Biomedical subjects
Publications and source records attributed to V Artiko.
We report the case of a littoral-cell angioma of the spleen, a recently described benign vascular tumour, whose imaging and pathological characteristics have been discussed only by a few authors. The diagnosis was made after elective splenectomy. The CT images, scintigraphy and histological specimens are presented, and differential diagnoses discussed.
The aim of the study is evaluation of hepatocellular function, as well as morphology and patency of the biliary three of the liver transplants by dynamic hepatobiliary scintigraphy. The study was performed in 10 controls and 10 patients after orthotopic transplantation (up to two years). Sixty minutes dynamic acquisition (1 frame/min) was performed with scintillation camera after injection of 360 MBq 99mTc-diethyl- IDA. Hepatobiliary scintigrams were analysed for morphology, and parenchymal and hepatobiliary TA curves were generated and analysed as regard to the time to maximal acitivity (Tmax) and the time to half of maximum acitivity (T1/2). Uptake of the radiopharmaceutical was slightly but not significantly delayed (Tmax=18.5 +/- 2.9 min) in comparison to the controls (Tmax=14.2 +/- 3.4min), while excretion was significantly prolonged (T1/2=59.5 +/- 12.1 min) than physiological (Tmax=34.2 +/- 4.1min). Intrahepatic bile flow was nonsignificantly prolonged (Tmax=31.3 +/- 3.7 min) in comparison to the controls (Tmax=25.7 +/- 3.5 min) while extrahepatic one is high significantly prolonged (T1/2=89.0 +/- 14.3 min) than physiological (T1/2 =45.0 +/- 7.2 min). Biliary phase of hepatobiliary scintigraphy showed increased accumulation of radiopharmaceutical in the left (n=1) or right (n=2) hepatic duct. Radionuclide methods are noninvasive, and apear to be sensitive and valuable for the monitoring of liver transplants.
The aim of the study was evaluation of the clinical reliability of the immunoscintigraphy for the detection of metastases and recurrences of colorectal carcinomas using three different radiopharmaceutical substances. With IMACIS 1, the number of true negative findings (TN) was 4/7 and true positive (TP) 3/7, while in one patient, the results of immunoscintigraphy significantly influenced the therapeutical management. With INDIMACIS 19-9, there were 2/8 TN and 6/8 TP. In three patients, immunoscintigraphy results influenced patient further management. With ONCOSCINT in 2 patients findings were TN, in one FN and in one FP. In 3 patients, immunoscintigraphy influenced the management of the patient. Other imaging methods (CT, US, MRI) have advantage in detection of liver metastases, while immunoscintigraphy is more specific for the assessment of reccurences of the abdominal tumors. Thus immunoscintigraphy should be applied in patients with suggested recurrences and inconclusive outcome of routine diagnostic workup.
The aim of the study is detection of the abdominal infective foci using 99mTc-ciprofloxacin, radiopharmaceutical supposed to distinguish inflammation from infection. Twenty-one patient was investigated. There were 11 true positive findings, 7 true negative, two were false negative, while 1 was false positive. Sensitivity of the method was 79% and specificity 91%. According to our results, scintigraphy with infection is a useful method for detection and assessment of exact localization of deep seated bacterial infections, which might be useful for (differential) diagnosis, surgical treatment in due time as well as monitoring of the treatment of conservative therapy.
The aim of the study is detection of the recurrences and metastases of colorectal carcinomas using (111)In labelled antibodies B72.3 in 14 patients. With tomography, we can access better distinction of tumour in comparison to other structures and estimation of its size. Other imaging methods (CT, US) have advantage in detection of liver metastases, while immunoscintigraphy is more specific for the assessment of malignant abdominal tumours and extrahepatic metastases. The first results point out that Oncoscint CR-103 can be useful in diagnosis of recurrences and metastases of colorectal carcinoma, viability assessment after radiotherapy and in the choice of the adequate surgical treatment in dependence of the spread of the disease.
