RESUMO
Simple bone cyst (SBC) is very rare in adult ribs. The diagnosis basically relies on conventional radiography and occasionally on CT. There has been no earlier publication on PET/CT diagnosis of SBC. We report a case of adult costal SBC diagnosed by positive 18F-fluorodeoxyglucose (FDG) uptake. Histology showed the FDG uptake to be associated with reactive woven bone formation and nonspecific chronic inflammation. Correlation of PET, CT, plain radiography and sonography are also described.
Assuntos
Adulto , Humanos , Cistos Ósseos , Fluordesoxiglucose F18 , Inflamação , Osteogênese , Publicações , CostelasRESUMO
Meniscus-like presentation of ulcerating gastric carcinoma on upper gastrointestinal series radiograph was first described in 1921 by Carman and has since been known as a useful differential diagnostic sign in radiology. In 1982 using then newly introduced computed tomography (CT) Widder and Mueller revisited the meniscus sign. Their study was primarily focused on a dynamic assessment of the demonstrability of the meniscus sign that largely depends on the judgment and technical skill of examiner, especially graded compression and patient positioning. One year earlier Balfe et al. assessed the diagnostic reliability of gastric wall thickening as observed on CT scan in adenocarcinoma, lymphoma and leiomyosarcoma and concluded that it is not a reliable finding. In contrast, however, Lee et al. recently emphasized that the wall thickness measurement on CT of exophytic carcinoma, myoma and ulcers was a useful diagnostic means. Thus, it appears that gastric wall thickening or mucosal heave-up is by itself not as reliable as the meniscus sign. The electronic search of world literature failed to disclose earlier report of this sign demonstrated by 18F-FDG positron emission tomography and computed tomography (PET/CT). The present communication documents 18F-FDG PET/CT finding of the meniscus sign as encountered in a case of ulcerating gastric carcinoma, the histological diagnosis of which was moderately differentiated tubular adenocarcinoma. Unlike most gastric tumors without ulceration that tend to unimpressively accumulate 18F-FDG the present case of Borrmann type III gastric carcinoma demonstrated markedly increased 18F-FDG uptake.
Assuntos
Adenocarcinoma , Diagnóstico , Fluordesoxiglucose F18 , Julgamento , Leiomiossarcoma , Linfoma , Mioma , Posicionamento do Paciente , Tomografia por Emissão de Pósitrons , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia Computadorizada por Raios X , ÚlceraRESUMO
We report a case of gastric adenoma which was found incidentally on 18F-FDG PET/CT study for cancer screening in asymptomatic patient. It showed focal and intensely increased FDG uptake in the antrum of stomach. On the gastroduodenoscopy, it showed flat elevated lesion with irregular margin. Histologically, the lesion was confirmed gastric adenoma with high grade dysplasia and removed by endoscopic mucosal resection.
Assuntos
Humanos , Adenoma , Detecção Precoce de Câncer , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , EstômagoRESUMO
Image fusion is fast catching attention as Wagner pointed out in his 2006 version of the recent progress and development presented at the annual meeting of Society of Nuclear Medicine. Prototypical fusion of bone scan and radiograph was already attempted at in 1961 when Fleming et al. published an article on strontium-85 bone scan. They simply superimposed dot scan on radiograph enabling simultaneous assessment of altered bone metabolism and local bone anatomy. Indeed the parallel reading of images of bone scan and radiography, CT, MRI or ultrasonography has been practiced in nuclear medicine long since. It is fortunate that recent development of computer science and technology along with the availability of refined CT and SPECT machines has permitted us to open a new avenue to digitally produce precise fusion image so that they can readily be read, exchanged and disseminated using internet. Ten years ago fusion was performed using Bresstrahlung SPECT/CT and it is now achievable by PET/CT and SPECT/CT software and SPECT/CT hardware. The merit of image fusion is its feasibility of reliable assessment of morphological and metabolic change. It is now applicable not only to stationary organs such as brain and skeleton but also to moving organs such as the heart, lung and stomach. Recently, we could create useful fusion image of cardiac SPECT and 64-channel CT angiograph. The former provided myocardial metabolic profile and the latter vascular narrowing in two patients with coronary artery stenosis and myocardial ischemia. Arterial stenosis was severe in Case 1 and mild in Case 2.
