Normative data for the Fototest from neurological patients with no cognitive impairment.

OBJECTIVES: To contribute normative data for the Fototest from neurological patients with no cognitive impairment, including disaggregated data on each domain of the test (naming, free recall, total recall, and naming fluency). MATERIAL AND METHODS: We performed a cross-sectional study in which neurological patients with no cognitive impairment were tested with the Fototest; we recorded total and domain scores. We performed a descriptive study of the total and domain scores, with data disaggregated by sex, age (over/under 65 years), and level of education (primary education completed/not completed; further study completed). RESULTS: We included a sample of 1055 patients, who were mainly women (57.1%), aged over 65 (60.6%), and had a low level of education (38.6% had not completed primary education). Sex, age, and level of education influence total Fototest score (34.6 ±â€¯5.3; P10: 28; P5: 27) and free recall (8.5 ±â€¯2.2; 6; 4), total recall (10.0 ±â€¯1.5; 8; 7), and naming fluency scores (18.7 ±â€¯4.9; 13; 12). For total score, the multivariate analysis revealed values of 1.5 ±â€¯0.3 (ß ±â€¯SD) for sex (female), -2.4 ±â€¯0.3 for age (>65), and -1.6 ±â€¯0.4 and 3.3 ±â€¯0.4 for incomplete primary education and completed post-primary education, respectively (completed primary study was used as a reference). CONCLUSIONS: We provide normative data for total and domain Fototest results for each of the groups defined according to sex, age, and level of education. We also provide a percentile distribution of scores. We hope that these normative data will translate into increases in efficiency in Fototest administration in the clinical setting.

Valores normativos del Fototest en pacientes neurológicos sin deterioro cognitivo / Normative data for the Fototest from neurological patients with no cognitive impairment

Objetivos: Proporcionar valores normativos del Fototest relativos a pacientes neurológicos sin deterioro cognitivo, que incluyan datos desagregados para cada uno de los dominios que conforman este instrumento (denominación, recuerdo libre, recuerdo total y fluidez de nombres). Material y métodos: Estudio transversal en pacientes neurológicos sin deterioro cognitivo a los que se aplicó el Fototest, registrándose las puntuaciones desagregadas y total. Estudio descriptivo de los resultados totales y desagregados del Fototest estratificados por sexo, edad (< 65/> 65 años) y estudios (< primaria/primaria/> primaria). Resultados: Muestra de 1.055 sujetos con predominio de mujeres (57,1%), mayores de 65 años (60,6%) y con bajo nivel educativo (36,8% sin estudios primarios). La puntuación total del Fototest (34,6 ± 5,3; 28; 27 [media ± DE; P10; P5]), así como las desagregadas para denominación (5,9 ± 0,3; 6; 5), recuerdo libre (8,5 ± 2,2; 6; 4), recuerdo total (10,0 ± 1,5; 8; 7) y fluidez de nombres (18,7 ± 4,9; 13; 12), están influidas por el sexo, la edad y el nivel educativo. Para la puntuación total, los resultados del estudio multivariante son: sexo (mujer) 1,5 ± 0,3 (ß ± EE), edad (> 65 años) −2,4 ± 0,3, estudios < primaria −1,6 ± 0,4 y estudios > primaria 3,3 ± 0,4 (primaria = referencia estudios). Conclusión: Se proporcionan valores normativos (media ± DE, P10; P5) del Fototest para cada uno de los estratos definidos por las variables sexo, edad y estudios tanto para las puntuaciones totales como desagregadas del Fototest, así como una distribución percentual para cada uno de los valores posibles de estas puntuaciones. Estos valores normativos es de esperar que se traduzcan en una mayor eficiencia del Fototest en el ámbito clínico. (AU)

