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Biomedical subjects

E Shalaby-Rana

Publications and source records attributed to E Shalaby-Rana.

9 recordsLinked to original sources
PubMed2001

The spectrum of heterotopic gastric mucosa in children detected by Tc-99m pertechnetate scintigraphy.

Meckel's diverticulum is the most common site of heterotopic gastric mucosa (HGM). Other sites include intestinal duplication and the small bowel proper. Tc-99m pertechnetate abdominal scintigraphy is used commonly to detect HGM. This article describes various scintigraphic patterns of HGM and reviews technical aspects of the procedure, with emphasis on pharmacologic enhancement.

Child, Preschool↗
PubMed2001

Acute pyelonephritis: comparison of diagnosis with 99mTc-DMSA, SPECT, spiral CT, MR imaging, and power Doppler US in an experimental pig model.

PURPOSE: To compare the sensitivity and specificity of technetium-99m dimercaptosuccinic acid (DMSA) single photon emission computed tomography (SPECT), spiral computed tomography (CT), magnetic resonance (MR) imaging, and power Doppler ultrasonography (US) for the detection and localization of acute pyelonephritis by using histopathologic findings as the standard of reference. MATERIALS AND METHODS: Bilateral vesicoureteric reflux was surgically created in 35 piglets (70 kidneys). One week later, a liquid bacterial culture of Escherichia coli was injected into the bladder. Three days after induction of urinary infection, imaging studies were performed, and the kidneys were removed for histopathologic examination. SPECT images were obtained 2-3 hours after injection of 99mTc-DMSA. Transverse and coronal MR images were obtained with gadolinium-enhanced fast inversion recovery. Transverse CT images were obtained before and after injection of contrast agent. Power Doppler US was performed in longitudinal, transverse, and coronal planes. Each kidney was divided into three zones for correlation of findings. RESULTS: Histopathologic examination revealed pyelonephritis in 102 zones in 38 kidneys. Sensitivity and specificity for detecting pyelonephritis in the kidneys were 92.1% and 93.8% for SPECT, 89.5% and 87.5% for MR imaging, 86.8% and 87.5% for CT, and 74.3% and 56.7% for US. Sensitivity and specificity for detecting pyelonephritis in the zones were 94.1% and 95.4% for SPECT, 91.2% and 92.6% for MR imaging, 88.2% and 93.5% for CT, and 56.6% and 81.4% for US. The pairwise comparison of these modalities showed no statistically significant difference among them except for US. CONCLUSION: 99mTc-DMSA SPECT, spiral CT, and MR imaging appear to be equally sensitive and reliable for the detection of acute pyelonephritis; power Doppler US is significantly less accurate.

Acute Disease↗
PubMed2001

(99m)Tc-MDP scintigraphic findings in children with leukemia: value of early and delayed whole-body imaging.

UNLABELLED: The purpose of this study was to reveal the bone scan abnormalities in children with leukemia and to show the value of whole-body scanning in early and delayed phases. METHODS: From a database of all patients with a diagnosis of leukemia from January 1990 to April 2000, 12 children (9 male, 3 female; mean age, 8.0 y; age range, 4.7--13.2 y) were identified for whom the diagnosis of leukemia was suggested on the basis of bone scans obtained as part of the initial work-up for unexplained skeletal pain. Early and delayed whole-body bone scans and radiographs were reviewed retrospectively. Areas of abnormal uptake on early and delayed phases were categorized into locations: metaphysis--diaphysis--epiphysis (MDE), pelvis, ribs, spine, and others. MDE lesions included abnormalities in the metaphysis extending into the diaphysis for some length: metaphysis/diaphysis, metaphysis only, diaphysis only, epiphysis only, and the entire bone. Pelvic and spine lesions were further characterized as focal or diffuse. RESULTS: Ten patients had lesions in 2 or more locations on both phases. Two patients had multiple lesions on the early scans but only rib lesions on the delayed scans. Lesions correlated with symptomatic sites in 8 patients on the delayed scans and in 11 patients on the early scans. The most common sites of abnormalities on the delayed scans were metaphyseal/diaphyseal, pelvis (focal), and ribs. The most common locations of lesions on the early scans were metaphyseal/diaphyseal, pelvis (diffuse or focal), and spine. More metaphyseal/diaphyseal lesions were seen on the early scans than on the delayed scans. Diffuse involvement of the pelvis and spine was seen only on the early phase. However, rib lesions were seen more frequently on the delayed scan. CONCLUSION: Early whole-body imaging in conjunction with delayed whole-body scanning may enhance the diagnostic accuracy of bone scanning in the evaluation of children with skeletal pain of obscure etiology, such as that associated with leukemia.

Adolescent↗
PubMed1997

Imaging in pediatric urology.

