Reproducibility of regional left ventricular wall thickening obtained by gating resting and redistribution 201Tl myocardial SPECT studies.

BACKGROUND: We have assessed the reproducibility of the estimates of regional left ventricular wall thickening between resting and redistribution Tl gated single photon emission computed tomography (SPECT) studies. METHODS: Thirty patients (28 males, two females) aged between 38 and 72 years (57.0 +/- 8.4 years) underwent resting and redistribution Tl gated SPECT. Perfusion was assessed semi-quantitatively using scores of 0-4. The assessment of wall thickening was performed both visually and by using automated software using scores of 0-3. The assessment of reproducibility was performed in 20 individual segments and 37 pairs of contiguous segments in each patient. RESULTS: In resting studies, mean global left ventricular ejection fraction (LVEF), end diastolic volume and end systolic volume were 34.2 +/- 11.7%, 180.5 +/- 70.6 ml and 123.3 +/- 60.0 ml, respectively. The corresponding values for the redistribution studies were 32.7 +/- 10.1%, 179.7 +/- 70.6 ml and 125.5 + 63.0 ml, respectively. There was good correlation between the resting and redistribution LVEFs (r=0.88), end diastolic volumes (r=0.90) and end systolic volumes (r=0.933). Reproducibility of visual wall thickening was 66% in individual segments and 82% in pairs of contiguous segments, and that of automated wall thickening was 48.0% in individual segments and 68% in pairs of contiguous segments. CONCLUSION: In conclusion, global left ventricular functional parameters obtained by resting Tl gated SPECT studies are highly reproducible in patients with impaired resting left ventricular function and large areas of scarred myocardium. Wall thickening and wall motion data are more reproducible in contiguous segments than in individual segments.

Recurrent osteoid osteoma: a case report with imaging features.

We present a case of a 14-year-old boy, who presented with pain in the left thigh region for 1 year. The pain exacerbated at night, waking up the child and was relieved by salicylates. On the basis of clinical history, conventional radiography, computerized tomography and bone scintigraphy, a diagnosis of osteoid osteoma was made. The tumor was completely excised, and there was complete remission of symptoms. Six months following surgery, the pain recurred in the same region. Conventional radiography revealed dense sclerosis at the surgical site. Three-phase skeletal scintigraphy showed a focal area of increased blood pool activity followed by intense focal uptake in delayed images, characteristic of osteoid osteoma. Computerized tomography confirmed the findings of skeletal scintigraphy.

Hemoptysis demonstrated on Tc99m-sulfur colloid scanning: a rare complication of amoebic liver abscess.

We report the finding of bleeding into right lung from a ruptured amoebic liver abscess. A 25-year-old male presented with pain in the right lower chest and cough associated with expectoration of chocolate-colored sputum. Radiographs of chest showed right-sided pleural effusion. Serial images of Tc99m-sulfur colloid study revealed progressive accumulation of radiotracer in the upper photopenic area extending into the right lung region suggestive of active bleeding from the abscess cavity.

Soft tissue uptake of Tc99m-MDP in acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) is associated rarely with hypercalcemia. This may be due to elevated levels of parathyroid hormone-related peptide (PTHrP). We report a case of an 18-year-old female patient who was presented with a pathological fracture of left intertrochanteric region. Bone scintigraphy was consistent with features of hypercalcemia associated with metastatic calcification. A bone marrow biopsy led to the diagnosis of ALL. The mechanism of hypercalcemia in ALL, metastatic calcification and soft tissue uptake of bone seeking agents in this case are discussed in detail.