Scintiscans of two siblings with tumoral calcinosis.
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Adult↗
Biomedical subjects
S Balachandran
Publications and source records attributed to S Balachandran.
Scintiphoto of a frontal sinus osteoma.
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Frontal Sinus↗
Ferrochelatase deficiency in an infant with anemia and growth delay.
A 5-month-old infant with hypochromic anemia and iron overload secondary to ferrochelatase (heme synthetase) deficiency is described. Decreased activity of iron-containing enzymes in the absence of any other proven cause is suggested as the main cause of the associated growth retardation.
Anemia, Hypochromic↗
Dynamic scintigraphy in renal arteriovenous fistula.
Radiographic contrast aortography and radionuclide dynamic scintigraphy were used to diagnose a congenital renal arteriovenous fistula in a 33 year old woman who presented with hypertension, cardiac decompensation and abdominal bruit. Since dynamic scintigraphy is a noninvasive, nontraumatic, low risk and easily repeatable procedure, it is invaluable for the diagnosis of the fistula and for monitoring patients who are managed without surgery.
Adult↗
Discordant thyroid nodule images with pertechnetate at 30 minutes and 3 hours.
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Female↗
Adrenal imaging with 131I-19-iodocholesterol in the diagnostic evaluation of patients with aldosteronism.
The results of adrenal scintiscans, venograms and venous aldosterone levels are compared with the histologic findings in 33 patients submitted to operations for primary aldosteronism. Standard and suppression scintiscans were performed 2-14 days following intravenous administration of 2mCi of 131I-19-iodocholesterol. The adrenal lesions were histologically classified into four categories: 25 patients had adenomas, 6 had macronodular hyperplasia, 1 had microscopic hyperplasia and 1 had an adenocarcinoma. Asymmetrical uptake between the two adrenals seen on standard scintiscans did not differentiate between a tumor or asymmetrical hyperplasia, unless the tumor was greater than 2 cm in diameter. During suppression scintiscans, unilateral uptake visible within five days of tracer injection was consistent with adenoma. Patients with nodular hyperplasia demonstrated early uptake in both adrenal glands during suppression scintiscans, while the patient with microscopic hyperplasia did not. The type of adrenal lesion was correctly identified in 20/26 (77%) of patients by suppression scintiscans; 21/28 (75% of patients by venograms and 12/16 (75%) of patients who had adrenal venous aldosterone measurements attempted. The majority of surgically correctible lesions could be identified on suppression adrenal scintiscans. Adrenal vein catheterization can be reserved for those patients in whom the results of suppression scintiscans are inconsistent with the clinical degree of aldosteronism.
Adenoma↗
Selenium-75-19-selenocholesterol-a new adrenal scanning agent with high concentration in the adrenal medulla.
A tissue distribution study with 75Se-19-selenocholesterol in rats, rabbits, and dogs showed high adrenal concentrations and good adrenal images. In the dog, higher concentrations were obtained in the adrenal medulla than in the cortex at Days 1 and 7 after dosing. Extraction and thin-layer chromatography of the adrenal lipid in dogs given this compound showed that 75Se in the adrenal is still attached to the steroid moiety. A reduction in production costs is expected from its longer shelf life. Selenium-75-19-selenocholesterol is being evaluated in humans not only for routine use as a adrenal cortex scanning agent, but also for the detection of pheochromocytomas and other sympathetic tissue tumors, especially neuroblastomas.
Adrenal Gland Diseases↗
Gallium citrate Ga 67 scanning: clinical usefulness in lymphoma patients.
Gallium citrate Ga 67 (67Ga) scans were performed in 50 consecutive lymphoma patients who underwent routine staging. The overall accuracy of 67Ga scans was greater than 80% for all nodal sites except the spleen (68%). Sensitivity was greater than 88% in the neck and mediastinum, 67% in the abdomen-pelvis, and 33% for the spleen. Specificity was greater than 85% for all nodal sites except for the mediastinum (67%). The accuracy of pedal lymphangiograms was 75%, sensitivity 87%, and specificity 68%. Gallium 67 scans complemented the lymphogram in the abdomen-pelvis but, due to limited sensitivity and high number of equivocal studies (16%), did not replace it. Infraclavicular, pectoral, and mediastinal lesions were detected by 67Ga scans when missed by other means. In 20% to 25% of patients, 67Ga scans provided information not afforded by other diagnostic studies and are therefore considered an important staging procedure for lymphoma patients.
Abdominal Neoplasms↗
Simplified radioimmunoassay for triiodothyronine: evaluation of a new commercial kit.
A new triiodothyronine (T3) radioimmunoassay kit offers simplicity of method, short incubation time, specificity, and reproducibility. 125I-labeled T3 and unknown serum (or standard) are added to alkaline buffered (pH 12.4) Sephadex G-25 columns; the T3 is freed of proteins with an alkaline buffer wash, antiserum is added, and the columns are incubated at room temperature for 2 h. "Free" hormone (i.e., unbound to antiserum) remains on the column after a second wash. The radioactivity on the column is counted and related to the total activity added. The T3 standards produced a straight line on log-logit plot; reactivity of analytical-grade thyroxine was 0.6% on weight basis; and the analytical recovery of T3 added to a T3-free serum was complete. Euthroid, hyperthyroid, and hypothyroid ranges were 0.74-2.64, 2.91-7.52, and 0-1.21 mug/liter, respectively. These values correlated well with both the clinical status of patients and with values obtained by an established radioimmunoassay method. The procedure is simply done; results may be obtained in less than 4 h.