Spleen is being surgically removed because of trauma, in diagnostic and-or therapeutical purposes because of the benignant and malignant diseases. The percentage of morbidity during and after splenectomy is relatively low. During surgery might occur bleeding, trauma of the pancreatic tail, stomach, lineal flexure of the colon, left hemidiafragm, left suprarenal gland and upper pole of the left kidney, which must be correspondingly reclaimed during the same intervention. In the early postoperative period, postoperative bleeding, subfrenic abscess, pulmonal atelectasis, bronchopneumonia and left pleural extravasations might occur. Especially is important notification of these events in due time and adequate conservative and surgical treatment. After splenectomy, there is an increase of the number of trombocytes, which might lead to the tromboembolic complications. In the prevention of these complications in the postoperative period prolonged antiagregation therapy is suggested. Postsplenectomy sepsis is very late, general complication of splenectomy, which occurs because of the lower immunity in the child age. To prevent these complications, partial splenectomies, reimplantations of the spleen, prolonged application of the penicillin medicines after splenectomy and antipneumococcal vaccine are performed.
Auto transplantation of the spleen can be performed in the patients with traumatic rupture of the spleen, in whom spleen could not be conserved in the other way. The right indication for this method is isolated rupture of the spleen (concvasation or complete devascularisation). This method is not recommended in the endangered patients, patients with previous disease of the spleen as well as in the patients with the perforation of the other abdominal organs at the same time. Auto transplantation was performed in 12 patients with isolated splenic rupture and hematoperitoneum, 11 men and one woman. The majority of patients are younger. In 8 patients, autotransplant was placed into big omentum, in three into lipomatous tissue surrounding left kidney, and in one into anterior abdominal wall. In all the patients from this group, following analysis were taken: MCV (middle volume of erythrocytes), HTC, Hb, Le, Glucose, urea, creatinin, sodium, potassium, alkali phosphatasis, target cells, Howell Jolly's bodies, Heinz's bodies, IgG, IgA, IgM, C3, C4, T3, T4, T8, B, segmentated, eosinophiles, lymphocytes, reticulocytes, thrombocytes, fibrinogen, PT, APTT, aggregation of thrombocytes and aggregation of thrombocytes on collagen. The same parameters were taken in 12 patients with surgery similar to splenectomy and in 12 after splenectomy. After splenectomy, there was decrease of the immunologic defending abilities of the organism because of the loss of the childrens function of the spleen, decreased level of the opsonines and tutsin, which leads to the impaired phagocytosis, decreased concentration of IgM and T and B lymphocytes, while in patients after auto transplantation the results were physiological. The most important thing in the assessment of the function of the autotransplanted spleen is scintigraphic investigation using 99mTc-denaturated red blood cells. In our study, auto transplant function was assessed in 10/12 patients by scintigraphy. Five years after surgery, no one patient was proved to have postsplenectomic sepsis.
Hepatic radionuclide angiography (HRA) is a recognised method of investigation of liver blood flow disorders caused by: diffuse and focal diseases of liver parenchyma or disorders of blood flow in extrahepatic liver vessels. Hepatic perfusion index (HPI) based on Sarper's slope method is significantly lower in patients with e.g. liver cirrhosis, malignant primary and metastatic liver diseases and portal vene thrombosis, but not in patients with benign focal liver leasions. Determined in liver as a whole, HPI is a sensitive indicator of the presence of malignant liver tumours, but is within normal range in patients with hepatic hemangioma. The aim of the study was to investigate characteristic of blood flow in hemangioma itself, separately from but in relation to the liver blood flow, using hepatic radionuclide angiography. We have examined 12 patients with liver hemangioma confirmed mainly by positive 99mTc-labeled red blood cell scintigraphy, which diagnostic specificity for liver hemangiomas is near 100%. 