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Biomedical subjects

U Büll

Publications and source records attributed to U Büll.

At least 109 records · Page 6Linked to original sources
PubMed1984

Measurement of 24 hour whole body retention of 99Tcm-diphosphonate by a single thyroid probe.

In a comparative study with a thyroid probe and a whole body counter (WBC) we found that whole body retention (WBR) (2 h and 24 h) may be correctly obtained using a single probe, provided that measurements are taken carefully. With the detecting geometry presented, the single probe yielded only a slightly higher WBR than the WBC (less than 3 percentage points). We conclude that the method is capable of differentiating between pathological and normal WBR values.

Diphosphonates↗
PubMed1984

[201Thallium single photon emission computer tomography (SPECT) in the functional evaluation of coronary stenosis changes. Results of a comparison of stress scintigraphic and coronary angiographic findings].

201TI-Single-photon-emission computed tomography (SPECT) was employed in 57 patients immediately after exercise, followed by a redistribution analysis 3 hours later. 44 patients had coronary artery disease as documented by angiography (of these, 27 patients had an earlier myocardial infarction confirmed). 13 patients produced normal angiograms. 201TI-SPECT revealed a sensitivity of 93% and a specificity of 84%. Referring to a subdivision of the left ventricle into anterior and posterior walls, sensitivity in infarcted segments (96%) was significantly (p less than 0.01) higher than in non-infarcted segments (71%). No difference in sensitivities was found comparing anterior and posterior walls. Specificity of segmental analysis was 92%. Evaluation of segmental pattern (positive or negative redistribution) in old infarctions revealed persisting 201TI defects as frequent as the combination of persisting defects with surrounding redistribution. Non-infarcted segments showed sole redistribution in 89% of the cases. Left ventricular 201TI-SPECT improves the anatomical definition of defects in 201TI uptake. It enhances the functional evaluation of changes in regional perfusion subsequent to pathological coronary morphology.

Cineangiography↗
PubMed1984

[Relative determination of hemisphere perfusion and hemisphere circulation. A comparison of the results of computer-assisted radionuclide angiography and dynamic single photon emission CT in patients with unilateral cerebrovascular disease].

Ratios of interhemispherical perfusion and blood flow were derived from 72 patients with reversible (TIA, PRIND) or irreversible (completed stroke) ischemic neurologic deficits. Differences from normal mean values (right-to-left: 1.00) were determined by employing CARNA with 99mTc-DTPA (perfusion) or DSPECT with 133Xe-gas (blood flow in ml/100 g/min). These differences were constantly higher for CARNA than for DSPECT. Such an excess for CARNA values was interpreted as the delay portion within the CARNA results, which increased from completed stroke (33% delay) to TIA (62% delay). The complement, i.e. the low flow portion, decreased in this sequence. Separation of CARNA values into delay and flow portions provides further information on the individual severity of cerebrovascular disease by employing a simple nuclear procedure. Moreover, it complements morphological findings from radiographic angiography and transmission CT.

Adolescent↗
PubMed1984

[Diagnosis of benign and malignant tumors of the female breast using single photon emission computed tomography with 99mTc-DTPA].

31 patients with suspicious findings on mammographic films were examined preoperatively by single photon emission computed tomography. A scintigraphic study was performed at 30 and 120 min after i.v. administration of 370 MBq (10 mCi) 99mTc-DTPA. The radionuclide accumulation in both breasts was analyzed quantitatively on transaxial slices using the ROI-technique. In benign lesions (n = 12) as well as in carcinomas (n = 19), an increased 99mTc-DTPA accumulation was found as compared to clinically and radiographically unaffected sides. A radionuclide accumulation exceeding 20% of the contralateral side was considered to indicate malignancy. Thus the sensitivity in diagnosing malignant tumours was 74%, the specificity 64% and the accuracy 70%. In contrast to studies with planar scintigraphic imaging techniques the results clearly show an increased 99mTc-DTPA uptake even in benign breast lesions.

Breast Neoplasms↗
PubMed1984

[Nuclear medicine diagnosis in intensive care using as example acute and chronic circulatory disorders (brain, lung, heart, kidney)].

The value of nuclear medicine procedures which are noninvasive and impose little burden on the the patient is assessed with respect of intensive care. Firstly, additional data are available to evaluate physiological functions. Secondly, these functions can be monitored under therapy. Thirdly, screening of the contralateral organ or of other organs can be provided. Cerebral procedures yield values of regional cerebral blood flow (ml/100 g /min) in addition to the morphological findings of CT. Cardiovascular procedures are supplementary in describing the regional as well as the global cardiac function. Using myocardium imaging with thallium-201 the extent of infarction can be estimated. In the crucial diagnosis of pulmonary embolism, radionuclide studies provide the necessary information. Renal procedures evaluate single kidney function yielding clearance values (ml/min). Furthermore, radionuclide flow studies are useful to detect early complications of transplanted kidneys. Diagnostic procedures with radionuclides if all instruments were care could be even more efficient if all instruments were available in the intensive care unit or could be transported there instead of transferring the patients to the nuclear medicine department.

