ABSTRACT
Objetivo. El corazón es uno de los órganos afectados por la anemia de células falciforme (SCA). El objetivo de este estudio prospectivo es evaluar la perfusión miocárdica y la función del ventrículo izquierdo (LV) en niños con SCA por la gammagrafía de perfusión miocárdica (G-MPS) y comparar los resultados con los hallazgos ecocardiográficos. Métodos. Se evaluaron cuarenta y tres pacientes con SCA mediante estudios de G-MPS y ecocardiografía. La perfusión miocárdica y la función ventricular con la valoración de la motilidad y del engrosamiento se analizaron tanto de forma visual como cuantitativa. Se calcularon el EDV, ESV, EF, y el índice pulmón /corazón (L/H). Resultados. Ninguno de los pacientes presentó deterioro de la perfusión post-estrés en el G-MPS. Se observó dilatación del LV en 15 pacientes, que también estuvo presente en el ecocardio. Los valores de EF se encontraban dentro de los límites normales. La correlación entre los valores de EF, mediante ambos métodos no fueron estadísticamente significativas. Sin embargo la dilatación del ventrículo izquierdo detectados por ambos métodos y los valores de EDV-ESV en la G-MPS se correlacionaron con los diámetros sistólico y diastólico final calculados por la ecocardiografía (p<0,05). La ecocardiografía en modo-M mostró mayor índice de rendimiento miocárdico (LV-MPI) en pacientes con dilatación del LV. También hubo una relación significativa entre la dilatación del ventrículo izquierdo y la frecuencia de transfusiones sanguíneas (> 5/año) y el síndrome torácico agudo (p <0,05). Conclusión. El deterioro de la perfusión miocárdica en los niños con SCA no se observa con frecuencia. Debe considerarse el realizar la gammagrafía sólo en pacientes con síntomas cardíacos. Puesto que los valores de EF de los niños con SCA no se deterioran en las primeras etapas, el LV-MPI y la dilatación del ventrículo izquierdo deberían considerarse como un parámetro significativo(AU)
Objectives. The heart is one of the organs affected by sickle cell anemia (SCA). This prospective study has aimed to evaluate myocardial perfusion and left ventricle (LV) function in children with SCA by gated myocardial perfusion scintigraphy (G-MPS) and to compare the results with echocardiographic parameters. Methods. Forty-three patients with SCA were evaluated by G-MPS and echocardiography. Myocardial perfusion and motion with thickening function were analyzed both visually and quantitatively. End-diastolic (EDV), end-systolic volumes (ESV), ejection fraction (EF), lung-to-heart (L/H) ratio were also calculated. Results. None of the patients showed stress perfusion impairment in G-MPS. LV dilatation in 15 patients was observed both by G-MPS and echocardiography. EF values were within normal limits. Correlation between EF values calculated by two methods was not statistically significant. However, LV dilatation detected by both methods and EDV-ESV values in G-MPS were correlated to end-diastolic and end-systolic diameters calculated in echocardiography (p<0.05). M-Mode echocardiography revealed higher myocardial performance index (LV-MPI) in patients with LV dilatation. There was also a significant relationship between LV dilatation and frequent blood transfusions (>5/years) and acute chest syndrome (p<0.05). Conclusion. Myocardial perfusion impairment in children with SCA is not frequently observed. Thus, performing the scintigraphy only in patients with cardiac symptoms should be considered. Since EF values of the children with SCA are not deteriorated in early stages, LV-MPI and LV dilatation should be considered as a significant parameter other than EF or perfusion data(AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Tomography, Emission-Computed, Single-Photon/methods , Tomography, Emission-Computed, Single-Photon , Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography , Myocardial Perfusion Imaging/methods , Myocardial Perfusion Imaging , Echocardiography/methods , Echocardiography , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/physiopathology , Anemia, Sickle Cell , Prospective StudiesABSTRACT
Hallazgos inesperados en la gammagrafía ósea, tales como la captación asimétrica en las extremidades, pueden causar confusión en el diagnóstico. Los autores describen tres casos de inyección intraarterial accidental de 99mTc-metilenedifosfonato (99mTc-MDP) en la región antecubital, discutiendo el origen de los hallazgos y su diagnóstico diferencial(AU)
Unexpected findings on bone scintigraphy such as asymmetrical uptake in extremities may cause confusion for the diagnosis. The authors describe three cases of accidental intraarterial injection of Tc-99m methylene diphosphonate (99mTc-MDP) on the antecubital region and discuss the findings and differential diagnosis(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Upper Extremity/pathology , Upper Extremity , Technetium Tc 99m Exametazime , Injections, Intra-Arterial/methods , Injections, Intra-Arterial , Infusions, Intra-Arterial/instrumentation , Infusions, Intra-Arterial/methods , Infusions, Intra-Arterial/trends , Infusions, Intra-Arterial , Nuclear Medicine/methodsABSTRACT