8/12 hemangiomas resulted in photopenic areas on angioscintigrams, indicating lower blood flow, and rest were isoactive to surrounding liver tissue. Regions of interest have been delineated around the photopenic areas (hemangiomas) and surrounding liver tissue. Time-activity curves have been generated and slope of the fitted hepatic artery and (portal) venous portions of the hemangioma and liver curves have been determined. Perfusion indexes of hemangioma (PIH) and liver (HPI) have been calculated from the slopes, expressing portal venous flow as a portion of entire blood flow to the region. In addition, times of arrival and transit of intravenous bolus of 99mTc-pertechnetate through the hemangioma and liver tissue have also been derived from time-activity curves. Slope of the venous portion of the hemangioma time-activity curve is significantly lower then that of the venous portion of the liver curve (p < 0.01). So that, perfusion index of hemangioma (PIH = 0.34 +/- 0.12 (mean +/- SD) is significantly lower then hepatic perfusion index (HPI = 0.57 +/- 0.08) (p < 0.05). Bearing in mind interference of superimposed liver activity with that of hemangioma, these results indicate that liver hemangiomas are dominantly if not exclusively irrigated by hepatic artery branches. There are no data regarding relation between arterial and venous blood flow in liver hemangiomas determined by HRA. Obtained results are in harmony with arteriography data which confirm slow arterial blood flow through hemangiomas. Portal venous inflow of some angiomatous liver lesions in infants and children, and arterio-portal shunting in hemangiomas have been rarely reported. Results of this study indicate that regional determination of perfusion index and other HRA parameters in patients with focal liver lesion enables differentiation between tissues with different intensity and pattern of blood flow. The method could be used in examination of vascularisation pattern of other focal liver lesions.
The aim of the study was estimation of the relation between the gallbladder (GB) motility function and the presence and quantity of enterogastric reflux (EGR). We investigated 172 patients with: physiological GB function (filling and emptying)(FGB), impaired GB function (prolonged filling and ejection fraction < 45%) and afunctional gallbladder (AGB)(without visualization). The study was performed during 90 min (1 f/min) after i.v. application of 185 MB 99mTc-dietil IDA. After 30 min. test meal was given while at the end stomach was marked. According to the parameters from time activity curves over stomach and hepatobiliary system, the index of ERG was calculated, while GB filling and ejection fraction were estimated from the GB time/activity curve. We can conclude that EGR occurs more frequently in the patients with afunctional GB in comparison to those with functional and decreased motor function. Also, EGR quantity is in correlation with the impairment of the GB function.
BACKGROUND: The purpose of this study was to investigate bladder function parameters by means of quantitative radionuclide cystography (QRC) in anxious, irritable children with unstable bladder. METHODS: Quantitative radionuclide cystography was performed in 18 children aged between 8 and 12 years, without evidence of neurologic and nephrologic disorders. Findings were compared with those obtained in 10 healthy children aged between 7 and 10 years. The dynamics of the bladder emptying were studied after intravenous injection of 37 MBq/10 kg b.w. 99mTc-diethylenetriaminepentaacetic acid (DTPA) in the posterior views. Images of 90 frames every 2 sec. were stored in the 64 x 64 computer matrix during voiding. The patients voided into a container and the volumes were measured. RESULTS: The parameters evaluated were: functional bladder capacity (ml)--FBC, expected bladder capacity (ml)--EBC, percentage of EBC (%), voided urine volume (ml)--VV, residual urine (ml)--RU, voiding time (sec)--VT, average flow rate (ml/sec)--AFR and peak flow rate (ml/sec)--PFR. There was a statistically significant difference between controls and children with unstable bladder in the following parameters: FBC 288 +/- 33 vs. 244 +/- 27 ml (p < 0.001), % of EBC 99 +/- 6 vs. 82 +/- 6% (p < 0.0001), VV 265 +/- 37 vs. 202 +/- 35 ml (p < 0.0001), RU 22 +/- 11 vs. 48 +/- 19 ml (p < 0.007), AFR 13 +/- 5 ml/sec vs. 9 +/- 4 ml/sec. (p < 0.01) and PFR 19 +/- 2 vs. 13 +/- 3 ml/s (p < 0.0001), respectively. The VT obtained from the control group of 23 +/- 9 s did not differ significantly from the value of children with unstable bladder of 28 +/- 14 s. CONCLUSION: The results show that quantitative radionuclide cystography is a simple, noninvasive method, which allows a good separation of patients with unstable bladder from the children with normal voiding pattern.
