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Biomedical subjects

D L Gilday

Publications and source records attributed to D L Gilday.

At least 55 records · Page 3Linked to original sources
PubMed1981

Thallium myocardial perfusion scans for the assessment of right ventricular hypertrophy in patients with cystic fibrosis. A comparison with other noninvasive techniques.

The incidence of right ventricular hypertrophy in 32 patients with cystic fibrosis was studied using thallium 201 (TI-201) myocardial perfusion scans, and compared with other noninvasive techniques including electrocardiography, vectorcardiography, and M-mode echocardiography. The patients (mean age, 17.3 yr; range, 7 to 33) had a wide range of clinical and pulmonary abnormalities (mean Shwachman-Kulczycki score, 66.6). In the total study group, TI-201 scans, like the vectorcardiograms and the M-mode echocardiograms, gave a surprisingly high proportion of positive predictions for right ventricular hypertrophy (RVH) (44%). The correlations with all other noninvasive methods were uniformly poor, so caution must be exercised in using this technique to predict early RVH in order to follow the natural history of cor pulmonale in cystic fibrosis. At the time of the study, 6 patients had clinical evidence of right ventricular failure, and in this disease setting must have had RVH. In 3 patients, RVH was confirmed at autopsy, and it was successfully predicted by TI-201 scans in 5 of the 6 patients. The false negative scan may have been due to regional myocardial ischemia secondary to severe right ventricular failure. In contrast, the vectorcardiogram, using Fowler's new criteria, made a successful prediction of RVH in all 6 patients, and the electro cardiogram in only 3. Although the M-mode echocardiogram was abnormal in all patients, it would have predicted RVH (with increased right ventricular anterior wall thickness) in only 1 patient. We concluded that TI-201 myocardial perfusion cans are good at confirming RVH in cases with established right ventricular failure, but have no advantage over vectorcardiographic assessments, which are logistically easier to perform and carry no radiation risks.

Adolescent↗
PubMed1980

Unsuspected costo-vertebral fractures demonstrated by bone scanning in the child abuse syndrome.

Many patterns of injury have been described in the child abuse syndrome. Until recently, all the bone manifestations of this syndrome have been diagnosed radiologically. Four cases of multiple costovertebral fracture diagnosed by bone scan are described and their etiology discussed. The use of bone scanning in identifying fractures which previously would have been missed is advocated.

Child Abuse↗
PubMed1980

Problems in the scintigraphic detection of osteomyelitis.

Bone imaging has played a major role in the early detection of pediatric osteomyelitis. The single gamma camera view (rather than whole body imaging) successfully delineates the growth zones of the long bones and can detect subtle changes in these regions. If a high suspicion of osteomyelitis is entertained despite a normal bone scan, gallium imaging should be employed. Cases have been reported in which delayed scans were normal but the blood pool image was not.

Bone and Bones↗
PubMed1980

Scintigraphic appearances of osteoid osteoma.

A series of 42 osteoid osteomas is reviewed, and the scintigraphic appearances are described. In all cases, a marked, well-localized area of increased activity was demonstrated at the tumor site in both the blood-pool and standard two-hour images. The blood-pool images were performed after the injection of technetium-99m methylene diphosphate which showed a small hyperemic lesion in all cases of osteoid osteoma, thus distinguishing this tumor from other lesions which may show uptake of radionuclide activity after two hours.

Adolescent↗
PubMed1980

Bone scintigraphy in chondroblastoma.

Scintigraphy in 3 patients with chondroblastoma showed that the tumors were hyperemic and avidly accumulated the radionuclide. These changes were also present in adjacent normal bone, but to a lesser degree. This suggest that radionuclide uptake in chondroblastoma is a function of the blood supply to the tumor rather than primary matrix extraction.

Bone Neoplasms↗
PubMed1980

Primary neuroblastoma uptake of 99mtechnetium methylene diphosphonate.

Forty patients, ages three days to 12 years, with neuroblastomas had bone scans with 99mtechnetium methylene diphosphonate (99mTc-MDP) as part of their pretreatment examination. Twenty-four (60%) had primary tumor uptake and 16 (40%) did not. No difference was seen between the two groups in the incidence of tumor calcification or necrosis. No relationship between the level of urinary vanillylmandelic acid (VMA) and the presence of primary tumor uptake of 99mTc-MDP was found. The possible causes for the localization of 99mTc-MDP are discussed.

Adrenal Gland Neoplasms↗
PubMed1980

Renal nuclear imaging and analysis in pediatric patients.