Assuntos
Humanos , Angiografia , Encéfalo , Constrição Patológica , Estenose Coronária , Vasos Coronários , Coração , Internet , Pulmão , Imageamento por Ressonância Magnética , Metabolismo , Metaboloma , Microcomputadores , Isquemia Miocárdica , Medicina Nuclear , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Radiografia , Esqueleto , Estômago , Tomografia Computadorizada de Emissão de Fóton Único , UltrassonografiaRESUMO
Reflex sympathetic dystrophy (RSD) is a common rheumatic disorder manifesting painful swelling, discoloration, stiffening and atrophy of the skin. Radiographic alterations include small, spotty subperiosteal bone resorption (SBR) and diffuse porosis, and MR imaging shows bone and soft-tissue edema. The purposes of current investigation were to assess 99mTc HDP pinhole SPECT (pSPECT) findings of RSD, to correlate them with those of radiography and MRI and to speculate about causative mechanism of SBR which characterizes RSD. pSPECT was performed in five patients with RSD of the foot. pSPECT showed small, discrete, spotty hot areas in the subperiosteal zones of ankle bones in all five patients. Diffusely increased tracer uptake was seen in the retrocalcaneal surface where the calcaneal tendon inserts in two patients with atrophic RSD. pSPECT and radiographic correlation showed spotty hot areas, that reflect focally activated bone turnover, to closely match with SBR. Further correlation with MRI showed both spotty hot areas and SBR to coincide in location with the insertions of ligaments and tendons, onto which pulling strain is constantly exerted. In contrast, the disuse osteoporosis in unstrained bones did not show any more significantly increased tracer uptake than normal cancellous bones.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabsorção Óssea , Osso e Ossos/patologia , Edema , Ossos do Pé/patologia , Doenças do Pé/patologia , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Osteoporose/patologia , Distrofia Simpática Reflexa/patologia , Tecnécio/farmacologia , Tomografia Computadorizada de Emissão de Fóton Único/métodosRESUMO
Lymphoma is the third most common childhood malignancy after leukemia and brain tumor. In contrast to adult non-Hodgkin's lymphoma, that occurring in children is usually found extranodally. The most common site is the abdomen, including the gastrointestinal tract, kidney and pancreas, and the next most common is the extranodal head and neck. Gastrointestinal non-Hodgkin's lymphoma in adults is usually considered to be MALT lymphoma, a distinct B-cell type, but the occurrence of this variety in the small bowel of children is relatively rare. We report a case of high-grade MALT lymphoma occurring in a nine-year-old boy who presented with ileoileal intussusception.
Assuntos
Adulto , Criança , Humanos , Masculino , Abdome , Linfócitos B , Neoplasias Encefálicas , Trato Gastrointestinal , Cabeça , Íleo , Intussuscepção , Rim , Leucemia , Linfoma , Linfoma de Zona Marginal Tipo Células B , Linfoma não Hodgkin , Pescoço , PâncreasRESUMO
The most common developmental anomaly of midgut rotation and fixation is non-rotation. Symptomatic intestinal malrotation is relatively common in infants and children but uncommon in later ages. Most adult cases are silent throughout life and are not discovered unless they cause acute or chronic abdominal pain. Many such patients have ill-defined abdominal complaints and are labeled as having a "functional" disorder since no definite clinical abnormalities are found other than the subjective complaints. The most frequent symptomatic presentation in the adult is midgut volvulus the symptom of which is usually self-limited although often recurrent and sometimes leading to an abdominal catastrophe. The diagnostic means for the adulthood malrotation include simple and contrast radiographic studies and CT scan. Malrotation first detected by cholescintigraphy is rare. We report a case of intestinal non-rotation incidentally discovered on DISIDA hepatobiliary scintiscan.
Assuntos
Adulto , Criança , Humanos , Lactente , Dor Abdominal , Volvo Intestinal , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: The aim of this study was to assess the diagnostic value of the (99m)Tc-DMSA pinhole imaging by comparing the detection rate of cortical defects identified from planar and pinhole imaging. METHODS: (99m)Tc-DMSA planar and pinhole imaging, voiding cystoureth-rogram(VCUG), renal ultrasonography were performed in 67 patients diagnosed with urinary tract infection at the Department of Pediatrics, Sung-Ae General Hospital, from September, 1999 to Feburary, 2001. The follow-up of (99m)Tc-DMSA pinhole imaging was performed on 25 patients. RESULTS: Overall detection rate of (99m)Tc-DMSA planar imaging was 41.8%(28 patients/67 patients), but (99m)Tc-DMSA pinhole imaging showed cortical defects in 62.7%(42 patients/67 patients) and the patients with renal cortical defects in planar imaging showed all definite or more additional cortical defects in pinhole imaging. The detection rate of cortical defect by (99m)Tc- DMSA pinhole imaging in patients with vesicoureteral reflux(VUR) was 80%(24 kidneys/30 kidneys). Those without VUR, however, also presented high detection rate as 25.9%(27 kidneys/ 104 kidneys). Out of 25 patients, improvement of cortical defect was presented in 19, no change in 4, and aggravation in 2 from the follow-up studies by (99m)Tc-DMSA pinhole imaging. CONCLUSION: This study indicates that (99m)Tc-DMSA pinhole imaging is superior to planar imaging and, hence, that pinhole imaging is a useful initial diagnostic tool for children suspected of urinary tract infection, irrespective of VUR, and to identify patients who need more extensive radiological studies and early treatment.