The aim of the study is assessment of the relationship between enterogastric reflux and the presence of Helicobacter pylori infection as a factors that cause gastritis, peptic ulcer and adenocarcinoma ventriculi. The study was performed in 52 patients with different digestive disorders, using gamma camera, during 90 minutes (1 frame/min) after intravenous injection of 185 MBq 99mTc-dietil IDA in cubital vein. According to time activity curves from the region of hepatobiliary system and gaster, index of enterogastric reflux was assessed (EGR). There is no correlation between the presence of Helicobacter pylori and EGR (r = 0.181, DF = 52, P < 0.05). However, Helicobacter is present more frequently in the patients with positive EGR (p 0.01). However, there is no significant difference (p < 0.05) in reflux value in patients with both positive and negative finding of Helicobacter.
BACKGROUND: The aim of the study is to evaluate gallbladder (GB) motor function, by infusion cholescintigraphy, in patients after total gastrectomy (Roux-en-Y) with expected disturbances in the physiological regulation of biliary tract motility. METHODS: The study was done in 10 controls, as well as in 12 patients early (less than 2 months) and in 14 late (6 months-2 years) after surgery. Anterior abdominal imaging by gamma camera and computer acquisition was performed during three-hours infusion of 150 MBq, preceded by the loading dose of 50 MBq of 99mTc-EHIDA in bolus injection. The test meal stimulation was done in the 120th min of the study. GB TA curve was obtained and five parameters of GB motility were analysed: durations of filling (ascending) and emptying (descending) phases, filling and emptying rate ratio and ejection fraction and rate. RESULTS: Our results have shown that in the early period after the operation GB filling is prolonged and emptying impaired, while after several months GB motor function is normalised. CONCLUSIONS: It can be concluded that the infusion cholescintigraphy is potentially useful in patients after such surgery to decide on the specific treatment introduction in order to prevent GB calculosis and other complications.
Estimation of the gallbladder (GB) motility disorders after gastric surgery has not yet been assessed because of the shortage of the reliable diagnostic methods. The aim of the study is introduction, modification and establishment of the infusion cholescintigraphy into clinical practice and its performance in the groups of patients with gastric resection (RVBI i RVBII), total gastrectomy and patients after gastroplasty. Obtained data produced information about motility disorders caused by billateral truncal vagotomy, lack of the food transit through duodenum and if the motility disorders are the same in different time periods after operation. In groups of patients without truncal vagotomy (RVBI and RVBII), minor motility disorders are registered in comparison to the groups after truncal vagotomy. In the period of 6 months after surgery, higher motility disorders are registered in the group of patients with total gastrectomy, while after 9-12 months GB motility completely recovers. Groups with preserved transit of food through duodenum (RVBI and gastroplasty), has minor motility disorders in comparison to the group without transit of food through duodenum (RVBII and total gastrectomy). By introducing infusion cholescintigraphy, reliable method for the GB motility assessment is obtained.
The aim of this study is the assessment of the gallbladder (GB) motility in the controls without (C) and with (Cs) test-meal stimulation, as well as in the patients early (EPG) and late (LPG) after total gastrectomy. Data were collected with ROTA scintillation camera, during (3 h, 10 ml/h) infusion of 150 MBq, 0.25 mg/ml 99mTc-EHIDA, preceded by a loading dose (0.5 mg/ml, 50 MBq). While in EPG, GB motility is impaired, it achieves physiological values in LPG patients, which can be attributed to establishment of corresponding hormonal mechanisms, in the late postoperative period.
