Análise comparativa das alterações periapicais diagnosticadas pela técnica radiográfica do paralelismo e pelo mapeamento tomográfico cintilográfico (com e sem blindador de raios gama)J / Comparison analyzes of periapical alterations diagnosed by radiograph exam by the parallel technique and through scintigraphic tomographic mapping (with and without intra-oral apparatus)

O diagnóstico precoce de focos de infecção dentários é de fundamental importância para prevenir a ocorrência de maiores injúrias locais ou sistêmicas. Dentre os diversos métodos utilizados para complementar os achados radiológicos das alterações dentoalveolares surge uma alternativa: a cintilografia tomográfica (SPECT/CT), que permite a fusão de achados morfológicos com alterações metabólicas. Com o objetivo de estabelecer o diagnóstico precoce e acurado de processos infecciosos dentários, foram estudadas 320 áreas dentárias em mandíbula e maxila em (10 pacientes de ambos os sexos selecionados por meio de exames clínicos e radiológicos convencionais, seguidos de cintilografia tomográfica com e sem aparato blindador de raios gama. Os exames cintilográficos foram realizados no Serviço de Medicina Nuclear do Hospital Israelita Albert Einstein (HIAE). Para isso, foi administrado para cada paciente o radiofármaco tecnécio 99- metilenodifosfonato (99mTc-MDP) via endovenosa com a dose de 37mBq/3Kg de peso corporal do paciente. Após o período de acúmulo de três horas, foi realizado o protocolo de aquisição de imagens. Todas as imagens foram analisadas por um médico nuclear e um endodontista, com experiência em cintilografia tomográfica. O resultado obtido por meio do exame radiográfico intrabucal pela técnica periapical digital mostraram 6 imagens positivas, em um total de 1,87% da amostra; exame do mapeamento cintilográfico dos ossos da face com a utilização do blindador de raios gâma revelou 9 imagens positivas, correspondendo a 2,81% do total de áreas estudadas, havendo diferença estatisticamente significante ao nível de 95% pelo teste qui-quadrado. Pode-se concluir que o SPECT/CT permitiu identificar as alterações periapicais em maior número quando comparadas ao exame radiográfico periapical e ao mapeamento cintilográfico dos ossos da face com a utilização do blindador de raios gama; o exame de SPCET/CT além de mostrar imagens mais detalhadas...

The early diagnosis of cases with dental infection is very important to prevent the occurrence of major local or systemic injuries. With many methods used to complement the radiological findings of the bone alterations there's the tomographic scintigraphy witch allows the fusion of morphological and metabolic findings. With the objective of the establishment of early diagnosis and accurate dental infectious processes, it was studied 320 dental areas in maxilla and mandible (10 patients) selected randomly, through conventional radiological exams, followed by tomographic scintigraphy with and without intra-oral apparatus. The scintilographic exams were done at the Nuclear Medicine Service of Hospital Israelita Albert Einstein. For that, methylenediphosphonate-technetium-99m (99mTc-MDP) was dispensed intravenous. After the period of accumulation of 3 hours, the image acquisition protocol was taken. This protocol includes images from the top of the head to the neck. After the image analyzes, statistics was done. The intrabucal radiograph exam by the digital periapical technique showed 6 positive images, in a total of 1.87% of the total sample, Intra-oral apparatus showed 9 positive images, in a total os 2,81% of the sample and SPECT/CT exam revealed 15 positive images, corresponding to 4.28% of the total studied areas, showing statistical significance by the level of 95% of qui-square. We could conclude that SPECT/CT allowed identifying the endodontic infections in a larger number when compared with the radiograph exams; and the SPECT/CT exam showed to be of great interest by allowing the union of the diagnosis precocity with the image detail, presenting exact localization of inflammatory/infectious alterations due to the presence of the CT...

Significance of ~(99m)Tc-Diethyl Iminodiacetic Acid Hepatobliliary Planar and Tomographic Scintigraphy in Diagnosis on Biliary Atresia / 实用儿科临床杂志

Objective To evaluate the clinical value of 6 h 99mTc-diethyl iminodiacetic acid (99mTc-EHIDA) planar hepatobiliary scintigraphy (HBS),6 h tomographic HBS and 24 h planar HBS in diagnosis on biliary atresia(BA).Methods Seventy cases(32 male,38 female) with continuous jaundice received planar and tomographic HBS in Beijing Friendship Hospital from Jan.2005 to Dec.2007.The mean age was 48.7 d (29 d-4 months).According to final diagnosis,all cases were divided into BA group (45 cases) and non-BA group (25 cases).All cases fasted at least 4 hours before HBS.The equipment was 3 head IRIX from Philips company with low energy high resolution collimator.The tracer was 99mTc-EHIDA and the radiochemistry purity was more than 95 percent.The dosage was 7.4 MBq/kg.All diagnosis demonstrated by operation pathology and clinical follow-up.All cases received HBS at 5,10,15,20,30 min and 1,6 h after tracer injection.HBS would ended if radioactivity appeared in gallbladder or intestine.These cases would received tomographic HBS and 24 h HBS if radioactivity did not appear in gallbladder or intestine at 6 h post injection.All these images were analyzed by 2 or more nuclear medicine physicians.Results There were not radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 27 cases,which suggested the BA.There were radioactivity appearing in gallbladder and intestine on planar and tomographic HBS of 30 cases,which suggested the non-BA.Positive rate of 6 h tomographic HBS was significantly higher than that of 6 h planar HBS and there was significantly difference between the 2 methods.Positive rate of 6 h tomographic HBS was significantly higher than that of 24 h planar HBS and there was significant difference between the 2 methods.Conclusions 99mTc-EHIDA HBS is a noninvasive,safety,valuable examing method and has definitely clinical value in the diagnosis on BA.The clinical value of 6 h tomographic HBS is significantly higher than that of 6 h planar HBS and 24 h planar HBS.

Effects of the Body Position Changes on Upper Airway Caliber in Obstructive Sleep Apnea during Sleep / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is the intermittent cessation of breathing during sleep due to the collapse of the pharyngeal airway. Pharyngeal collapsibility and oropharyngeal caliber are affected by the respiratory cycle and the body position. Several methods have been used to evaluate the states of upper airway in patients with OSA according to body positions during wakefulness, but there were no reports about the upper airway states according to body positions during sleep. The aim of this study is to evaluate the states of upper airway in patients with OSA according to body position changes during sleep. MATERIALS AND METHOD: Using a multi detector CT, we studied 10 patients with OSA. Each patient was scanned at supine position during the awake state and then induced to sleep using Midazolam. According to body positions (supine, decubitus, and prone), images were acquired during sleep state. The following 4 transverse levels were obtained to evaluate the minimal cross sectional area, collapsibility index, and airway volume: 1) high retropalate level, 2) low retropalate level, 3) high retroglossal level, 4) low retroglossal level. RESULTS: During sleep, the upper airway cross sectional area was decreased and the airway wall collapsibility was increased. Cross sectional area and airway volume were larger at prone and decubitus positions than supine position. Airway wall collapsibility index was lower at prone and decubitus positions than at the supine position. CONCLUSION: In this study, we confirm that the upper airway collapsibility decreases and the airway caliber increases according to body position changes (prone, decubitus) during sleep. Furthermore, the decubitus position is better than the prone position for improving upper airway patency during sleep.