Cross Reactions↗
Tissue distribution of 14C-, 125I-, and 131I-diphenylhydantoin in the toadfish, rat, and human with insulinomas.
Carbon-14-diphenylhydantoin (DPH) concentrated maximally in pancreatic islet cells of the toadfish 10 min after its intravenous administration. The islet cell-to-acinar-tissue ratio at this time was 6:1. The islet cell-to-liver ratio was 20:1. Iodine-125-paroiodo-DPH at 10 min in the toadfish showed an islet cell-to-acinar-tissue ratio of 1.7:1 and an islet cell-to-liver ratio of 2.3:1. When 14C-DPH was given to four patients 10-17 min before removal of norma pancreatic tissue and of an insulinoma in three of the patients, the concentration of radioactivity in the insulinoma was never greater than in the pancreas and concentrations in insulinoma and pancreas were always less than in liver in the same individual. Forty-five to 90 min after administration of 131I-DPH, the liver and pancreas were delineated in three patients but the insulinoma was not imaged. Five days after administration of 131I-DPH, the concentration of 131I radioactivity in excised tissue was greater in the insulinomas than in the pancreas of two patient but not sufficient to produce positive images of the insulinoma in the pancreas.
Adenoma, Islet Cell↗
Patterns of fluid accumulation in splenic trauma: demonstration by CT.
Detection of hemoperitoneum in splenic trauma is as important as detection of the visceral injury itself. Observation of a consistent spectrum of fluid accumulation in patients with splenic trauma prompted us to investigate the patterns in more detail. Twenty-three computed tomographic (CT) scans in 20 patients were evaluated with respect to presence of fluid collections in various peritoneal and retroperitoneal compartments. These were correlated with severity of injury and operative and pathologic findings. Hemoperitoneum was detected in the pelvis (65%), paracolic gutters (52%), left subphrenic space (48%), perihepatic space (48%), Morison's pouch (17%) and in the lesser sac (9%). In addition to free fluid, pleural fluid (39%) and retroperitoneal hematoma in the left anterior pararenal space (13%) were also encountered. These ancillary findings may help to substantiate the diagnosis of splenic trauma in equivocal cases, particularly when the spleen itself is obscured by artifacts. Early detection may reduce mortality and morbidity associated with splenic trauma.
Hemoperitoneum↗
Lymphoepithelial cyst of the pancreas.
Lymphoepithelial cyst of the pancreas is a rare lesion which may mimic a pancreatic pseudocyst or mucinous cystic neoplasm. To our knowledge, this lesion has never been reported in the radiologic literature. We present a patient with lymphoepithelial cyst of the pancreas, and we discuss the radiographic and pathologic findings.
Aged↗
Severe subcutaneous hemiatrophy following treatment of Wilms' tumor: CT demonstration.
Hemiatrophy of the subcutaneous tissues following radiation therapy for Wilms' tumor has received little attention in the radiologic literature. We present a patient with this complication, and discuss the findings on computed tomography (CT).
Atrophy↗
CT findings in abdominal actinomycosis.
The diagnosis of abdominal actinomycosis is difficult because of its relative infrequency and imitation of other diseases. We present four cases in which these difficulties in diagnosis were experienced and show the utility of CT in suggesting this disease. Aspiration, biopsy, and proper culture technique, in conjunction with typical CT findings of transfascial and multiple organ involvement, led to the proper diagnosis in all cases.
Abdomen↗
Postoperative atrophy of abdominal wall musculature: CT demonstration.
Eleven cases in which CT demonstrated severe unilateral atrophy of abdominal wall musculature were reviewed. All patients had undergone surgery on the ipsilateral side 6 months to 28 years prior to CT. The patterns of muscular atrophy correlated well with the type of incision made and the nature of surgery performed. Denervation injury resulting from surgical incision is the most likely explanation for this finding on CT. Normal innervation of abdominal wall muscle groups is discussed, and the relationship of unilateral muscular atrophy to previous surgical incision is emphasized.
Abdominal Muscles↗
Postoperative atrophy of posterolateral chest wall musculature: CT demonstration.
We review five cases in which CT demonstrated severe unilateral atrophy of the latissimus dorsi muscle. In four of these cases, similar findings were also seen in the inferior portion of the serratus anterior muscle. All patients had undergone thoracic surgery on the ipsilateral side 10 months to 3 1/2 years prior to CT. All patients had undergone posterolateral thoracotomy, including one who had undergone successive right and left posterolateral thoracotomies. The most likely explanation for the CT finding of atrophy is denervation injury resulting from surgical incision. We discuss normal innervation of the posterolateral chest wall musculature, with emphasis on the relationship of unilateral atrophy of posterolateral chest wall musculature to previous surgical incision.
Adult↗
Patient autonomy, advocacy and the critical care nurse.
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Critical Care↗
Lymphoma of the thyroid gland associated with mycosis fungoides: sonographic, scintigraphic and CT features.
A thyroid mass in a 63 year old man with mycosis fungoides, histologically was a not well differentiated B cell lymphoma. Sonographically, it presented as a mass with nonhomogeneous echo pattern along with "target" lesions. On the scintigram, the mass failed to accumulate radioiodine and on the CT it was a nonenhancing lesion. None of these patterns are specific for the disease.
B-Lymphocytes↗