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PubMed1982

Perfusion scintigraphy in the diagnosis of pulmonary embolism: a self-assessment quiz.

The authors present ten case reports with lung scintigrams in a format suitable for a self-assessment quiz. The first seven cases include perfusion scintigrams and the final diagnosis was established by postmortem examination. The last three studies include ventilation images (using nebulized Tc-99m tin colloid) and the final diagnosis established by nonradionuclide studies. The authors believe this quiz demonstrates the necessity for ventilation studies when using lung scintigraphy for a positive diagnosis.

Adult↗
PubMed1982

Tc-99m diphosphonate imaging in the differential diagnosis of thyroid nodules.

Early Tc-99m diphosphonate (DP) imaging was performed in 122 patients with cold thyroid nodules in an effort to differentiate benign nodules from malignant. Immediately upon completion of the routine 24-hour I-123 uptake and multiview pinhole imaging, Tc-99m DP was injected intravenously and three serial 3-minute anterior images of the thyroid gland were obtained. Follow-up information was available in 85 patients. All cystic lesions had less Tc-99m uptake as compared with the uptake in the normal parts of the thyroid. However, 48 of 50 solid nodules had Tc-99m DP uptake to the same or greater degree than did the normal gland. The other two had mixed pattern on ultrasound examination. Most of the carcinomas (8 of 10) and benign adenomas (15 of 22) had identical appearance on Tc-99m scans, i.e., uptake in the lesion being the same as in the normal thyroid. It appears that by using this technique it is possible to separate solid nodules from cystic, but not benign from malignant.

Diagnosis, Differential↗
PubMed1983

Decreased gallium uptake in acute hematogenous osteomyelitis.

Decreased radiopharmaceutical uptake was noted on both bone and gallium scans in the case of acute hematogenous osteomyelitis of the right ilium (acetabular roof). This combination of findings is probably rare. The mechanism of decreased gallium uptake is unknown, but may be related to decreased blood flow.

Acetabulum↗
PubMed1983

Transient loss of femoral head Tc-99m diphosphonate uptake with prolonged maintenance of femoral head architecture.

Nine pediatric patients presented with synovitis and suspected Legg-Perthes disease, hemarthrosis, acute slipped capital femoral epiphysis, prolonged traumatic hip dislocation, or transcervical femoral fracture. All had hip scintigraphs that showed loss of Tc-99m diphosphonate uptake in the affected femoral head. Radiographic changes associated with aseptic necrosis failed to appear during the initial follow-up period of three to 14 months. Repeat scintigraphy showed complete revascularization in six cases and partial revascularization in two. Reambulation at 1.5 to eight months after presentation was accomplished without recurrence of pain in seven cases, without development of x-ray changes in 5 cases. Three children developed x-ray changes associated with avascular necrosis after reambulation, while one child had minimal x-ray changes. Some children with loss of uptake in the femoral head do not develop x-ray changes associated with aseptic necrosis.

Adolescent↗
PubMed1983

Lymphoscintigraphic demonstration of intestinal lymphangiectasia.

The authors report a case of intestinal lymphangiectasia that was clearly demonstrated during abdominal lymphoscintigraphy using Tc-99m Sb colloid. Although lymphoscintigraphy has been used in many different clinical situations, this is, to our knowledge, the first scintigraphic description of this disease. Clinical and pathologic presentations of intestinal lymphangiectasia are briefly reviewed. Some possible approaches to the confirmation of the presence of a protein-losing gastroenteropathy are mentioned.

Adult↗
PubMed1983

Bone scintigraphy in slipped capital femoral epiphysis.

Tc-99m diphosphonate bone scans were performed on 11 children with slipped capital femoral epiphysis. On pinhole hip images, seven hips in seven patients had increased radionuclide uptake in the physis and adjacent proximal femoral metaphysis where the slip had occurred. Three hips in three patients had decreased radionuclide uptake in the femoral head on the side of the slipped epiphysis, indicating compromise of the femoral head blood supply. Three or more months following internal fixation, three children had scintigraphy that showed loss of the usual focal uptake in the physis and adjacent proximal femoral metaphysis. Bone scintigraphy in pediatric patients with slipped capital femoral epiphysis is valuable in defining the metabolic status of the femoral head. Absence of radiopharmaceutical uptake in the affected femoral head indicates that the femoral head is at risk for development of radiographic changes associated with aseptic necrosis.