Objectives: To contribute normative data for the Fototest from neurological patients with no cognitive impairment, including disaggregated data on each domain of the test (naming, free recall, total recall, and naming fluency). Material and methods: We performed a cross-sectional study in which neurological patients with no cognitive impairment were tested with the Fototest; we recorded total and domain scores. We performed a descriptive study of the total and domain scores, with data disaggregated by sex, age (over/under 65 years), and level of education (primary education completed/not completed; further study completed). Results: We included a sample of 1,055 patients, who were mainly women (57.1%), aged over 65 (60.6%), and had a low level of education (38.6% had not completed primary education). Sex, age, and level of education influence total Fototest score (34.6 ± 5.3; P10: 28; P5: 27) and naming (5,9±0,3; 6; 5), free recall (8.5 ± 2.2; 6; 4), total recall (10.0 ± 1.5; 8; 7), and naming fluency scores (18.7 ± 4.9; 13; 12). For total score, the multivariate analysis revealed values of 1.5 ± 0.3 (ß ± SE) for sex (female), −2.4 ± 0.3 for age (> 65), and −1.6 ± 0.4 and 3.3 ± 0.4 for incomplete primary education and completed post-primary education, respectively (completed primary study was used as a reference). Conclusion: We provide normative data for total and domain Fototest results for each of the groups defined according to sex, age, and level of education. We also provide a percentile distribution of scores. We hope that these normative data will translate into increases in efficiency in Fototest administration in the clinical setting. (AU)

Ictus isquémico en territorio posterior como complicación de embolización de arterias bronquiales / No disponible

No disponible

Normative data for the Fototest from neurological patients with no cognitive impairment. / Valores normativos del Fototest en pacientes neurológicos sin deterioro cognitivo.

OBJECTIVES: To contribute normative data for the Fototest from neurological patients with no cognitive impairment, including disaggregated data on each domain of the test (naming, free recall, total recall, and naming fluency). MATERIAL AND METHODS: We performed a cross-sectional study in which neurological patients with no cognitive impairment were tested with the Fototest; we recorded total and domain scores. We performed a descriptive study of the total and domain scores, with data disaggregated by sex, age (over/under 65 years), and level of education (primary education completed/not completed; further study completed). RESULTS: We included a sample of 1,055 patients, who were mainly women (57.1%), aged over 65 (60.6%), and had a low level of education (38.6% had not completed primary education). Sex, age, and level of education influence total Fototest score (34.6 ± 5.3; P10: 28; P5: 27) and naming (5,9±0,3; 6; 5), free recall (8.5 ± 2.2; 6; 4), total recall (10.0 ± 1.5; 8; 7), and naming fluency scores (18.7 ± 4.9; 13; 12). For total score, the multivariate analysis revealed values of 1.5 ± 0.3 (ß ± SE) for sex (female), -2.4 ± 0.3 for age (> 65), and -1.6 ± 0.4 and 3.3 ± 0.4 for incomplete primary education and completed post-primary education, respectively (completed primary study was used as a reference). CONCLUSION: We provide normative data for total and domain Fototest results for each of the groups defined according to sex, age, and level of education. We also provide a percentile distribution of scores. We hope that these normative data will translate into increases in efficiency in Fototest administration in the clinical setting.

Mortalidad asociada al ictus en un hospital andaluz de tercer nivel. Análisis y reflexiones / Stroke-related mortality in a tertiary care hospital in Andalusia: Analysis and reflections

Objetivos: El ictus constituye una causa muy frecuente de muerte, especialmente en el sur de España; se analiza la mortalidad intrahospitalaria asociada a ictus en un hospital andaluz de tercer nivel. Métodos: Registro de pacientes con ictus como diagnóstico en su informe de defunción en el Hospital Virgen de las Nieves de Granada durante 2013. Se utilizan además datos globales sobre altas en ictus y se comparan con iguales variables en síndrome coronario agudo (SCA). Resultados: Altas con diagnóstico de ictus 825 (96 defunciones, 11,6%); 562 isquémicos (44 fallecidos, 7,8%); 263 hemorrágicos (52 muertes, 19,7%). Los hemorrágicos, por tanto, tuvieron mayor mortalidad (OR = 2,9) y más precoz durante el ingreso (mediana 4 vs. 7 días, global 6 días), aunque los isquémicos fueron más ancianos y más pluripatológicos. Altas con SCA 617 (36 fallecidos, 5,8%); OR de mortalidad en ictus/SCA = 2,1. Un 23% de los fallecidos con ictus estaban anticoagulados cuando lo presentaron. El 60% de los ictus isquémicos y el 20% de los ictus hemorrágicos fallecidos tenían fibrilación auricular; solo el 35% de los pacientes con ictus isquémico y fibrilación auricular estaban anticoagulados. Conclusiones: El ictus supera al SCA en ingresos y mortalidad intrahospitalaria. El ictus hemorrágico supera al isquémico en mortalidad asociada. La anticoagulación crónica es frecuente en pacientes con ictus fatal; 2 tercios de los pacientes con ictus isquémico mortal y fibrilación auricular no estaban anticoagulados. Según nuestros resultados, optimizar la prevención en pacientes con fibrilación auricular podría impactar favorablemente sobre la mortalidad intrahospitalaria asociada al ictus (AU)

