tomography examinations of the pelvis. This unusual presentation illustrates another potential artifact that may be present in scintigraphic bone imaging of the pelvis.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Advancements in imaging technology have led to better diagnoses of ectopic parathyroid adenomas. Although surgery is curative in the majority of patients with parathyroid adenomas in normal preoperative locations, imaging is definitely required in ectopic adenomas in the neck and more importantly in the chest. The various imaging modalities used in the diagnosis of parathyroid adenomas are isotopic techniques, MRI, CT, ultrasound, arteriography, and venous sampling for parathormone. This review presents four patients studied with different diagnostic techniques resulting in cures with surgery or arteriographic ablation. The literature survey suggests the sensitivity of Tc-99m MIBI scanning to be more than 90%, MRI 70-75%, and CT scanning slightly lower. On the basis of the authors' experience and a literature review, a combination of MIBI scanning and MRI appears to be the most logical approach. If these two tests do not provide sufficient diagnostic confidence, then CT or a contrast arteriogram should be considered. Recent advances in arteriography/catheters have made angiographic ablation with alcohol or contrast material possible in patients who cannot undergo surgery.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The three-phase bone scan has been shown to be useful in the diagnosis of osteomyelitis, with a high sensitivity and specificity under optimal conditions. However, there are many causes of focally-increased uptake of Tc-99m diphosphonates in the extremities that may mimic infection, especially when there is increase on all three phases. Radiolabeled leukocyte scintigraphy is often performed in this clinical setting, although many pitfalls resulting in false-positive scans still remain. The authors present three cases of gouty arthritis in which skeletal scintigraphy illustrates this lack of specificity. Further causes of increased extremity uptake are reviewed, with attention to those that have been reported to show an increase on all three phases of the bone scan. Additional factors that can improve the specificity of the bone scan are discussed, as are the panoply of more recent scintigraphic approaches aimed at distinguishing infection from aseptic inflammation in the extremity. Unfortunately, no nuclear medicine procedure to date has proven itself to be reliably specific for infection.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Increased hepatic uptake and absent bone marrow uptake on bone marrow immunoscintigraphy has been reported after the formation of human antimurine antibodies. A case of generalized bone marrow metastases is presented, in whom an elevated liver uptake on bone marrow immunoscintigraphy proved to be associated with extramedullary hematopoiesis. Extramedullary hematopoiesis should be included as a possible cause of a disproportionately elevated liver uptake on bone marrow immunoscintigraphy, especially on initial studies, or on repeat studies with low human antimurine antibody titers. Tc-99m labeled BW 250/183 immunoscintigraphy may aid in the localization of suspected sites of extramedullary hematopoiesis.

ISSN:0363-9762    

出版商:OVID    

年代:1996

数据来源: OVID