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J Sciuk

Publications and source records attributed to J Sciuk.

50 records · Page 3Linked to original sources
PubMed1992

[99mTc-MAB bone marrow scintigraphy and probe-guided biopsy in aplastic anemia].

The diagnosis of systemic haematological disorders is often confirmed by bone marrow biopsy which is usually performed "blind". False-negative results may be obtained because this method is restricted to a small part of the blood-forming organ. Bone marrow scintigraphy has the potential of detecting the distribution of active haematopoietic bone marrow and to localize infiltrative lesions. This case report of a patient with pancytopenia demonstrates that the diagnosis of aplastic anaemia can be confirmed by bone marrow scintigraphy in combination with probe-guided bone marrow biopsy.

Aged↗
PubMed1992

[Hemangioma of the left ventricle].

The authors describe the case of a histologically proven hemangioma in the left coronary artery of the left ventricle of a 24-year-old woman. The results of the different medical imaging methods applied are described and the treatment of cardiac angiomas is discussed.

Adult↗
PubMed1991

Benzodiazepine receptors and cerebral blood flow in partial epilepsy.

It was the aim of this study to compare benzodiazepine (Bz) receptor binding and cerebral perfusion in patients with partial epilepsy. Single photon emission tomography (SPET) studies with the flow-marker technetium 99m hexamethylpropylene amine oxine (99mTc-HMPAO) and with the 123I-labelled Bz-receptor ligand Ro 16-0154 (123I-Iomazenil) were performed in 12 patients with partial epilepsy, all with normal magnetic resonance imaging (MRI) and computed tomography (CT) scans. The SPET studies with 123I-Iomazenil were carried out 5 min and 2 h after injection. At 2 h the distribution of activity was very similar to the expected distribution of Bz-receptors in the human brain, known from positron emission tomography (PET) work and post-mortem studies. Early images showed a significantly higher tracer accumulation in the area of the basal ganglia, cerebellum, and naso-pharyngeal space. This finding is caused by non-specific binding and the contribution of the tracer in the blood pool in this phase. Also after 2 h p.i. of 123I-Iomazenil, 9 of the 12 patients showed a focal decrease of of Bz-receptor binding. Ten patients had focal flow abnormalities with 99mTc-HMPAO SPET. In 8 subjects impairment of flow was seen in sites of reduced 123I-Iomazenil uptake. 123I-Iomazenil is suitable for Bz-receptor mapping. In this series of patients, Bz-receptor mapping with SPET seems to offer no advantage over 99mTc-HMPAO in the detection of epileptic foci.

Adult↗
PubMed1991

Comparison of technetium 99m polyclonal human immunoglobulin and technetium 99m monoclonal antibodies for imaging chronic osteomyelitis. First clinical results.

The accuracy of technetium-99m human immunoglobulin (HIG) for the detection of chronic osteomyelitis (OM) was compared with white blood cell scintigraphy using 99mTc-labelled monoclonal mouse antibodies (MAB). Seventeen patients suspected of having OM in 20 lesions went through three-phase skeletal scintigraphy, HIG scintigraphy and MAB scintigraphy. The final diagnosis was established by open surgery, histology and bacteriology. Chronic OM was proved in 14/20 lesions. Six of these 14 infections were located in peripheral areas without active bone marrow and 8/14 in central areas with active bone marrow. In peripheral OM, 5/6 with HIG and 6/6 with MAB were true positives. In the central skeleton all 8/8 infections appeared as cold lesions in the MAB study, which were defined as being false negative due to their non-specificity. Using HIG, 5/8 central infections were determined to be truly positive by showing photon-rich lesions. These 5 lesions were located in the hip region and in the pelvis, whereas 3 lesions of the spine were missed. There were no false-positive results in either studies. In conclusion, MAB was superior to HIG in peripheral OM concerning sensitivity, anatomical landmarks and differentiation of soft tissue versus bone infection. In central OM MAB detected all lesions accurately, but no differential diagnosis was possible due to the non-specificity of photon-low areas. In this respect HIG seems to be more specific due to the increased accumulation even in central infection sites.

