ABSTRACT
Objective[s]: in this study, we aimed to analyze the relationship between the diagnostic ability of fused single photon emission computed tomography/computed tomography [SPECT/CT] images in localization of parathyroid lesions and the size of adenomas or hyperplastic glands
Methods: five patients with primary hyperparathyroidism [PHPT] and 4 patients with secondary hyperparathyroidism [SHPT] were imaged 15 and 120 minutes after the intravenous injection of technetium99mmethoxyisobutylisonitrile [[99m]Tc-MIBI]. All patients underwent surgery and 5 parathyroid adenomas and 10 hyperplastic glands were detected. Pathologic findings were correlated with imaging results
Results: the SPECT/CT fusion images were able to detect all parathyroid adenomas even with the greatest axial diameter of 0.6 cm. Planar scintigraphy and SPECT imaging could not detect parathyroid adenomas with an axial diameter of 1.0 to 1.2 cm. Four out of 10 [40%] hyperplastic parathyroid glands were diagnosed, using planar and SPECT imaging and 5 out of 10 [50%] hyperplastic parathyroid glands were localized, using SPECT/CT fusion images
Conclusion: SPECT/CT fusion imaging is a more useful tool for localization of parathyroid lesions, particularly parathyroid adenomas, in comparison with planar and or SPECT imaging
ABSTRACT
An 82-year-old woman fell into a state of shock during the treatment for a urinary tract infection. Computed tomography and transthoracic echocardiography revealed massive pericardial effusion. Pericardiectomy was performed in the operating room and hemorrhagic effusion was observed. Emergent sternotomy was performed, and the bleeding site was located at the posterior portion of the left ventricular outflow. We diagnosed a rupture of a left ventricular outflow tract pseudoaneurysm after infectious endocarditis. A pericardium patch closure of the pseudoaneurysm and an aortic valve replacement were performed. The patient was discharged 35 days after the operation without recurrence of infection. Left ventricular outflow tract pseudoaneurysms is an uncommon complication following infective endocarditis, aortic valve surgery or chest trauma. Transesophageal echocardiography and multidetector-row computed tomography (MDCT) is useful for identifying such lesions.
ABSTRACT
A 65-year-old man had received closure of the entry and false lumen Stanford type B acute aortic dissection via left thoratectomy 23 years previously. The patient underwent emergency graft replacement for a ruptured aneurysm of the thoraco-abdominal aorta 10 years previously. Enhanced computed tomography (ECT) revealed that the residual aortic dissection of the distal arch and the descending aorta were dilated. Reoperation via left thoracotomy usually requires a long cardiopulmonary bypass time and intraoperative bleeding. So we selected to perform open stent-grafting through median sternotomy alone, avoiding a left thoracotomy.