A multitude of disorders of the genitourinary tract can occur in children. Although some entities may be diagnosed clinically, radiologic imaging is often necessary for diagnosis and management. The radiologic work-up has been discussed using a problem-oriented approach in five clinical situations: urinary tract infection, hydronephrosis or hydroureter, trauma, swollen scrotum, and hematuria. This discussion provides some general guidelines, although the evaluation of each child may need to be individualized depending on their specific clinical symptomatology.

Acute Disease↗
PubMed1997

In-111 pentetreotide scintigraphy in patients with neuroblastoma. Comparison with I-131 MIBG, N-Myc oncogene amplification, and patient outcome.

OBJECTIVE: 1. To evaluate the relative efficacy of In-111 pentetreotide and 1-131 radioiodinated meta-idobenzyl guanidine (MIBG) for detection of primary and metastatic neuroblastoma. 2. To assess the prognostic value of In-111 pentetreotide uptake. METHODS AND MATERIALS: Seven In-111 pentetreotide and seven I-131 MIBG scans were obtained in six patients with stage IV neuroblastoma and 1 with stage III ganglioneuroblastoma. Three scans were obtained at initial staging and four were obtained during therapy. Correlation was made with concomitant computed tomography scans, bone scans, N-myc oncogene amplification, and clinical outcome. RESULTS: Primary tumor was present in six patients and had been resected in 1. In-111 pentetreotide uptake was seen in two of six primary tumors, I-131 MIBG scan was positive in five of six. In-111 pentetreotide scan was positive in two of four patients with bone metastases, I-131 MIBG scan was positive in three of four. Both showed liver metastases in one patient and did not show bone marrow metastases in another. Overall sensitivity for primary or metastatic disease was 57% (four of seven) for In-111 pentetreotide and 86% (six of seven) for MIBG. Correlation between N-myc oncogene and In-111 pentetreotide uptake was seen in four of seven patients. In-111 pentetreotide uptake correlated with the clinical outcome in six patients with more than 1 year follow-up. Two patients with negative In-111 pentetreotide scans had unfavorable outcome. One patient died, and the other had local recurrence 15 months after diagnosis. Four patients with a positive scan are alive without disease on follow-up at 13-31 months after diagnosis. CONCLUSION: In-111 pentetreotide scintigraphy is less sensitive than I-131 MIBG for detecting active neuroblastoma. In-111 pentetreotide uptake on scintigraphy may correlate with the prognosis. However, a larger series of patients is needed for further evaluation.

3-Iodobenzylguanidine↗
PubMed1996

The role of 131 iodine-metaiodobenzylguanidine scanning in the correlative imaging of patients with neuroblastoma.

OBJECTIVE: Metaiodobenzylguanidine (MIBG) scans were studied to determine the impact of the scan results on the clinical treatment of pediatric patients with neural crest tumors. METHODS: Serial scans were reviewed retrospectively for 27 patients with neural crest tumors: 25 with initial diagnoses of neuroblastoma (NB), 1 with ganglioneuroblastoma, and 1 with ganglioneuroma (GN). Results were compared with bone scans and computed tomography scans, as well as surgical pathologic findings. RESULTS: At initial diagnosis, when compared with bone and computed tomographic scans, MIBG imaging did not identify any unsuspected lesions that resulted in a change in staging. Thirteen patients with NB who had initially positive MIBG scan results had serial studies that normalized during therapy. However, after completion of therapy, 8 of 13 had relapses of the disease. Although areas of active disease were well delineated by other standard imaging modalities for all 8, only 4 (50%) had MIBG study results that were positive in sites of relapse. There were 4 cases of GN (1 at diagnosis and 3 after therapy for NB) demonstrating an uptake of MIBG that was similar in appearance to that in NB. CONCLUSIONS: MIBG imaging did not change the staging or alter treatment during therapy for any patient. Normalization of positive study results was an unreliable indicator of outcome for children with NB. Furthermore, when relapse occurred, MIBG scans identified only 50% of those with active NB. The uptake of MIBG in GN was indistinguishable from that in NB. In this series, the results of serial MIBG studies did not have a significant impact on patient treatment.

3-Iodobenzylguanidine↗
PubMed1995

Stress fractures of the femoral diaphysis in young children. A report of 2 cases.

Stress fractures of the femoral diaphysis in young children are rare. Pain and an antalgic gait are the most common features. There is usually no history of either trauma or a recent increase in physical activities. Initial radiographs may be normal. Technetium bone scanning is the most sensitive method of early diagnosis, but may not be diagnostic. Computed tomography and magnetic resonance imaging are useful in early confirmation of the diagnosis. Serial radiographs will show maturation of the periosteal new bone with evidence of repair. Biopsy should be avoided, except in cases of obvious neoplasm shown by computed tomography or magnetic resonance imaging, or in cases with progressive cortical destruction shown on serial radiographs, because fracture callus may be difficult to distinguish from osteosarcoma. Treatment consists of protected weight bearing and activity restriction until resolution of symptoms and radiographic evidence of healing.

Age Factors↗