Adult↗
PubMed1984

[Quantitative resting radionuclide-ventriculography for multifactorial analysis of left ventricular function].

Results from 388 patients, examined with quantitative equilibrium radionuclide ventriculography (qERNV) at rest, were stored in a data bank system and evaluated statistically. The value of time and velocity parameters [ejection time (ET), filling time (FT), time ES to peak filling rate (TpFR), mean (mER) and peak (pER) ejection rate, peak filling rate (pFR)] were evaluated in patients with coronary heart disease (CHD, with and without history of earlier myocardial infarction) or with cardiomyopathy (CMP). Significant (p less than 0.025) changes vs. normal in CHD I/II were obtained from pER, pFR, ET, in CHD III from gEF, EDV, mER, pER, pFR, in CHD IV from gEF, EDV, mER, pER, pFR, in patients with infarction or with CMP from gEF, EDV, mER, pER, pFR, ET and TpFR. Resting qERNV revealed a sensitivity in diagnosing a CHD (stages I-III) by mER of 30-59%, by pER of 40-65%, by pFR of 48-60% and by ET of 58-61%, which was higher than the sensitivity of gEF (19-56%).

Cardiac Output↗
PubMed1984

[Quantitative equilibrium radionuclide ventriculography at rest in the evaluation of the severity of coronary disease].

The results of examining 373 patients with a quantitative equilibrium radionuclide ventriculography were stored in a data bank and evaluated statistically. The following left ventricular parameters were evaluated: global and regional ejection fractions ( gEF , rEF1 - rEF5 ) and volume parameters (EDV, ESV, stroke volume, cardiac output, heart index). It appeared that in stages I and II of coronary heart disease evaluation of gEF , EDV and ESV under resting conditions does not sufficiently discriminate diseased patients from normals. Significant changes (p less than 0.025) of these parameters (vs. normal) were found only in CHD III and IV or in patients with a history of old myocardial infarction. The additional evaluation of the regional fraction yields, however, a significant increase (CHD I and II: +25%) of the sensitivity of the equilibrium radionuclide ventriculography in the diagnosis of coronary heart disease.

Coronary Disease↗
PubMed1983

[The iodine 131-hippurate clearance for the determination of the nephrotoxic effect of cis-dichlorodiamino-platin (II) (cis-platin, cis-DDP)].

In 25 patients, who received repeated doses of cis-DDP, we determined iodo-131-hippurate-clearance, creatinine clearance and serum creatinine to assess the nephrotoxic effect induced by cis-DDP. A highly significant decrease in the iodo-131-hippurate-clearance was found between the first and the following cycles. There was no significant change in serum creatinine and creatinine clearance however. The radio-hippurate-clearance showed a clinically not important reduction during several cytotoxic courses in 15/25 patients (60%). A clinically relevant impairment of the radio-hippurate-clearance occurred in 8/25 patients (32%), mainly before the third and fifth cytotoxic cycle. In two patients this clearance did not alter or was even rising. In 12 cases a diminuation of the iodo-131-hippurate-clearance was observed, which in only 5 cases correlated to a decreased creatinine clearance and in only two cases to an elevated serum creatinine. Therefore, we consider neither creatinine nor creatinine clearance nor the combination of both parameters to be appropriate to assess tubular nephropathy induced by cis-DDP. Radio-hippurate-clearance should play a superior role deciding on treatment stop or dose reduction of cis-DDP. The regression of cis-DDP-induced nephropathy was not evaluated.

Adult↗
PubMed1983

Improvement of bone scintigraphy by quantitative evaluation compared with X-ray studies and iliac crest biopsy in malignant disease.

Bone marrow biopsy of the iliac crest was performed on 268 patients (124 males; 144 females). Of these patients 206 had haematological systemic disorders (HSD) or carcinoma and suspected bone involvement, which was confirmed by biopsy on 66 patients. Bone biopsy was performed not longer than 3 weeks after X-ray examination and bone scintigraphy which, combined, had already raised the suspicion of skeletal involvement in 55% of the 66 patients with skeletal involvement diagnosed by biopsy. Additional quantitative evaluation of the bone scans using bone to soft tissue ratios was able to increase the overall accuracy to 67% in that group. Additional quantitative assessment of the scan yielded considerably more effective bone scintigraphy, particularly in cases with visually normal patterns. Available equipment should therefore be used in scintigraphic bone imaging on a routine basis. It was shown that the various methods of examination, i.e. X-ray, biopsy and scintigraphy with both visual and quantitative evaluation provide their own individual values for the final diagnosis. Therefore, if one of the methods shows a negative result, bone involvement is not excluded and the others should be used for confirmation.

Adult↗
PubMed1983

[Single photon emission computed tomography (SPECT). Principles, results, outlook].

