摘要:

The hepatic clearance of Tc-99m labeled iminodiacetic acid (IDA) compounds is believed to be impaired in patients with severe hyperbilirubinemia. Competitive inhibition of hepatocyte uptake of IDA by bilirubin has been demonstrated in vitro, but not by clinical scintigraphy. We present a patient with Crigler-Najjar syndrome without evidence of hepatobiliary damage, who demonstrated normal uptake and excretion of Tc-99m DISIDA despite a serum indirect bilirubin level in excess of 30 mg/dl. It is therefore suggested that a markedly elevated serum bilirubin level per se does not inhibit hepatic uptake of Tc-IDA and does not preclude clinically useful scintigraphic examination.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The most urgent diagnosis addressed by cholescintigraphy is acute cholecystitis. By administering lowdose intravenous morphine sulfate to patients undergoing cholescintigraphy (who demonstrate visualization of both the common bile duct and intestine and nonvisualization of the gallbladder), the time required to complete the study has been reduced to a maximum of 90 minutes. One hundred twenty-eight patients underwent cholescintigraphy for clinically suspected acute cholecystitis. Forty patients received intravenous morphine sulfate during the procedure. In patients who received morphine sulfate during the examination, the sensitivity of cholescintigraphy for the diagnosis of acute cholecystitis was 100%; the specificity was 85%.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Radial bone mineral content and bone mineral density were measured in 1515 women referred for osteoporosis screening. A detailed questionnaire allowed the selection of 1069 normal white women for further analysis who had no historical evidence of bone disease or predisposing factors for bone disease. The nondominant radius was measured at two locations: the midradial bone density (MRBD) composed of predominantly cortical bone and the distal radial bone density at the 5 mm site (DRBD) composed of a mixture of cortical and trabecular bone. Women considered at risk were defined as those whose bone density values fell below fracture risk levels (0.550 g/cm2for the MRBD and 0.325 g/cm2for the DRBD). Between the ages of 20 and 70 years, the DRBD showed significantly greater sensitivity in defining subjects at risk (N = 223) than the MRBD (N = 80); P < 0.001. Analysis of all ages showed that 684 women were above the fracture risk value (FRV) at both sites (64.0%), 260 were below the FRV at the DRBD 5 mm site (24.3%), 14 were below the FRV at the MRBD site (1.3%), and 111 were below the FRV at both sites (10.4%). Postmenopausal women age 50 to 70 years receiving estrogen replacement therapy (N = 221) had significantly higher values at both sites (P < 0.001) than age-matched postmenopausal women not receiving replacement therapy (N = 239). Hereditary factors significantly correlated with both sites but neither site showed that calcium intake, activity level, or cigarette smoking were significant variables. In conclusion, measurement of radial bone density at the distal 5 mm site adds significant value to single photon absorptiometry in the early determination of trabecular bone osteopenia and therefore in screening for osteoporosis.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Two cases of small cell carcinoma of the lung in which flare responses were demonstrated are discussed. Although the primary tumor and extraskeletal metastases responded to first-line chemotherapy, bone scintigraphs performed 3 months after the start of treatment suggested tumor progression. However, following repeat bone imaging and subsequent clinical evaluation, the interim scintigraphs appeared to represent an unusual flare response, in which the activity of pre-existing hot spots increased and new lesions developed.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Over 3 years, a prospective comparison was made between Tc-99m pertechnetate and 1-131 for the detection of residual and metastatic tissue in the follow-up of patients with cancer of the thyroid. All patients stopped thyroid medication for a minimum of 4 weeks. All patients had imaging done first with Tc-99m pertechnetate followed within a maximum of 2 weeks by 1-131. The study included 66 patients in whom 81 studies were done with both Tc-99m and 1-131. The results showed that 27 studies were positive with both Tc-99m and 1-131 (true positive): 19 in the thyroid bed, four lymph nodes, two bony metastases, and two pulmonary metastases. Five patients had negative results with Tc-99m and positive results with 1-131 (false negative): three in the thyroid bed, one lymph node metastasis, and one pulmonary metastasis. Only one case was positive with Tc-99m in the neck but negative with 1-131 (false positive). The remaining 48 studies were negative both with Tc-99m and 1-131 (true negative). Considering 1-131 imaging as the standard procedure, Tc-99m had a sensitivity of 87%, specificity of 97%, and accuracy of 92.5% for the detection of residual or metastatic functioning thyroid tissue.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Tc-99m labeled RBC imaging is becoming increasingly useful in detecting gastrointestinal (Gl) bleeding sites. A patient is presented who had massive Gl bleeding from an unsuspected gastric leiomyoma in whom a Tc-99m sulfur colloid Gl bleed image was negative. The Tc-99m labeled RBC imaging done on the day after sulfur colloid imaging revealed increased gastric activity due to active bleeding from an intragastric leiomyoma. Tc-99m labeled RBC imaging helped in early detection of the bleeding site resulting in its successful treatment. This experience also reinforces the assertion that Tc-99m labeled RBC imaging may be more helpful than Tc-99m sulfur colloid imaging in patients with upper Gl or intermittent bleeding.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A retrospective study of 51 patients with a negative lower extremity radionuclide venogram and a 6-month followup was performed. None of the patients received anticoagulation. Fifty of the 51 patients had no subsequent symptoms nor signs suggesting undiagnosed deep venous thrombosis or pulmonary emboli. On reviewing the radionuclide venogram of the one patient who returned with persistent symptoms and signs of deep venous thrombosis, it was found that the initial radionuclide venogram was misinterpreted. These findings suggest that a negative radionuclide venogram, properly performed and interpreted, implies the absence of clinically significant deep venous thrombosis.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Patients with arteriovenous malformations of the bowel may have multiple symptoms secondary to chronic blood loss. A case of ileal cavernous hemangioma detected by Tc-99m labeled red blood cell imaging in the absence of active gastrointestinal bleeding is presented.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This case report describes a 43-year-old woman with polycystic renal disease and cyst infection. Infected cysts of the left kidney were successfully localized with Ga-67 citrate SPECT imaging and CT. Other imaging, including planar gallium imaging, was helpful diagnostically, but could not determine the exact location of infection within the kidney.

ISSN:0363-9762    

出版商:OVID    

年代:1988

数据来源: OVID