Perfusión y función ventricular en SPECT cardiaco y coronariografía del mismo día según localización en enfermedad de un vaso / Single-photon emission computed tomography for the assessment of ventricular perfusion and function

Single-photon emission computed tomography (SPECT) can be used as a non-invasive tool for the assessment of coronary perfusion. Aim: To assess ventricular perfusion and function by SPECT in patients with single vessel coronary artery disease. Material and Methods: Among patients with indications for a coronary artery angiography, those with significant lesions in one vessel, were selected for the study. Within 24 hours, cardiac SPECT examinations on basal conditions and after high doses of dipyridamole, were performed. SPECT data from 38 patients with a low probability of coronary artery disease was used for comparisons. Results: Ten patients aged 61 ± 8 years (seven men) were studied. Visual analysis of SPECT revealed signs suggestive of ischemia in eight patients. The remaining two patients did not have perfusion disturbances. SPECT detected eight of ten abnormal vessels reported in the coronary artery angiography. There were two false negative results Summed stress, summed rest and summed difference scores were 9.78 ± 6.51, 3.22 ± 5.07 and 6.33 ± 4.97, respectively. The ejection fractions under stress and at rest were 53 ± 11.7% and 61 ± 15.7% respectively (p < 0.01). The figures for the control group were 69.1 ± 13.5% and 75.2 ± 12.04% respectively (significantly different from patients). Two patients had a summed motion score above 14.9. Likewise, two patients had a summed thickening score above 10.9. Conclusions: SPECT detected 80% of coronary lesions found during coronary artery angiography. Visual analysis of perfusion is highly reliable for diagnosis. Quantitative parameters must be considered only as reference parameters.

Radionuclide evaluation of enterogastric reflux using caerulein to stimulate biliary excretion

O refluxo biliar desempenha um importante papel na patogenia da esofagite, gastrite e úlcera gástrica. Recentemente, um método utilizando radioisótopos tem sido empregado como o mais fisiológico na avaliaçäo desta condiçäo. No presente artigo, estudou-se o refluxo enterogástrico, empregando o Tc-99m DISIDA em 37 pacientes em várias situaçöes, a saber: esofagite de refluxo, úlcera péptica, ressecçöes gástricas, vagotomia gástrica proximal e colecistite crônica calculosa. Em 19 pacientes, o esvaziamento vesicular foi estimulado com uma dieta hipercalórica altamente concentrada e nos restantes com a injeçäo endovenosa de 5 ng/kg (14 casos) ou 50 ng/kg de ceruleína. Os resultados obtidos sugerem que a injeçäo endovenosa de ceruleína nas doses de 5 ou 50 ng/kg está associada com refluxo enterogástrico significativo