Adult↗
PubMed1991

[Magnetic resonance tomography of the ankle joint].

To define the clinical role of MRI of the ankle joint, a total of 88 patients was investigated. In the evaluation of ligamentous injury, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint. In the latter conditions, MRI may make other more conventional methods of examining the ankle joint unnecessary.

Ankle Injuries↗
PubMed1991

[Atypical bone metastases in prostate cancer].

Two cases of prostatic cancer with single bone metastasis in the tibia are discussed. The intense uniform involvement of a solitary limb bone with high perfusion and blood pool activity in the 3-phase bone scan and the positive white blood cell scan (observed in one case) were not typical for a metastatic bone lesion. Conventional radiomorphology--lamellar, periosteal reaction, disseminated medullar sclerosis, no localized lesion--also led to other differential considerations such as osteomyelitis and malignant lymphoma, which could not be specified by CT and MRI. Even if there is no typical morphology in scintigraphic and radiologic imaging, biopsy should be performed to exclude bone metastasis in prostatic cancer.

Adenoma↗
PubMed1990

Response of osteosarcoma and Ewing sarcoma to preoperative chemotherapy: assessment with dynamic and static MR imaging and skeletal scintigraphy.

In 15 osteosarcomas and six Ewing sarcomas, response to preoperative chemotherapy was assessed with magnetic resonance (MR) imaging without and with gadolinium diethylenetriaminepentaacetic acid (DTPA) enhancement and with dynamic Gd-DTPA studies, and the results were compared with the scintigraphic findings. All studies were obtained prior to and following preoperative chemotherapy. Static MR imaging was of little value for assessment of response; reduction in signal intensity within soft-tissue masses on the T2-weighted spin-echo images indicated response with a sufficient degree of accuracy (71%) but low sensitivity, whereas an increase in signal intensity after Gd-DTPA administration indicated zones of viable tissue with low specificity. With three-phase skeletal scintigraphy, the findings in the perfusion and blood-pool phases were of no value, whereas the findings in the osseous phase allowed the prediction of response with an accuracy of 73.7%. Of all techniques employed, dynamic MR imaging had the highest degree of accuracy (85.7%) and was superior to scintigraphy, particularly in patients who were receiving intraarterial chemotherapy.

Adolescent↗
PubMed1989

Digital subtraction angiography (IV DSA) in treatment planning of subdiaphragmatic Hodgkin's disease.

In subdiaphragmatic Hodgkin's disease the most common sites of involvement include the para-aortic region, in particular the celiac trunk, the splenic pedicle, and the spleen. In treatment planning, no imaging modalities (i.e. lymphography, CT, US) have so far been able to realize the need for direct imaging of any of these areas on a simulation film, necessary for individual beam shaping. With intravenous digital subtraction angiography (IV DSA) a new imaging method is available that allows direct imaging of these regions in a frontal view. The way and extent the splenic artery crosses the left kidney can exactly be delineated. By using a subtrascope (as common in angiography) the DSA can exactly be superimposed and documented on a simulation film. The DSA drawn onto the simulation film serves as a base for defining an individual target volume in the upper abdominal region (splenic pedicle etc.). The kidney can be shielded in a highly individualized way by individual beamshaping blocks. From December 1985 to December 1986, we treated 35 patients by using this technique for treatment planning. In 32 evaluable patients the imaging accuracy for all sites was judged as "excellent" in 74%, "reasonable" in 19%, and "poor" in 7%. The course of the splenic artery in relation to the left kidney revealed 78% within or above the upper third. By DSA assisted localization the target volume could be accurately defined in every case with shielding of the kidney as much as possible. Compared to nonindividualized standard definitions ("including L1" and "including upper third of the kidney") DSA assisted individual target volume definition was more precise: "including L1" overestimates in 63%, "including upper third" underestimates in 53%. Compared to the standard definition ("including L1") reduction of up to 25% kidney volume to be irradiated could be achieved in 63%. DSA could be performed on an outpatient basis. The median duration of DSA performance was 20 minutes; superimposing and drawing at the subtrascope took median 20 minutes. There were no severe side effects.