BACKGROUND/AIMS: The aim of the study was to introduce the chosen and modified model of the nuclear medicine method for the detection and quantification of enterogastric reflux, as well as evaluation of its clinical validity. METHODOLOGY: The study was performed in 172 patients: with gastric and duodenal ulcer, after Billroth I and Billroth II gastrectomy, with gastroesophageal reflux, after cholecystectomy, with chronic cholecystitis and chronic duodenal disease. Acquisition was performed with a gamma camera, during 90 min after intravenous application of 185MBq 99mTc-Dietil IDA. Test meal was given in the 30th minute, while the gastric region was marked at the end of the study. On the basis of the radioactivity changes in the regions of the stomach and hepatobiliary system, the presence of enterogastric reflux was determined and its index calculated. RESULTS: In all the groups of patients, values were significantly higher than in the controls (P < 0.05). The most frequent occurrence and the largest quantity of reflux was present in patients after Billroth II gastrectomy with significantly different values from other groups of patients (P < 0.05). CONCLUSIONS: The obtained results approve clinical value of the chosen and modified scintigraphy of enterogastric reflux, as a non-invasive and physiological method, which provides exact data about its presence and quantity.
The aim of the study is evaluation of the clinical validity of the chosen and modified own model of the nuclear medicine method for the detection and quantification of enterogastric reflux (EGR), as well as evaluation of its clinical validity. The study was performed in 172 patients: with gastric and duodenal ulcer, after Billroth I and Billroth II gastrectomy, with gastroesophageal reflux, after cholecystectomy, with chronic cholecystitis and chronic duodenal disease. Acquisition was performed with gamma camera, during 90 minutes after intravenous application of 185 MBq 99m-Tc-Dietil IDA. Test meal was given in 30th minute, while gastric region was marked at the end of the study. On the basis of the radioactivity changes in the regions of the stomach and hepatobiliary system, presence of enterogastric reflux is determined and its index calculated. In all the groups of patients, values are significantly different from physiological. The most frequent occurrence and the largest quantity of reflux is present in patients after Billroth II gastrectomy with significantly different values from other groups of patients. The obtained results approve clinical value of the chosen and modified scintigraphy of EGR as a non-invasive and physiological method, which provides data about its presence and quantity.
We evaluated possibilities of bone scintigraphy with 99mTc-methylendiphosphonate (99mTc-MDP) and magnetic resonance imaging (MRI) in follow-up and prediction of effect in patients with extensive bone metastatic disease treated with betha-emitter 89SrCl2. 24 patients with prostate cancer and extensive metastatic involvement of skeleton were referred for the study. 89SrCl2 was injected as single injection of 150 MBq (4 mCi), in eighteen from Amersham plc., England, as Metastron, in six--from Medradiopreparat, Russia). In all patients bone scintigraphy with 99mTc-MDP and MRI study of metastatic regions were performed before and in 3 months after 89SrCl2 injection. Patients treated with Metsatron were also studied in 6 months after injection. Quantitative analysis of data comprised count and anatomic dimensions of metastatic areas and calculation of indices [metastasis/intact bone] both for scintillation count of 99mTc-MDP bone scans and signal intensity of T1-weighted MRI scan. Henceforth, we conclude the data of bone scanning with 99mTc-MDP and of MRI give evidencies for significant regress of bone metastases in patients treated with 89SrCl2 besides symptomatic suppression of pain syndrome. 99mTc-MDP bone scanning is also of predictive value for the prognosis of therapeutic effect of systemic radiotherapy with 89SrCl2 in prostate cancer.
BACKGROUND/AIMS: The aim of the study is detection of the recurrences and metastases of colorectal carcinomas using 111In-labeled antibodies B72.3. METHODOLOGY: Fourteen patients underwent planar immunoscintigraphy and/or tomoscintigraphy. RESULTS: With tomography in comparison to planar scintigraphy, we can access better distinction of tumor and estimation of its size. Other imaging methods (computed tomography, ultrasonography) have an advantage in detection of liver metastases, while immunoscintigraphy is more specific for the assessment of malignant abdominal tumors and extrahepatic metastases. CONCLUSIONS: The first results point out that Oncoscint CR-103 can be useful in diagnosis of recurrences and metastases of colorectal carcinoma, viability assessment after radiotherapy and in the choice of the adequate surgical treatment in dependence of the spread of the disease.