Objectives: Stroke is a very common cause of death, especially in southern Spain. The present study analyses in-hospital mortality associated with stroke in an Andalusian tertiary care hospital. Methods: We gathered the files of all patients who had died at Hospital Universitario Virgen de las Nieves in Granada in 2013 and whose death certificates indicated stroke as the cause of death. We also gathered stroke patients discharge data and compared them to that of patients with acute coronary syndrome (ACS). Results: A total of 825 patients had a diagnosis of stroke (96 deaths, 11.6%); of these, 562 had ischaemic stroke (44 deaths, 7.8%) and 263 haemorrhagic stroke (52 deaths, 19.7%). Patients with haemorrhagic stroke therefore showed greater mortality rate (OR = 2.9). Patients in this group died after a shorter time in hospital (median, 4 vs 7 days; mean, 6 days). However, patients with ischaemic stroke were older and presented with more comorbidities. On the other hand, 617 patients had a diagnosis of ACS (36 deaths, 5.8%). The mortality odds ratio (MOR) was 2.1 (stroke/SCA). Around 23% of the patients who died from stroke were taking anticoagulants. 60% of the deceased patients with ischaemic stroke and 20% of those with haemorrhagic stroke had atrial fibrillation (AF); 35% of the patients with ischaemic stroke and AF were taking anticoagulants. Conclusions: Stroke is associated with higher admission and in-hospital mortality rates than SCA. Likewise, patients with haemorrhagic stroke showed higher mortality rates than those with ischaemic stroke. Patients with fatal stroke usually had a history of long-term treatment with anticoagulants; 2 thirds of the patients with fatal ischaemic stroke and atrial fibrillation were not receiving anticoagulants. According to our results, optimising prevention in patients with AF may have a positive impact on stroke-related in-hospital mortality (AU)

Physiological expression of pancreatic somatostatin receptors in 99mTc-HYNIC-TOC scintigraphy

Purpose. To describe the frequency of head and/or pancreas uncinate process uptake of 99mTc-HYNIC-TOC, to study its nature, and analyze its diagnostic value. Materials and methods. Retrospective evaluation of 47 consecutive 99mTc-HYNIC-TOC examinations was conducted. Head and/or pancreas uncinate process uptake was considered to be physiological in patients with normal CT at the same episode and in follow-up. It was analyzed if age or diabetes mellitus was justifying the existence or not of uptake. Results. 32.5% patients showed uptake; 73% of them were mild. 84.6% patients with uptake have no pathology and 4% had neuroendocrine pancreatic disease at CT. Neither the age nor the diabetes mellitus established differences in patients without lesion. Conclusions. Near one-third of patients show physiological uptake by head and/or pancreas uncinate process at 99mTc-HYNIC-TOC scintigraphy. It seems that neither the diabetes nor the ages are factors that determine this physiological uptake (AU)

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Physiological expression of pancreatic somatostatin receptors in 99mTc-HYNIC-TOC scintigraphy.

PURPOSE: To describe the frequency of head and/or pancreas uncinate process uptake of 99mTc-HYNIC-TOC, to study its nature, and analyze its diagnostic value. MATERIALS AND METHODS: Retrospective evaluation of 47 consecutive 99mTc-HYNIC-TOC examinations was conducted. Head and/or pancreas uncinate process uptake was considered to be physiological in patients with normal CT at the same episode and in follow-up. It was analyzed if age or diabetes mellitus was justifying the existence or not of uptake. RESULTS: 32.5% patients showed uptake; 73% of them were mild. 84.6% patients with uptake have no pathology and 4% had neuroendocrine pancreatic disease at CT. Neither the age nor the diabetes mellitus established differences in patients without lesion. CONCLUSIONS: Near one-third of patients show physiological uptake by head and/or pancreas uncinate process at 99mTc-HYNIC-TOC scintigraphy. It seems that neither the diabetes nor the ages are factors that determine this physiological uptake.

