Sujets)
Adulte , Enfant , Femelle , Humains , Mâle , Coeur foetal/chirurgie , Cardiopathies congénitales/chirurgie , Défaillance cardiaque/chirurgie , Transplantation cardiaque/méthodes , Transplantation cardiaque/normes , Brésil , Foetus , Cardiopathies congénitales/diagnostic , Défaillance cardiaque/congénital , Défaillance cardiaque/diagnostic , Appréciation des risques , Facteurs de risque , Sociétés médicalesRésumé
The aim of this study was to compare gallium-67 citrate lung imaging with the pulmonary clearance of 99mTc-DTPA (technetium 99m diethylenetriaminepentaacetic acid) in 9 patients with amiodarone pneumonitis (8 males and 1 female, aged 58 to 76 years). The diagnosis of amiodarone pneumonitis was based on clinical and radiological grounds in all patients, and histological changes in seven. The mean values for the effective half-life of the pulmonary clearance of 99mTc-DTPA aerosol were below the normal range in all 9 patients, and lower than the values obtained previously for patients on a long-term amiodarone regimen without side effects. Positive gallium-67 accumulation was demonstrated in 7 of the 9 patients. Two patients had negative gallium-67 imaging and increased alveolar-capillary 99mTc-DTPA clearance; with corticosteroid therapy and discontinuation of amiodarone, their radiological changes and clearance became normal within 120 days. In conclusion, when compared to gallium-67 lung imaging, the 99mTc-DTPA aerosol clearance is more advantageous because it is a much faster test than the gallium scan. This is essential for those patients suspected of amiodarone pneumonitis who need specific therapy as soon as possible. Moreover, the 99mTc-DTPA aerosol clearance test appears to be a more useful diagnostic tool because it is positive even in those patients who have normal gallium-67 lung imaging.
Sujets)
Adulte , Humains , Femelle , Adulte d'âge moyen , Amiodarone/effets indésirables , Radio-isotopes du gallium , Pneumopathie infectieuse/diagnostic , Pentétate de technétium (99mTc) , Hormones corticosurrénaliennes/usage thérapeutique , Sujet âgé de 80 ans ou plusRésumé
Foram estudados retrospectivamente 18 pacientes com febrereumática (FR), sendo 9 do sexo masculino, com idade média de 14,1 anos, tendo 16 cardite, 1 coréia e 1 FR sem cardite, sob regime de internamento hospitalar, com avaliaçäo clínica, laboratorial, radiológica, eletrocardiográfica e cintilográfica (67-Ga) extensiva. Dos 16 casos de cardite, 5 correspondiam ao 1§ surto da FR, 7 à recorrência e 4 à doença inativa. Os pacientes foram divididos em dois grupos: a) tratados clincamente, b) tratados cirurgicamente. No primeiro grupo de 13 pacientes (11 com cardite) efetuou-se correlaçäo clínica, eletro, eco e cintilográfica que resultou concordante, tendo 6 casos provas reumáticas negativas. No 2§ grupo (5 pacientes) a correlaçäo clínico-cintilográfico-histológica foi concordante em 4 e discordante em 1 (cuja intervençäo ocorreu 2,5 meses após estudo com 67-Ga). Houve acompanhamento terapêutico em 6 pacientes coincidindo a evoluçäo clínica com imagens de 67-Ga em todos, embora as provas reumáticas fossem negativas em 3. Estes resultados sugerem que os estudo com 67-Ga sejam úteis para caracterizar atividade de cardite reumática, como elemento de acompanhamento terapêutico e definir sua inatividade nos casos cirúrgicos