Because a renal scan reflects the physiologic configuration and function of the kidney, it provides information that cannot be obtained with conventional intravenous pyelography. It is particularly useful in children with hydronephrosis, vesicoureteral reflux, chronic pyelonephritis, and congenital renal anomalies.

Diuretics↗
PubMed1980

The futility of bone scanning in neonatal osteomyelitis: concise communication.

Twenty-one neonates suspected of having acute osteomyelitis were studied by technetium-99m phosphate radiopharmaceuticals. Of the ten infants subsequently proven to have osteomyelitis involving 20 sites in all, only sis sites (31.5%) were abnormal by bone imaging. Fifty-eight percent were normal and 10.5% equivocal. These poor results are contrary to the high accuracy rate achieved in slightly older infants; they negate the ability of the bone scan to diagnose neonatal osteomyelitis.

Acute Disease↗
PubMed1980

Primary hydronephrosis. Assessment of diuretic renography, pelvis perfusion pressure, operative findings, and renal and ureteral histology.

Hydronephrosis generally implies ureteropelvic junction obstruction, but may be mimicked by a variety of other disorders. The authors have attempted to determine the relative diagnostic value of diuretic renography and the pelvis perfusion test in children with hydronephrosis by correlating the results with operative findings, renal and ureteral histology, and postoperative results.

Child↗
PubMed1979

Transient myocardial ischemia of the newborn infant demonstrated by thallium myocardial imaging.

Five term and two premature newborn infants were referred for respiratory distress and congestive heart failure, and were found to have electrocardiographic Q or ST-T abnormalities suggesting ischemia. Echocardiographic and/or hemodynamic assessment excluded anatomic heart disease in six infants. In three infants, moderate or severe hemodynamic impairment within 36 hours of age was suggested by these studies. Myocardial perfusion images in all patients showed very poor myocardial uptake of thallium 201, compatible with global myocardial ischemia. Infants of similar age with myocarditis, or with congenital heart disease and congestive failure, had normal myocardial uptake. Rapid clinical improvement occurred within three to seven days. Two to five months later, all infants were well. Two had persistent electrocardiographic abnormalities but repeat thallium 201 imaging in six demonstrated almost normal myocardial uptake. These data provide further evidence that perinatal respiratory distress may be associated with myocardial dysfunction and congestive heart failure in some infants without anatomic heart disease, and suggest that myocardial dysfunction in these infants is associated with global myocardial ischemia, most of which is transient. The timing and nature of the insult causing the ischemia are unclear.

Coronary Disease↗
PubMed1979

Radionuclide skeletal survey in neuroblastoma.

Of 63 99mTc-phosphate bone images in 49 patients with neuroblastoma, 41 were abnormal, 17 showed tracer uptake within the primary tumor, 29 showed evidence of skeletal metastatic disease, and 17 demonstrated renal/urinary tract involvement. The metastases were asymmetric in 24 patients and symmetrical in 9, in whom they involved the metaphyses and epiphyses of the long bones. Except for one patient with multiple "cold" areas, all metastases were seen as focal hyperactive regions. Eleven of 42 skeletal radiographic surveys were abnormal. The radionuclide study appears to be more accurate than skeletal radiography in estimating bone involvement in neuroblastoma. Primary tumor concentration of the tracer is almost pathognomonic of neural crest neoplasms in childhood.

Abdominal Neoplasms↗
PubMed1979

Craniosynostosis: correlation of bone scans, radiographs, and surgical findings.

Skull scintigraphy was performed in 68 children with suspected craniosynostosis after injection of technetium-99m methylene diphosphonate. The scans demonstrated four patterns of sutural activity: normal, absent, increased, and wide. When correlated with surgical findings, "absent" indicated fused sutures, "increased" indicated fusing hyperactive sutures or sutures reacting to fusion elsewhere, and "wide" indicated splite sutures. Upon correlation with the radiographs, it was found that when the radiograph was normal, the scan contributed little; when the radiograph was abnormal or equivocal, the scan was often of great assistance in confirming fused sutures and detecting other abnormal sutures.

Child, Preschool↗
PubMed1979

Radiopharmaceutical bone scanning in pediatric neurosurgery.

Radionuclide bone scanning is an extremely sensitive, safe and widely applicable investigative aid. In most circumstances it cannot be employed to the exclusion of plain radiography as the two procedures--one dynamic and the other static--complement each other. In children, bone imaging demonstrates physiologic characteristics of bone growth and early suture closure, delineates obscure tumors and infection, recent or old trauma not always visible on orthodox radiography and may solve the diagnostic dilemma of a child with heretofore undiagnosed head, neck or back pain.

Back Pain↗