Stroke-related mortality in a tertiary care hospital in Andalusia: Analysis and reflections. / Mortalidad asociada al ictus en un hospital andaluz de tercer nivel. Análisis y reflexiones.

OBJECTIVES: Stroke is a very common cause of death, especially in southern Spain. The present study analyses in-hospital mortality associated with stroke in an Andalusian tertiary care hospital. METHODS: We gathered the files of all patients who had died at Hospital Universitario Virgen de las Nieves in Granada in 2013 and whose death certificates indicated stroke as the cause of death. We also gathered stroke patients discharge data and compared them to that of patients with acute coronary syndrome (ACS). RESULTS: A total of 825 patients had a diagnosis of stroke (96 deaths, 11.6%); of these, 562 had ischaemic stroke (44 deaths, 7.8%) and 263 haemorrhagic stroke (52 deaths, 19.7%). Patients with haemorrhagic stroke therefore showed greater mortality rate (OR=2.9). Patients in this group died after a shorter time in hospital (median, 4 vs 7 days; mean, 6 days). However, patients with ischaemic stroke were older and presented with more comorbidities. On the other hand, 617 patients had a diagnosis of ACS (36 deaths, 5.8%). The mortality odds ratio (MOR) was 2.1 (stroke/SCA). Around 23% of the patients who died from stroke were taking anticoagulants. 60% of the deceased patients with ischaemic stroke and 20% of those with haemorrhagic stroke had atrial fibrillation (AF); 35% of the patients with ischaemic stroke and AF were taking anticoagulants. CONCLUSIONS: Stroke is associated with higher admission and in-hospital mortality rates than SCA. Likewise, patients with haemorrhagic stroke showed higher mortality rates than those with ischaemic stroke. Patients with fatal stroke usually had a history of long-term treatment with anticoagulants; 2 thirds of the patients with fatal ischaemic stroke and atrial fibrillation were not receiving anticoagulants. According to our results, optimising prevention in patients with AF may have a positive impact on stroke-related in-hospital mortality.

[Thalamic metabolism and neurological outcome after traumatic brain injury. A voxel-based morphometric FDG-PET study]. / Metabolismo talámico y situación neurológica tras un traumatismo craneoencefálico. Estudio mediante PET-FDG y morfometría basada en vóxel.

OBJECTIVE: to study the relationship between thalamic metabolism and neurological outcome in patients who had sustained a traumatic brain injury (TBI). METHODS: nineteen patients who had sustained a severe TBI and ten control subjects were included in this study. Six of the 19 patients had a low level of consciousness (vegetative state or minimally conscious state), while thirteen showed normal consciousness. All patients underwent a PET with 18F-FDG, 459.4 +/- 470.9 days after the TBI. The FDG-PET images were normalized in intensity, with a metabolic template being created from data derived from all subjects. The thalamic trace was generated automatically with a mask of the region of interest in order to evaluate its metabolism. A comparison between the two groups was carried out by a two sample voxel-based T-test, under the General Linear Model (GLM) framework. RESULTS: patients with low consciousness had lower thalamic metabolism (MNI-Talairach coordinates: 12, -24, 18; T = 4.1) than patients with adequate awareness (14, -28, 6; T = 5.5). Control subjects showed the greatest thalamic metabolism compared to both patients groups. These differences in metabolism were more pronounced in the internal regions of the thalamus. CONCLUSIONS: the applied method may be a useful ancillary tool to assess neurological outcomes after a TBI, since it permits an objective quantitative assessment of metabolic function for groups of subjects. Our results confirm the vulnerability of the thalamus to suffering the effects of the acceleration-deceleration forces generated during a TBI. It is hypothesized that patients with low thalamic metabolism represent a subset of subjects highly vulnerable to neurological and functional disability after TBI.

