Subject(s)
Chest Pain , Myocardial Ischemia/pathology , Pain , Acute Coronary Syndrome/diagnosis , Aged , Coronary Angiography/methods , Diagnostic Imaging/methods , Humans , Male , Myocardial Perfusion Imaging/methods , Radiopharmaceuticals/pharmacology , Rest , Technetium Tc 99m Sestamibi/pharmacologyABSTRACT
Dementia with Lewy bodies (DLB) is the second most common cause of dementia. The diagnosis of DLB is particularly important because these patients show good response to cholinesterase inhibitors. Clinical and neuroimaging criteria for DLB have not been acceptable for predictive accuracy. We report a case of progressive dementia in which the differentiation of DLB and Alzheimer disease (AD) on the basis of clinical criteria alone was not possible. The patient was admitted to the hospital because he became worse after he had started treatment for severe AD. Both MRI and brain magnetic resonance spectroscopy were normal. The patient underwent myocardial scintigraphy with I-123 MIBG showing marked reduction in cardiac MIBG accumulation. The heart to mediastinum ratio of MIBG uptake was impaired in both early and delayed images. FDG-PET scan before and after activation with a visual attention task showed occipital cortex hypometabolism as compared with AD and a normal control. This case illustrates the value of combining activated brain FDG PET and cardiac MIBG. The association of these 2 techniques could be used as a potential diagnostic tool in a patient with dementia misdiagnosed as AD.
Subject(s)
3-Iodobenzylguanidine , Alzheimer Disease/diagnostic imaging , Fluorodeoxyglucose F18 , Heart/diagnostic imaging , Lewy Body Disease/diagnostic imaging , Aged , Diagnosis, Differential , Humans , Image Enhancement/methods , Male , Radionuclide Imaging , RadiopharmaceuticalsSubject(s)
Bone Marrow Cells/diagnostic imaging , Coronary Vessels/diagnostic imaging , Coronary Vessels/surgery , Hematopoietic Stem Cell Transplantation/methods , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/surgery , Technetium Tc 99m Exametazime , Humans , Male , Middle Aged , Radionuclide Imaging , Radiopharmaceuticals , Treatment OutcomeABSTRACT
The authors report a case of small bowel bleeding diagnosed by Tc-99m-labeled red blood cell (RBC) scintigraphy during the postoperative period after aortic valve replacement. There is a relationship between aortic valve stenosis and gastrointestinal bleeding in elderly patients, called Heyde syndrome. The described patient had chronic anemia that worsened after surgery. RBC scintigraphy localized the source of bleeding from jejunal angiodysplasia confirmed by mesenteric angiography. This case illustrates the diagnostic information provided by RBC scintigraphy in this syndrome.