Child↗
PubMed1984

Radiocolloid liver imaging in tuberculous hepatitis.

Twenty of 22 patients with tuberculous hepatitis had abnormal Tc-99m tin colloid liver scans. However, in the majority of the patients the changes were mild and nonspecific. The most frequent scintigraphic picture was a decreased uptake of the radiocolloid by the liver, with shunting to the spleen and bone marrow. The decreased hepatic uptake was usually mildly heterogeneous, but it was sometimes homogeneous, and in five patients obvious defects were present. The liver was enlarged in six patients and the spleen in six patients. Increased extrahepatic uptake of the radiocolloid was the only abnormality in five patients. The severity of the scintigraphic changes did not correlate with the following histologic findings: number of granulomas, degree of associated fibrosis, degree of hepatocyte swelling, or extent of fatty change.

Colloids↗
PubMed1984

Early diagnosis of myositis ossificans with Tc-99m diphosphonate imaging.

Myositis ossificans is primarily a disorder of young adults, whereby an area of muscle mass undergoes progressive ossification. The authors review a case in which the patient's presentation was somewhat atypical, and where the course of disease was unusually prolonged. Examination of the soft tissue lesion using Tc-99m diphosphonate bone scans was helpful in establishing the diagnosis and in determining the full extent of the process early in its evolution.

Adult↗
PubMed1984

Liver metastasis from embryonal carcinoma of the ovary with complete situs inversus. First reported case and review of literature.

Embryonal carcinoma of the ovary in a 17-year-old Saudi girl with complete situs inversus is reported. According to reports since 1936, this is the sixteenth case of cancer associated with complete situs inversus, the second ovarian cancer, the first embryonal carcinoma of the ovary, and the youngest cancer case to be reported in association with this congenital anomaly.

Adolescent↗
PubMed1985

Is ECT imaging with Tc(V)-99m dimercaptosuccinic acid useful to detect lung metastases of osteosarcoma?

ECT imaging, using Tc(V)-99m dimercaptosuccinic acid [Tc(V)-DMS] was performed in two patients with lung metastasis of osteosarcoma, and the results were compared with those of CT scan. Clear accumulation of Tc(V)-DMS was recognized in all cases in the same area that CT scans demonstrated. Tc(V)-DMS was labeled under optimal pH 8, had very low SnCl2 concentrations, an equilibrium between a stable form and a dissociated form of anion TcO4(3-) structurally similar to PO4(3-), and was postulated for tumor uptake. Considering this proposed mechanism for Tc(V)-DMS uptake by tumor cells, ECT imaging using this tracer could be of use in the early detection of lung metastasis of osteosarcoma.

Adolescent↗
PubMed1985

A comparison of the tumor-seeking agent Tc-99m(V) dimercaptosuccinic acid and the renal imaging agent Tc-99m dimercaptosuccinic acid in humans.

Being aware of the ideal nuclear properties of Tc-99m, our interest has been focused on the design of the (+5) oxidation state Tc-99m(V) dimercaptosuccinic acid (Tc(V)-DMSA) as a tumor-seeking agent. Tc-99m(V) DMSA holds a TcO4(3-) core and, like PO4(3-), has excellent characteristics for tumor uptake, but has a different distribution than the well-known renal scanning agent, Tc-99m DMSA. The differences in chemical behavior of Tc-99m(V) DMSA and Tc-99m DMSA are discussed. Three cases in which neoplasms were studies with Tc-99m(V) DMSA and Tc-99m DMSA are presented. Tc-99m DMSA and Tc-99m(V) DMSA, having a common ligand and tracer but, with the metal ion core in a different oxidation state, the uptake characteristics are altered markedly.

Adrenal Gland Neoplasms↗
PubMed1985

Lymphedema secondary to filariasis.

A 1-year-old immunodeficient boy developed brawny edema of the left foot. Lymphoscintigraphy revealed no evidence of left inguinal activity following pedal injection of Tc-99m-Sn phosphate. Over the next two months, the patient developed lymphedema on the right and repeat scintigraphy demonstrated no movement of isotope from the dorsum of either foot. Subsequent studies identified microfilaria in a nocturnal blood smear, which were thought to represent Brugia beaveri acquired by mosquito transmission in Oklahoma.

Brugia↗