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Biomedical subjects

M L Lecklitner

Publications and source records attributed to M L Lecklitner.

At least 37 records · Page 2Linked to original sources
PubMed1985

Hepatobiliary scintigraphy and hepatic cavernous hemangioma.

As the most common benign hepatic tumor, hepatic hemangioma may be misinterpreted during radiographic cancer staging, inadvertently biopsied, or pursued surgically as a solitary malignancy. Two cases of hepatic hemangiomas discovered during hepatobiliary scintigraphy are presented: the first involving multiple anechoic lesions by ultrasound and the second involving a solitary echogenic lesion by ultrasound. Whereas the former patient eventuated in surgery solely for the evaluation of a space-occupying lesion, the latter was totally obstructed at the common bile duct; both patients' hemangiomas were documented surgically.

Adult↗
PubMed1985

Failure of quality control to detect errors in the preparation of technetium-99m disofenin (DISIDA).

Uptake of Tc-99m disofenin is so strongly hepatobiliary that striking appearance of radioactivity in the reticuloendothelial system (RES) is almost certainly caused by improper preparation of the disofenin kit. Four patients who received injections of Tc-99m disofenin demonstrated a pronounced RES biodistribution in addition to the expected hepatobiliary pattern. Since routine quality control testing had not forewarned us of this gross lack of radiochemical purity, Tc-99m disofenin kits were subjected to a variety of insults to elucidate the mechanisms of quality control failure. Assessment of radiochemical purity was conducted using instant thin-layer chromatography (ITLC) and two solvent systems. We concluded that both Tc-99m pertechnetate and Tc-99m sulfur colloid had been injected into the cold disofenin kit. Visual inspections were not reliable for verifying the final radiopharmaceutical product because of dilution of the sulfur colloid by pertechnetate. ITLC testing failed because the assay method being used at that time did not accurately assess the hydrolyzed fraction (colloidal component). Recommendations are made to preclude recurrence of the errors that occurred.

Adult↗
PubMed1985

Absence of gallium-67 avidity in diffuse pulmonary calcification.

Diffuse pulmonary uptake by bone-seeking radiopharmaceuticals has been reported previously but, in the same patient, would pulmonary uptake of Ga-67 citrate yield clinically meaningful results? A patient with hypercalcemia and renal failure in whom bone scintigraphy demonstrated striking diffuse bilateral pulmonary uptake, but subsequent gallium imaging demonstrated no evidence of pulmonary uptake greater than body background, is discussed. We conclude that pulmonary uptake of gallium cannot be attributed to calcium deposition and should carry the same clinical significance in regard to inflammatory and malignant lesions as would be assigned to patients without pulmonary calcific deposits.

Adult↗
PubMed1984

Arterio-colonic fistula during scintigraphic evaluation of gastrointestinal bleeding.

The use of scintigraphic imaging in the evaluation of gastrointestinal (GI) hemorrhage has been established recently as a screening procedure prior to anigography. We report an unusual and previously unreported cause of acute GI bleeding which illustrates several technical factors to be considered during scintigraphic evaluation of GI bleeding.

Colonic Diseases↗
PubMed1984

Verification of global cerebral ischaemia using scintigraphy.

The induction of global cerebral ischaemia in laboratory animals is difficult to accomplish and has been even more difficult to verify. Most reported verification methods suffer from lack of sensitivity or from being traumatic and highly invasive. We describe a non-traumatic global cerebral ischaemia verification technique which is quantitative, simple, and highly sensitive. Radioactive technetium-99m pertechnetate is injected intravenously during the ischaemic phase of an experiment and the appearance of radioactivity within the animal's head is quantitated using a gamma camera and nuclear medicine computer. Radioactivity levels below the visual perception threshold are readily measured, thus providing a high degree of confidence in assessing the partial or total nature of cerebral ischaemia.

Animals↗
PubMed1984

Postoperative evaluation of penetrating hepatic trauma and complications.

Postoperative hepatobiliary scintigraphy is recommended in selected cases of hepatic trauma to evaluate the integrity and patency of the biliary system. We present a patient with a traumatic hematoma that eventuated in a biloma with spontaneous biliary-cutaneous fistula. Repeat study demonstrated biliary obstruction at the canalicular level, which by more invasive imaging was found secondary to total obstruction of the common hepatic duct. The precise anatomical level and cause of his obstruction were defined by the findings of endoscopic retrograde cannulation of the pancreas, percutaneous transhepatic cholangiography, and surgery.

Adult↗
PubMed1983

Incidence and function of residual splenic tissue following splenectomy for trauma in adults.

A limited study of children requiring splenectomy for trauma suggested a 59% incidence of splenosis. We attempted to confirm these results in 40 adult patients with trauma. Residual splenic tissue, from either splenosis or accessory spleens, was seen in 26% of patients who underwent splenectomy for trauma and subsequent splenic scintigraphy. There was no significant difference in serum IgM levels between control patients and splenectomy patients with or without residual splenic tissue. There was also no difference in the percentage of pitted RBCs in splenectomized patients with or without residual splenic tissue. However, both groups of splenectomized patients had significantly higher numbers of pitted RBCs than did controls. These results indicate that the incidence of residual splenic tissue, though significant, is lower than previously reported, and that natural splenosis probably results in a small splenic mass incapable of restoring total splenic function.

Abdominal Injuries↗
PubMed1983

Bone scintigraphy and postoperative ureteropelvic urine extravasation.

A case of severe urinary extravasation after renal pyeloplasty resulted in symptoms strongly suggestive of musculoskeletal origin. Bone scintigraphy revealed no findings relating to the skeletal system, but because of renal excretion of the tracer, the cause of the postoperative pain was revealed. The value of bone scintigraphy as a urinary tract diagnostic screening tool is probably underrated, even though at least 15% of studies fortuitously detect abnormalities of the urinary tract.

Adolescent↗
PubMed1983

Neonatal hepatic malignant tumor. A correlative imaging approach.

We report the hepatobiliary study of a neonate with hepatomegaly. Biliary atresia was ruled out. Fortuitous demonstration of massive parenchymal lesions redirected the clinical management of the child. Other imaging modalities were employed to define further the nature of the lesions. Pediatric reports of non-biliary lesions demonstrated by hepatobiliary scintigraphy are uncommon. To our knowledge, the present case of multiple hepatoblastomas discovered by hepatobiliary imaging is the first report in the literature.

Carcinoma, Hepatocellular↗