摘要:

Administration of captopril to animals with two-kidney, one clip, renovascular hypertension (RH) lowers the glomerular filtration rate (GFR) in the clipped kidney. The authors therefore tested the hypothesis that a decrease in GFR after captopril administration would identify patients with RH. Total GFR was measured by the plasma disappearance of Tc-99mdiethylenetriaminepentaacetic acid (DTPA) after bolus injection and single-kidney GFR from renal uptake of DTPA assessed by renography. The authors studied six patients with arteriosclerotic RH who had strongly lateralizing renal vein renin levels and greater than 80% stenosis of the renal artery to that kidney. Results were contrasted with those of six patients with essential hypertension (EH) with a similar mean arterial blood pressure (MABP). Captopril (50 mg orally) increased total GFR (ml/min) in all patients with EH (102 ± 8 to 120 ± 12, P < 0.005). However, GFR decreased in patients with RH (73 ± 8 to 61 ± 9, P< 0.05) after captopril. Although the single-kidney GFR of patients with RH decreased in all six stenotic kidneys (27 ± 4 to 21 ± 5, P < 0.02), it did not change consistently in the contralateral kidneys (45 ±8 to 40 ± 6, N.S.). Clonidine (0.3 mg) also lowered MABP in patients with RH but, unlike captopril, it did not reduce total kidney GFR (75 ± 10 to 79 ± 11, N.S.). In conclusion, short-term captopril administration increases GFR in patients with EH, but decreases it in those with RH. This action is unrelated to its depressor response. Thus, captopril-induced changes in GFR may separate patients with RH from those with EH. However, changes in the DTPA renogram are not reliable for discriminating between stenotic and contralateral kidneys.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

In order to evaluate the renal excretion quantitatively, the authors analyzed the Tc-99m DTPA renogram using mean transit time (MTT) with deconvolution analysis and compared it to the perfusion index. One hundred thirteen studies consisting of 25 normal, 11 obstruction, 35 transplant-norm, 12 transplant-obstruction, and 30 transplant-rejection were evaluated. In the non-transplant obstruction, MTT is significantly long (3.40 ± 0.85 minutes vs 2.02 ± 0.42 minutes) and has high sensitivity (100%) and specificity (93% 23/25) for the diagnosis of obstruction. In the transplant-obstruction, if the field of view includes both transplant and liver or spleen as a blood pool image, MTT has high sensitivity for the diagnosis (10/11) and for the follow up of obstruction (12/12), with the same specificity, but low sensitivity for rejection (25%). Perfusion index is of value in the diagnosis of rejection (73% specificity, 77% sensitivity) but is useless for the detection of obstruction (25%; specificity, 75%; sensitivity). The authors conclude that MTT is a useful marker for diagnosis and serial quantitative evaluation of renal obstruction. Also, they suggest the use of multiple techniques based on different principles for the complete evaluation of the renal scan.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Extracranial bone metastases from glioblastoma multiforme are rarely reported in the medical literature. The authors describe a case of glioblastoma multiforme with distant osseous metastases that were detected by a Tc-99m MDP image. The metastases were osteolytic and expansile on plain radiographs.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Forty-five patients with Graves' disease were studied prospectively to determine if 24-hour I-131 uptake measurements alone or in combination with serum thyroid hormone levels at six weeks would determine the necessity for retreatment of the thyrotoxicosis. All patients with an I-131 uptake greater than 30% at six weeks required retreatment. No patient with an I-131 uptake of less than 15% required retreatment. Patients with uptakes between 15% and 30% were variable. An elevated free thyroxin index at 6 weeks Is not helpful to determine which patients will remain thyrotoxic. Patients with a free thyroxin index within the normal range at six weeks can be predicted to be euthyroid by 12 weeks if their 24-hour I-131 uptake is between 15%and 30% and to be hypothyroid if their 24-hour I-131 uptake is below 15%. There was no difference between patient groups treated initially with antithyroid medication and those who were not.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Rapid and reliable transmission of nuclear medicine studies using conventional telephone lines and commercially available modems and computer systems has been accomplished through use of software developed within the authors' hospital. Original digital images of all-night and weekend studies, acquired on any of the acquisition computers from different manufacturers, are now routinely sent for remote reading at the physician's home. Data, software, and letters are routinely exchanged using modems and standard telephone lines with a sister institution in Haifa, Israel. The software has been designed to achieve no loss data compression and minimal turnaround time loss. Thus, an average lung perfusion image or gallbladder study requires about 1-3 minutes of transmission time. Full analysis and display software is available on the remote computer.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The scintigraphic findings of a patient with characteristic clinical, laboratory, and radiographic features of congenital lipodystrophy were studied. Bone scan showed uniform increased bone uptake of Tc-99m MDP with markedly enhanced peri-articular activity and very prominent renal activity. Liver-spleen scan showed marked hepatosplenomegaly. This combination of scintigraphic abnormalities is unique in congenital lipodystrophy and constitutes a very interesting constellation of findings. Observed scintigraphic findings are compatible with previously described radiographic findings.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Autologous bone marrow trnsplantation is being offered with increasing frequency as a therapeutic alternative to patients who have failed conventional chemotherapy. Presently, these patients are being evaluated with a variety of imaging modalities, including planar radiographs, nuclear bone and bone marrow scans, and CT and magnetic resonance imaging. A case is presented here that demonstrates potential pitfalls encountered in this multimodality approach. Correlation of imaging findings with patients history and clinical findings is essential for optimal interpretation of functional imaging modalities.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Three patients with regional migratory osteoporosis (RMO) of the lower extremity were observed over a period of time with clinical and scintigraphic follow-up. The diagnosis of RMO is clinically and radiographically difficult, but a three-phase bone image is very helpful in diagnosing patients with RMO.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A standard, dual-isotope meal (Tc-99m-egg sandwich and ln-111 DTPA in water) was administered to 14 normal volunteers and 37 patients, who had not undergone gastric surgery, to determine if the emptying characteristics of the liquid phase alone could accurately predict delayed solid emptying. Delayed gastric emptying was defined clinically as a solid half-emptying time more than two standard deviations greater than the mean for normal volunteers. Linear regression analysis was performed on the natural logarithm of liquid fractional retention at each time interval to yield a slope and y-intercept for each subject. There was no significant difference (0.6 < P < 0.8) between volunteers and patients with normal solid emptying for the liquid slope. In patients who exhibited delayed gastric emptying for solids, the liquid slopes were significantly different from the normal values (P < .001). There was a high correlation of liquid slope to solid half-emptying time in all patients and volunteers (r = - 0.80, P < .001). Comparison of the liquid slope measurement to solid half-emptying time criteria revealed a sensitivity of 96%, a specificity of 100%, and a predictive value of 100% for the slope test. These results suggest that delayed gastric emptying can be accurately detected with a liquid-solid meal using only a single-liquid label.

ISSN:0363-9762    

出版商:OVID    

年代:1989

数据来源: OVID