Metabolismo talámico y situación neurológica tras un traumatismo craneoencefálico. Estudio mediante PET-FDG y morfometría basada en vóxel / Thalamic metabolism and neurological outcome after traumatic brain injury. A voxel-based morphometric FDG-PET study

Objetivos: Estudiar la relación entre el metabolismo talámico y la situación neurológica en pacientes que han sufrido un traumatismo craneoencefálico (TCE). Material y métodos: Se incluyó a 19 pacientes que habían sufrido un TCE grave y 10 sujetos control. De los 19 pacientes, 6 presentaban un grado de alerta bajo (estado vegetativo o estado de mínima conciencia), mientras que 13 mostraban un grado de alerta normal. A todos los pacientes se les realizó una tomografía con emisión de positrones (PET) con 18-fluorodesoxiglucosa (18F-FDG) 459,4 ± 470,9 días después del TCE. Las imágenes de PET-FDG se normalizaron en intensidad, creándose posteriormente una plantilla metabólica del grupo entre todos los sujetos. El trazado talámico se generó automáticamente con una máscara de la región de interés. Se comparó el metabolismo talámico de los dos grupos de pacientes respecto al grupo control, para ello se utilizó un método de análisis basado en vóxel, con significación estadística, p < 0,05 corregido para múltiples comparaciones. Resultados: Los pacientes con grado de alerta bajo mostraron menor metabolismo talámico (coordenadas MNI-Talairach, 12, -24, 18; T = 4,1), con respecto a los sujetos control, que los pacientes con grado de alerta adecuado (14, -28, 6; T = 5,5). Estas diferencias en el metabolismo fueron más acentuadas en las regiones internas del tálamo. Conclusiones: La PET-FDG puede ser una herramienta útil para valorar la situación neurológica después de un TCE. El método utilizado permite una evaluación objetiva y cuantitativa de imágenes de PET-FDG para grupos de sujetos. Nuestros resultados confirman la vulnerabilidad del tálamo a sufrir los efectos de las fuerzas de aceleración-desaceleración generadas durante un TCE (AU)

Objective: To study the relationship between thalamic metabolism and neurological outcome in patients who had sustained a traumatic brain injury (TBI). Methods: Nineteen patients who had sustained a severe TBI and ten control subjects were included in this study. Six of the 19 patients had a low level of consciousness (vegetative state or minimally conscious state), while thirteen showed normal consciousness. All patients underwent a PET with 18F-FDG, 459.4 ± 470.9 days after the TBI. The FDG-PET images were normalized in intensity, with a metabolic template being created from data derived from all subjects. The thalamic trace was generated automatically with a mask of the region of interest in order to evaluate its metabolism. A comparison between the two groups was carried out by a two sample voxel-based T-test, under the General Linear Model (GLM) framework. Results: Patients with low consciousness had lower thalamic metabolism (MNI-Talairach coordinates: 12, -24, 18; T = 4.1) than patients with adequate awareness (14, -28, 6; T = 5.5). Control subjects showed the greatest thalamic metabolism compared to both patients groups. These differences in metabolism were more pronounced in the internal regions of the thalamus. Conclusions: The applied method may be a useful ancillary tool to assess neurological outcomes after a TBI, since it permits an objective quantitative assessment of metabolic function for groups of subjects. Our results confirm the vulnerability of the thalamus to suffering the effects of the acceleration-deceleration forces generated during a TBI. It is hypothesized that patients with low thalamic metabolism represent a subset of subjects highly vulnerable to neurological and functional disability after TBI (AU)

[Indication for bone scans in early breast cancer staging]. / Indicación del rastreo óseo en la estadificación del cáncer de mama de inicio.

OBJECTIVE: Evaluate the indication for bone scanning during staging of early breast cancer in the light of scientific evidence to assess the need to modify practices with scant effectiveness. MATERIAL AND METHODS: The bone scans carried out in our Nuclear Medicine Department in 2007 on patients with primary breast cancer were reviewed retrospectively. Results were analyzed in relation to the clinical and histopathologic findings for each tumor. Bone scan results of tumors >2 cm y 3 cm, and pre-treatment clinical stage. RESULTS: Out of 245 bone scans of patients with breast cancer, 237 (97%) were negative for metastatic disease and 8 (3%) were positive. Lesions <2 cm (Tis and T1) were diagnosed in 131 patients (53.5%), none of which had bone metastasis at time of diagnosis. Lesions >2 cm and 3 cm. The bone scan findings did not modify staging in any of the 66 patients with T2 tumors stage IIA, but it did modify staging in 2 of 12 patients with stage IIB tumors. Twenty percent of 15 patients with T3 tumors and 13% of patients with T4 tumors had bone metastasis at time of diagnosis. CONCLUSIONS: Ineffective practices should be modified and bone scanning should not be indicated in patients with early breast cancer Tis, T1 and T2 with tumor