Angiography↗
PubMed1989

[CT examinations in older age groups].

A total of 2,878 unselected subsequent CT examinations carried out in 1984 were analyzed retrospectively. All studies were performed in a university hospital with a centralized department of diagnostic radiology. Most of the patients investigated were hospitalized; there were only 12% outpatients. Of the patients studied 12.6% were older than 65 years and 20.5% older than 60; 17.7% were emergency cases and patients between 16 and 25 years of age represented the largest fraction. In all other age groups the relative distribution between emergency cases and regular studies revealed no significant differences. There was no statistically significant difference between the older age group (patients older than 65 years) and the total population of this study in almost all items investigated, i.e., no differences in CT examination time and no differences in preparation time (time between two CT studies). The rate of abdominal CT examinations was 7% higher in the older age group, while the relative distribution of all other CT examinations was again comparable to the total population under study. Thus, the expected increase in patients in the older age group does not measurably prolong the CT examination time. This statement applies to a major referral center with a high percentage of inpatients.

Aged↗
PubMed1989

[Digital subtraction angiography (i.v. DSA) in the planning of infradiaphragmatic irradiation of malignant lymphoma].

Intravenous digital subtraction angiography (i.v. DSA) - an almost non-invasive imaging procedure - makes it possible to visualize the vascular topography of the upper abdominal region, with the parenchyma of spleen and kidney, simultaneously with bony structures (spine) in a frontal view. With the aid of a subtrascope, spleen and kidney and the vascular topography can be directly superimposed on a simulation film. By this procedure an individual target volume can be delineated. From December 1985 to December 1987, planning procedures for 44 treatment regimens were evaluated using i.v. DSA. With reference to the determination of a precise and individual target volume, DSA-assisted treatment planning was found to be superior to non-individualized standard definitions.

Angiography↗
PubMed1989

[Sonography of the thyroid gland].

Real-time ultrasound is a generally available, noninvasive and inexpensive tool allowing evaluation of the thyroid gland without any radiation exposure. The method is highly sensitive with regard to shape, size, localization and morphology of this gland. Owing to low specificity ultrasound does not yield sufficient information concerning the function and degree of malignancy of lesions in relation to the structure and echogenic pattern. In some cases it is possible to achieve the final diagnosis with ultrasound in combination with clinical and laboratory findings. The information is based on the morphology of lesions and is an ideal supplement to the functional information yielded by scintigraphic examination and makes it possible to perform fine-needle biopsy. For primary examination and during follow-up, ultrasound is indispensable as a basic imaging modality. It is extremely important that the physician should be experienced.

Humans↗
PubMed1989

[Nuclear medical diagnosis of hip joint diseases in adults].

Skeletal scintigraphy has a high sensitivity but low specificity in early detection and follow up of hip diseases. Unexplained hip pain or indistinct X-rays may be the reason for scintigraphic examination. On the other hand, there is a wide range of clinical indications for nuclear medicine examination, such as metastatic and primary malignant disease, tumor-like lesions, inflammatory, infectious, degenerative and avascular diseases, and posttraumatic and postoperative changes. White blood cell scintigraphy is highly sensitive and highly specific in the detection of infectious disease of the hip. In the vast majority of cases, physiologic or postoperative granulocytic accumulation can be differentiated from infectious accumulation, which requires therapy.

Adult↗
PubMed1988

[Intrathoracic goiter in the posterior mediastinum].

Several examination methods are now available for diagnosis of intrathoracic goiter; diagnosis of suspicion is made by conventional plain radiography of the thorax, clinical findings being often normal or non-characteristic. If the iodine scintigram shows accumulation in the tumor, we can be practically sure of the diagnosis of an intrathoracic goiter. In case of a negative iodine scan we can obtain pointers to the nature of the tissue via CT or MR, especially if a connection between cervical thyroid tissue and intrathoracic mass can be demonstrated. Furthermore, these two methods (CT and MR) enable exact determination of the extension of the goiter and show the topographical relation to the neighbouring organs or their displacement.

Goiter, Substernal↗