1,721,069 research outputs found
[Clinical significance of the role of left ventricular cavitation ratio in the assessment of coronary artery disease with 99mTc-tetrofosmin]
No full textThis study was aimed at assessing the increase in left ventricular cavity volume in patients with induced stress ischemia, by the quantitative analysis of myocardial SPECT perfusion images obtained 30-45 min after 99mTc-Tetrofosmin injection.
PATIENTS AND METHODS: 31 consecutive patients with suspected CAD (group A) and 16 low risk CAD subjects (group B) underwent the study. Global (GMPR) and regional myocardial perfusion reserve indices were assessed superimposing a 17 ROI mask on stress and rest bull's eye images. Ventricular cavitation index (VCI) was calculated manually, outlining the left ventricular cavity on stress and rest midventricular SPECT slices. L/H ratio was determined on anterior SPECT images.
RESULTS: On the basis of perfusion patterns, group A was divided into two subgroups: subgroup 1 included the patients with reversible perfusion defects (n = 20) and subgroup B those with irreversible perfusion defects (n = 11). Average stress CI was significantly higher in group A than in group B (p < 0.01) and in subgroup 1 than in group B (p < 0.005). Rest CVI, GMPR and L/H ratio showed no significant intergroup differences. The stress VCI to rest VCI ratio (VCI ratio) was higher in subgroup 1 than group B (p < 0.0001) and in subgroup 1 than in subgroup 2 (p < 0.01). Moreover, VCI ratio was higher in group A than in group B.
CONCLUSION: These preliminary data show that, in ischemic patients, left ventricular cavity volume increases after stress also in 99mTc-Tetrofosmin images. Since our images were acquired 30-45 min after stress, when the dilatation due to ventricular dysfunction is usually resolved, the volume increase may be caused by a cavitation effect due to reduced intracardiac blood flow
Radionuclide accumulation in the proximal esophagus during esophageal scintigraphy
No full textA 7-year-old boy with acid regurgitation, heartburn, vomiting, and frequent respiratory infections in the previous 3 months underwent gastroesophageal scintigraphy to evaluate reflux. He had a history of congenital atresia of the esophagus with a fistula located between the trachea and the upper esophageal pouch and other associated congenital abnormalities, including those of the genitourinary tract and heart. Since his birth, surgery had been done to close the fistula, canalize the esophagus, perform esophageal anastomosis, and to obviate gastroesophageal reflux with a Nissen fundoplication. Esophageal scintigraphy showed significant holdup (>50% of ingested activity) of Tc-99m hepatate-labeled orange juice in the proximal third of the esophagus, which was confirmed by a barium stud
Nuclear cardiology and echocardiography for the assessment of myocardial viability
No full textThe review aims to make a comparative analysis of the nuclear cardiology and echocardiographic approaches for the assessment of myocardial viability on the basis of the most recent literature. Preliminarily the most extensively used methods are described: 1) metabolic tracers, especially as regards FDG-F18 (quantitative uptake; mismatch FDG uptake/perfusion); 2) sarcolemmal integrity tracers (201Tl- with stress-redistribution- reinjection or with rest-redistribution protocols; rest MIBI 99mTc); 3) low dose dobutamine stress echocardiography (LDDSE) for the detection of residual contractility reserve. Global sensitivity values of thallium studies are reported to be similar to those of LDDSE, but in selected patients populations with akinetic or severely hypokinetic segments the LDDSE sensitivity seems to be significantly lower, when metabolic viability assessed by FDG studies is assumed as gold standard. According to the Authors' opinion thallium study with a protocol including a rest injestion can be considered at the moment the first choice for myocardial viability assessment because of its convenience, reproducibility, possibility of technical and interpretative standardization, amount of clinical and experimental validations. Anyway further clinical trials with adequate follow-up are necessary in order to define the scintigraphic and echocardiographic patterns that provide the best accuracy in the prediction of the post-revascularization clinical outcome
Renal scintigraphy with Tc-99m DTPA in pheochromocytoma : mistake or not?
No full textA 32-year-old man who reported abdominal pain and had an echographic diagnosis of renal or extrarenal mass (diameter, approximately 10 to 12 cm) underwent renal scintigraphy with 111 MBq (3 mCi) Tc-99m DTPA. The renal scan revealed increased uptake superior to the upper pole of the left kidney with normal renal function. Subsequently, the computed tomographic and magnetic resonance features showed a voluminous left paraaortic retroperitoneal mass, probably in the left adrenal compartment, of unknown nature. Results of a 24-hour urinary evaluation of vanillylmandelic acid were abnormal (59.5 mg; normal, 1 to 11 mg). Surgery and histologic examination confirmed the presence of a voluminous left adrenal pheocromocytom
Esophageal inflammation evident on oral Tc-99m sulfur colloid gastroesophageal imaging
No full textA 59-year-old woman underwent gastroesophageal and pulmonary scintigraphy with an acid liquid meal, labeled with Tc-99m sulfur colloid, to evaluate gastroesophageal reflux and eventual micropulmonary aspiration of gastric contents. Four years earlier she had endoscopic cardia dilatation. At the time of examination, she reported asthma, dry cough, sialorrhea, and mild heartburn. Static images showed accumulation of activity in the large bowel, mouth, salivary glands, and especially in the body of the esophagus. The uptake and its persistence in the esophagus for 18 hours could be a result of chronic inflammation of the esophagus. Endoscopy of the esophagus confirmed the diagnosis of esophagitis
Delayed Gastric Emptying in Advanced Parkinson Disease
No full textIntroduction Gastrointestinal dysfunction is often described in patients with Parkinson disease (PD), and gastrointestinal symptoms are usually attributed to gastroparesis. The consequent delayed gastric emptying (GE) may be an important pharmacokinetic mechanism underlying some of the response fluctuations that develop after long-term levodopa (l-dopa) therapy. The aim of this prospective study was to assess GE time by a liquid meal scintigraphy, in PD patients, and to correlate them with demographic, clinical, and therapeutic data. Methods Scintigraphy with radiolabeled albumin nanocolloids added to acidified orange juice was performed in 51 consecutive PD patients 1 hour after their usual dopaminergic therapy first dose and after a 12-hour fast. Demographic, neurologic, gastrointestinal, and pharmacologic data were collected. Results Fifty-one patients were divided into 2 groups using the cutoff point obtained in normal subjects (40 minutes): group 1 included 29 patients with GE T1/2 of 27.60 ± 7.30 minutes (normal), group 2 showed a GE T1/2 of 84.90 ± 53.80 minutes (delayed). The most striking significant difference between the 2 groups was the dopa-decarboxylase inhibitor mean dose that was significantly higher in the group of patients with delayed GE (201.32 ± 97.26 vs 127.65 ± 79.74; P = 0.005). Conclusions The impairment of gastric motility, frequently represented in PD patients, occurs in approximately 42% of patients with motor complications. A mechanism that may explain the GE delay is the effect of l-dopa on dopaminergic receptors in the stomach. Therefore, the dosage of dopa-decarboxylase inhibitor, increasing the l-dopa concentration, may contribute to GE delay and its consequent effect on drug delivery and efficacy
ESPERIENZA DI FOLLOW-UP NEFROLOGICO MEDIANTE SCINTIGRAFIA RENALE ED ECOGRAFIA IN BAMBINI AFFETTI DA GLICOGENOSI TIPO I IN DIETOTERAPIA
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