Los autores describen un patrón poco frecuente al observar captación de 99mTc-MDP a nivel de tejidos blandos en la gammagrafía ósea (GO) realizada a dos pacientes con diagnóstico de Linfoma no Hodgkin. Los dos pacientes tenían masas abdominales y la GO revelo captación del trazador en la región abdominal. Se discuten los posibles mecanismos de captación de los trazadores óseos en los tejidos blandos(AU)
The authors describe a rare pattern of soft tissue uptake observed in a 99mTc-MDP bone scintigraphy of two patients with the diagnosis of non-Hodgkin's lymphoma. Both patients had abdominal masses and bone scintigraphy revealed unusual 99mTc-MDP uptake in the abdominal region. The possible mechanisms of soft tissue uptake of bone seeking agents are discussed(AU)
Subject(s)
Humans , Male , Female , Technetium Tc 99m Pentetate , Technetium , Lymphoma, Non-Hodgkin/diagnosis , Soft Tissue Neoplasms/diagnosis , Lymphoma, Non-Hodgkin , Radioactive TracersABSTRACT
OBJECTIVES: The heart is one of the organs affected by sickle cell anemia (SCA). This prospective study has aimed to evaluate myocardial perfusion and left ventricle (LV) function in children with SCA by gated myocardial perfusion scintigraphy (G-MPS) and to compare the results with echocardiographic parameters. METHODS: Forty-three patients with SCA were evaluated by G-MPS and echocardiography. Myocardial perfusion and motion with thickening function were analyzed both visually and quantitatively. End-diastolic (EDV), end-systolic volumes (ESV), ejection fraction (EF), lung-to-heart (L/H) ratio were also calculated. RESULTS: None of the patients showed stress perfusion impairment in G-MPS. LV dilatation in 15 patients was observed both by G-MPS and echocardiography. EF values were within normal limits. Correlation between EF values calculated by two methods was not statistically significant. However, LV dilatation detected by both methods and EDV-ESV values in G-MPS were correlated to end-diastolic and end-systolic diameters calculated in echocardiography (p<0.05). M-Mode echocardiography revealed higher myocardial performance index (LV-MPI) in patients with LV dilatation. There was also a significant relationship between LV dilatation and frequent blood transfusions (>5/years) and acute chest syndrome (p<0.05). CONCLUSION: Myocardial perfusion impairment in children with SCA is not frequently observed. Thus, performing the scintigraphy only in patients with cardiac symptoms should be considered. Since EF values of the children with SCA are not deteriorated in early stages, LV-MPI and LV dilatation should be considered as a significant parameter other than EF or perfusion data.
Subject(s)
Anemia, Sickle Cell/physiopathology , Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography/methods , Myocardial Perfusion Imaging/methods , Ventricular Dysfunction, Left/diagnostic imaging , Adolescent , Anemia, Sickle Cell/drug therapy , Benzoates/therapeutic use , Chelation Therapy , Child , Deferasirox , Dilatation, Pathologic/diagnostic imaging , Dipyridamole , Echocardiography, Stress , Female , Heart Ventricles/diagnostic imaging , Humans , Hydroxyurea/therapeutic use , Iron Chelating Agents/therapeutic use , Iron Overload/chemically induced , Iron Overload/drug therapy , Male , Prospective Studies , Stroke Volume , Transfusion Reaction , Triazoles/therapeutic use , Vasodilator Agents , Ventricular Dysfunction, Left/etiologyABSTRACT
Unexpected findings on bone scintigraphy such as asymmetrical uptake in extremities may cause confusion for the diagnosis. The authors describe three cases of accidental intraarterial injection of Tc-(99m) methylene diphosphonate ((99m)Tc-MDP) on the antecubital region and discuss the findings and differential diagnosis.
Subject(s)
Injections, Intra-Arterial/adverse effects , Radiopharmaceuticals/administration & dosage , Radius/diagnostic imaging , Technetium Tc 99m Medronate/administration & dosage , Ulna/diagnostic imaging , Whole Body Imaging , Aged, 80 and over , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Diagnosis, Differential , False Positive Reactions , Female , Finger Phalanges/diagnostic imaging , Humans , Injections, Intravenous , Male , Metacarpal Bones/diagnostic imaging , Middle Aged , Radionuclide Imaging , Radiopharmaceuticals/pharmacokinetics , Technetium Tc 99m Medronate/pharmacokinetics , Thoracic Vertebrae/diagnostic imagingABSTRACT
The authors describe a rare pattern of soft tissue uptake observed in a (99m)Tc-MDP bone scintigraphy of two patients with the diagnosis of non-Hodgkin's lymphoma. Both patients had abdominal masses and bone scintigraphy revealed unusual (99m)Tc-MDP uptake in the abdominal region. The possible mechanisms of soft tissue uptake of bone seeking agents are discussed.
