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Biomedical subjects

L C Swayne

Publications and source records attributed to L C Swayne.

At least 73 records · Page 4Linked to original sources
PubMed1989

Diagnosis of acute cholecystitis by cholescintigraphy: significance of pericholecystic hepatic uptake.

Uptake of radionuclide by the liver next to the gallbladder in cholescintigraphy has been described as a useful secondary sign with a high positive predictive value for the diagnosis of acute cholecystitis. We retrospectively examined 780 consecutive cholescintigrams to (1) determine the positive predictive value at 1 hr of this sign for acute cholecystitis and (2) ascertain if the presence or absence of this finding could differentiate acute from gangrenous cholecystitis. Pericholecystic hepatic activity was present at 1 hr in 48 (34%) of 141 scans in which the gallbladder was not visualized, and cholecystectomy was performed within 6 days of scintigraphy. Forty-five of these patients had acute and three had chronic cholecystitis (94% positive predictive value for acute cholecystitis). In addition, 57% of patients with gangrenous cholecystitis exhibited pericholecystic hepatic activity, and the frequency of this finding was significantly higher (p less than .006) in gangrenous than in acute cholecystitis. In summary, pericholecystic hepatic uptake is a valuable secondary sign in the cholescintigraphic diagnosis of acute cholecystitis. The significance of the finding is (1) a high positive predictive value for acute disease at 1 hr and (2) a statistically significant increased frequency in patients with gangrenous cholecystitis.

Acute Disease↗
PubMed1989

Septic arthritis of a lumbar facet joint: detection with bone SPECT imaging.

We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.

Aged↗
PubMed1988

Scintigraphic detection of hemobilia and hemoperitoneum secondary to rupture of hepatic artery aneurysm.

Hemobilia frequently presents with variable gastrointestinal (GI) tract bleeding, biliary colic, and jaundice and should be considered in the differential diagnosis of obscure blood loss from the GI tract. Reported here is a case of a ruptured hepatic artery aneurysm that was diagnosed using Tc-99m labeled red blood cells. Delayed images demonstrated both hemobilia and free intraperitoneal hemorrhage, which were subsequently confirmed by computed tomography and laparotomy. A similar case has not been previously reported in the scintigraphic literature.

Aged↗
PubMed1988

Gallium detection of Salmonella costochondritis.

A case of Salmonella costochondritis developed at a traumatic focus in a 37-yr-old Hispanic male without hemoglobinopathy or systemic disease. Bone scans and gallium scans were initially positive and remained abnormal, despite a variable clinical course and repeatedly negative serology and blood cultures. Scintigraphy was valuable for both detection and monitoring of antibiotic treatment, as well as providing localization for subsequent surgical resection.

Adult↗
PubMed1987

Serendipitous detection of lung cancer on hepatic imaging.

A case of a primary lung carcinoma involving the left pulmonary hilum serendipitously detected utilizing hepatic imaging is presented. Malignant stimulation of the reticuloendothelial system resulted in diffuse pulmonary uptake of Tc-99m sulfur colloid, however, only the right lung was visualized. Subsequently, a chest radiograph and computed tomography of the chest demonstrated massive malignant involvement of the left pulmonary hila, adjacent mediastinum, and left atrium. Transbronchial biopsy revealed anaplastic small cell carcinoma.

Adult↗
PubMed1987

Differential gallbladder contractility in fundal adenomyomatosis: demonstration by cholecystokinin cholescintigraphy.

The cholecystokinin cholescintigraphic findings of fundal adenomyomatosis in a 29-yr-old male with severe post-prandial pain are presented. Planar cholescintigraphy demonstrated a trilobed gallbladder contour. Following the administration of 0.02 micrograms/kg of cholecystokinin at maximal gallbladder filling, fundal dyskinesia was observed. Regional gallbladder ejection fractions were: whole gallbladder, 43%; proximal two-thirds of the gallbladder, 70%; and gallbladder fundus, 32%. First harmonic Fourier phase and amplitude images demonstrated: (a) decreased fundal amplitude values, and (b) a phase shift of the pixels in the gallbladder fundus.

Adult↗
PubMed1986

Indium-111 leukocyte accumulation in intramuscular injection sites.

We report four cases of indium-111 leukocyte concentration in previous intramuscular injection sites. Three patterns were observed: small, discrete, and round; linear; irregular and large. The scintigraphic appearance did not necessarily correlate with the number of injections that the patient had received.

Adult↗
PubMed1986

Bone scan detection of renal vein thrombosis secondary to hypernephroma.

Detection of renal vein thrombosis with osseous scintigraphy has been reported previously. An additional case is presented that is secondary to a hypernephroma. The observation is significant, it is known that patients with hypernephroma in addition to renal vein thrombosis have a worse prognosis.

Bone and Bones↗
PubMed1986

Acute acalculous cholecystitis: sensitivity in detection using technetium-99m iminodiacetic acid cholescintigraphy.

Forty-one proved cases of acute acalculous cholecystitis imaged with technetium-99m iminodiacetic acid (IDA) cholescintigraphy were retrospectively analyzed. After the exclusion of one indeterminate scan (showing poor initial hepatic uptake and excretion), the study yielded a 92.5% (37 of 40) sensitivity for the detection of cystic or common bile duct obstruction. Each of the three patients with false-negative scintigrams had other abnormal scintigraphic findings suggestive of biliary tract disease. Of the 20 patients (48.8%) with focal or diffuse gangrenous cholecystitis or perforation, seven (35%) exhibited either free peritoneal spill or increased pericholecystic activity to indicate the presence of advanced disease.

Acute Disease↗
PubMed1986

Placental changes in fetal triploidy syndrome.

The sonographic findings in fetal triploidy syndrome include intrauterine growth retardation, hydrocephalus, oligohydramnios, and hydropic changes of the placenta. Ultrasonography can establish the diagnosis only when placental findings coexist with a fetus. Although the majority of triploid conceptions abort spontaneously in the first trimester, occasionally they will progress further, but rarely to term. Six cases are presented in which the diagnosis was suspected by early ultrasound examinations, including one case in which there was an unusually large trophoblastic cyst. Determination of the karyotype is important for the management of a pregnancy with a live fetus, and has implications for genetic counseling of subsequent pregnancies.

Abnormalities, Multiple↗