Methods, instrumentation, performance data, clinical use and results of SPECT are presented. Since SPECT is yielding functional tomograms, morphological data are not the major concern with this method. Essentially 99mTc labeled radiopharmaceuticals, 201Tl chloride or 133Xe gas are in current use. SPECT may be considered as a supplement to ultrasound in detecting space-occupying lesions of the liver (combined accuracy 95%). Cranial SPECT already allows quantification of regional cerebral blood flow following inhalation of 133Xe gas. The sensitivity of myocardial SPECT with 201Tl (three-dimensional reconstruction) at rest in patients with severe coronary artery disease was higher than 90%. To further develop SPECT as a functionally oriented supplementary method to other radiodiagnostic procedures, further improvements are required as to performance, reconstruction algorithms and radiopharmaceuticals.

Adult↗
PubMed1983

[133Xe-DSPECT (Dynamic Single Photon Emission CT). Results of a new noninvasive method for measuring regional cerebral blood flow (rCBF). Comparison with cranial angiography and transmission CT].

133Xenon-DSPECT provides measurement of regional cerebral blood flow (rCBF in ml/100 g/min) during and after inhalation of 133Xe gas. The result is displayed as a flow map of three transaxial slices. ROI divide a slice into 12 areas (SA) computing flow values (FSA). The results in 36 patients with cranial vascular disease are presented in comparison to 12 "normals". In all patients, FSA in the diseased hemisphere were found to be below the standard range of normals. Related to number of SA, this was true in completed stroke (bilateral) in 55% or (unilateral) in 14%, in PRIND in 5% of SA and in TIA in 7%. The absolute flow values did not decrease with the severeness of the disease, presumably depending on patient's age. There were more (p less than 0,005) SA found with decreased rCBF (21%) than areas with low density in T-CT (10%). Since unilateral cerebrovascular findings presented also bilateral reduced FSA, the validity of the method lies in the calculation of flow values, which significantly adds to the results of imaging.

Cerebral Angiography↗
PubMed1983

[Whole-body retention of 99mTc-methylene diphosphonate in skeletal diseases].

The 24 h-whole-body retention (WBR), determined by a whole-body counter, may be used to quantify exactly bone seeking properties of a radiopharmaceutical. The 24h-WBR of 99mTc-methylene-diphosphonate was determined in 200 patients and was found to be independent of kidney function if this function was normal or only slightly diminished. The 24h-WBR was slightly dependent on age since it decreased up to 20 years of age, reaching a minimum at 20-25 years, and then increased with increasing age. Normal values of 24h-WBR for individuals of more than 20 years of age were 31.8 +/- 5% of injected dose. Not more than two focal accumulations, i.e. skeletal metastases, failed to elevate the 24h-WBR significantly (p less than 0.1). However, a highly significant (p less than 0.001) difference to normals was found in patients with multiple metastases (24h-WBR: 38.2 +/- 7%), with diffuse osseous involvement as in primary hyperparathyroidism (24h-WBR: 49 +/- 11.7%, p less than 0.001) or with osteoporosis (24h-WBR: 45%). The 24h-WBR was found to be very sensitive in grading diffuse osseous involvement. This was shown in single-tumor patients by follow-up as the 24h-WBR in addition to bone scans was useful to describe progression or remission. Moreover, the 24h-WBR correlated closely with results of bone marrow biopsies in a small group of patients with malignancies of the lymphoreticular system.

Adolescent↗
PubMed1983

[Cause of increased focal uptake in the cervical vertebrae in skeletal scintigraphic routine studies].

Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior projection and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that x-ray control examinations to confirm the diagnosis can be omitted in many cases.

Aged↗
PubMed1983

Pancreatic grafts. Nuclear perfusion imaging to detect vascular complications and rejection crises.

Perfusion studies with 99m-Tc-DTPA were used routinely to investigate renal grafts. Efforts were made to employ this technique in monitoring the perfusion of pancreatic grafts. A total perfusion failure is as reliably detectable as in renal grafts. Smaller perfusion alterations could be demonstrated by follow up studies. It appears to be feasible to differentiate the salivary edema, well known from animal experiments, from a rejection reaction with the help of other parameters (e.g. creatinine). Further clinical studies, however, are necessary to confirm these results.

Adult↗
PubMed1983

[Myocardial 201-thallium uptake after hydralazine in coronary disease].

UNLABELLED: Following injection of hydralazine, a benign coronary-artery-dilating drug, myocardial blood flow increased by 25%. Myocardial 201-thallium uptake at rest and after intravenous injection of 12 mg hydralazine was quantitatively investigated in 28 patients. In patients with essential hypertension or coronary artery stenoses of up to 90%, myocardial 201-thallium uptake increased by 19%-30% in nonischemic areas. In 9 of 14 patients with regional imaging defects, thallium uptake also increased in these ischemic areas; 4 of these patients had asynergies in the area of imaging defects. In 3 patients with a complete obstruction of a major branch of a coronary artery perfusion defects developed following hydralazine application. CONCLUSION: An increased 201-thallium uptake in an ischemic area indicates reperfusion; this could be helpful for deciding whether coronary surgery should be performed or not.

Coronary Circulation↗