摘要:

Laparoscopic cholecystectomy is widely accepted as an alternative to traditional open cholecystectomy. Its advantages are a shorter hospital stay, earlier return to normal activity, less pain, and improved cosmetic results. However, in the initial experience with this technique, biliary leaks were several times more frequent than in traditional cholecystectomy. Four cases of scintigraphic detection of biliary leaks after laparoscopic cholecystectomy are described. The results of the examination are compared in two cases with endoscopic retrograde cholangiography and in the remaining two with intraoperative findings. Hepatobiliary scintigraphy is suggested for early evaluation of postoperative complications involving the biliary system.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This is the first report of a venous aneurysm detected by radionuclide venography. Aneurysms of the popliteal vein are very rare. Described here is a case of a saccular popliteal venous aneurysm that presented as dyspnea secondary to pulmonary embolism. In this case, there was recurrent PE despite anticoagulant therapy. Almost all such aneurysms are associated with PE, about half of which are recurrent. This report demonstrates another useful aspect of obtaining a simultaneous radionuclide venogram when performing a perfusion lung scan with Tc-99m MAA.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The evolution of multiple ventilation-perfusion mismatches on serial lung scintigraphy in a fully anticoagulated, bacteremic patient with small pulmonary infiltrates and repeatedly negative Doppler ultrasonography of the lower extremities suggested pulmonary emboli from right-sided valvular endocarditis. The demonstration of pulmonic valvular vegetations on follow-up transesophageal echocardiography supported this diagnosis. In the proper clinical setting, septic pulmonary emboli should be included in the differential diagnosis of high-probability ventilation-perfusion lung imaging.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In 43 patients with cystic fibrosis, the results of 122 Tc-99m DTPA aerosol ventilation (DAV) studies were compared with pulmonary function tests (PFTs) that were performed within 24 hours of the DAV studies. The DAV studies were evaluated blindly for (A) number of pulmonary segments showing little or no ventilation, (B) number of foci of bronchial deposition of aerosol, and (C) subjective overall improvement, lack of change, or worsening from the previous study. (A) and (B) correlated significantly with all PFTs (p's < .001, r's = -.51 to -.73). Changes in (A) and (B) also correlated with changes in PFTs (p's ≤ .001, r's = -.37 to -.58). The three populations in (C) were significantly different from each other with respect to changes in all PFTs (p ≤ .002). Intervals between studies showing subjective improvement, no change, and worsening averaged 60, 133, and 306 days, respectively. These results suggest that DAV is an indicator of both regional and global pulmonary function and may be useful in evaluating patients with cystic fibrosis.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

An esophagobronchial fistula developed in a patient who had well-differentiated squamous carcinoma of the lung that was treated with chemotherapy. Because the esophagobronchial fistula could not be surgically repaired, it was isolated with a mechanical stitch above and below it. Forty-eight hours after initiation of enteral nutrition, a perfusion lung scan was performed because of clinical suspicion of pulmonary embolism. Because the scan showed reduced pulmonary radioactivity and accumulation of activity in the kidneys and spine, an arteriovenous shunt was suspected. However, subsequent digital substraction angiography ruled out this possibility and a recurrence of the esophagobronchial fistula was confirmed with an esophagogram. The unusual extrapulmonary activity could be related to a reversible capillary shunt in the pulmonary vasculature, secondary to acute respiratory distress syndrome.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This study investigated the new radiopharmaceutical, Tc-99m mercaptoacetyltriglycine (MAG3), as a possible alternative to Tc-99m DTPA and I-131 Hippuran for renal transplant evaluation. Tc-99m MAG3 and I-131 Hippuran were used sequentially in 19 consecutive patient studies and compared qualitatively and quantitatively. Serum creatinine values ranged from 1.6 mg/dL to 10.3 mg/dL (mean, 5.4 mg/dL). The Tc-99m MAG3 images and time-activity curves were of superior quality (3+) compared to I-131 Hippuran (1-2+). Quantitative analysis of the time to peak activity (Tmax) demonstrated a high correlation and no significant difference for Tc-99m MAG3 (mean, 11.4 min) compared to I-131 Hippuran (mean, 11.2 min). The percentage of peak activity retained at 20 minutes (T20) also showed a high correlation between the two agents; however, Tc-MAG3 showed a significantly slower clearance (T20 mean, 77%) than I-131 Hippuran (mean, 71%). Flow images were judged to be of good quality; however, the first-pass time-activity curves were often different from that seen with Tc-99m DTPA. Interpretation of delayed Tc-99m MAG3 images, for example to diagnose a slow urinary leak, were sometimes complicated by bowel clearance. In conclusion, Tc-99m MAG3 is superior to I-131 Hippuran for evaluation of renal transplant function. Tc-99m is the agent of choice for evaluation of renal transplant blood flow and function.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Two cases of Tc-99m MAG3 renograms performed on the same day are presented. Both of them show considerable liver activity, which is a known drawback for MAG3 by distribution. In the first case, gallbladder activity appeared after 6 minutes, at the same time when tubular drainage and caliceal activity started to show in both kidneys. The gallbladder activity was superimposed over the upper calyces of the right kidney and simulated an obstructive pattern in the time-activity curves. This early gallbladder activity after intravenous injection of Tc-99m MAG3 has not been previously reported. The second case is presented for the purpose of confirming that nothing in the preparation of the kit contributed to this phenomenon.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Thirty patients with clinical signs of infective endocarditis and pathologic echocardiographic findings indicating vegetations underwent scanning with ln-111 or Tc-99m hexamethylpropylene amineoxime (HMPAO) labeled granulocytes. Blood cultures were positive in 60% of the patients. The other cases were negative as a result of antibiotic pretreatment. The results of scintigraphy were correlated with the subsequent clinical course, and in 20 cases with data obtained by histologic examination of the valves. With regard to the degree of the inflammatory process, the nuclear medical procedure provided the following results: true-positive in 6 cases, false-positive in 1 case, true-negative in 19 cases, and false-negative in 3 cases. In this study, positive granulocyte scans correlate with high activity of the inflammatory process and predict a poor prognosis for the patients concerned.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A 37-year-old man with atypical chest pain and complete left bundle branch block showed a marked exercise induced septal defect on Tc-99m sestamibi stress testing. A repeat examination at rest the next day revealed complete reversal of the previous septal defect. Coronary angiography two days later showed a normal coronary artery system. Left bundle branch block has been associated with false-positive results of exercise (and more recently, dipyridamole) TI-201 examinations for septal ischemia. The case presented here may be the first reported example of a false positive Tc-99m sestamibi examination for septal ischemia in the presence of left bundle block.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Serial cerebral perfusion studies were performed in a patient with moyamoya disease, utilizing N-isopropyl iodoamphetamine (I-123 IMP). The SPECT findings correlated closely with those of a CT scan and magnetic resonance imaging (MRI). In fact, the perfusion defects seen on SPECT studies were larger than those seen on CT and MRI studies. The SPECT findings paralleled the patient's improving clinical course. Cerebral perfusion SPECT studies may be very helpful in the evaluation and follow-up of patients with moyamoya disease.

ISSN:0363-9762    

出版商:OVID    

年代:1993

数据来源: OVID