Indicación del rastreo óseo en la estadificación del cáncer de mama de inicio / Indication of bone scans in early breast cancer staging

ObjetivosRevisar nuestra experiencia y reflexionar a la luz de la evidencia científica sobre la indicación del rastreo óseo (RO) en la estadificación del cáncer de mama de inicio en estadios precoces, con el fin de contribuir en la modificación de rutinas de baja eficacia.Material y métodosRevisión retrospectiva de los RO hechos en nuestro Servicio de Medicina Nuclear durante 2007 en las pacientes con cáncer de mama de inicio, analizando su resultado en función del tamaño clínico o anatomopatológico tumoral. Los RO para tumores T2 se analizaron estratificando las lesiones en dos grupos, <= o > de 3cm y en función de su estadio clínico pretratamiento.ResultadosSe incluyeron 245 rastreos, 237 de éstos (97%) fueron negativos y 8 de éstos (3%) fueron positivos para metástasis óseas. En 131 pacientes (53,5%) se diagnosticaron lesiones<2cm (Tis y T1) y ninguna tenía metástasis óseas. Se hallaron 84 lesiones (34%) que eran >2cm y <=5cm (T2) y entre éstas, el 3,6% de las pacientes presentó metástasis óseas, sin diferencias entre lesiones <=3cm y >3cm. El RO no modificó el estadio en ninguna de las 66 pacientes con tumores T2 en estadio IIA clínico, mientras que sí lo hizo en 2 de las 12 pacientes en estadio clínico IIB. El 20% de las 15 pacientes con lesiones T3 y el 13% de las 15 pacientes con T4 presentaron metástasis óseas en el diagnóstico.ConclusionesEs necesario modificar rutinas poco eficientes excluyendo de las indicaciones del RO la estadificación de las neoplasias de mama de inicio con lesiones <=2cm y lesiones en estadio clínico IIA, siendo necesaria su realización previa al tratamiento en el resto de los casos(AU)

ObjectiveEvaluate the indication for bone scanning during staging of early breast cancer in the light of scientific evidence to assess the need to modify practices with scant effectiveness.Material and methodsThe bone scans carried out in our Nuclear Medicine Department in 2007 on patients with primary breast cancer were reviewed retrospectively. Results were analyzed in relation to the clinical and histopathologic findings for each tumor. Bone scan results of tumors >2cm y <=5cm (T2) were analyzed in two groups stratified by tumor size, <=3cm or >3cm, and pre-treatment clinical stage.ResultsOut of 245 bone scans of patients with breast cancer, 237 (97%) were negative for metastatic disease and 8 (3%) were positive. Lesions<2cm (Tis and T1) were diagnosed in 131 patients (53.5%), none of which had bone metastasis at time of diagnosis. Lesions >2cm and <=5cm (T2) were diagnosed in 84 patients (34%), of which 3.6% had bone metastasis. There were no differences in the rate of bone metastases in patients with stage T2 disease and lesions <=3cm vs. >3cm. The bone scan findings did not modify staging in any of the 66 patients with T2 tumors stage IIA, but it did modify staging in 2 of 12 patients with stage IIB tumors. Twenty percent of 15 patients with T3 tumors and 13% of patients with T4 tumors had bone metastasis at time of diagnosis.ConclusionsIneffective practices should be modified and bone scanning should not be indicated in patients with early breast cancer Tis, T1 and T2 with tumor <=2cm, clinical stage IIA. Pre-treatment bone scanning is still indicated in T2 IIB, T3 and T4 disease(AU)

SPECT-TAC de baja dosis con 67Ga en un caso de espondilodiscitis y hernia de Schmorl / 67Ga SPECT/Low-Dose CT. A case report of spondylodiscitis and Schmorl's node

Varón de 61 años con diagnóstico microbiológico de espondilodiscitis en L3-L4, en tratamiento antibiótico, al que se le realizó un estudio gammagráfico con 67Ga para evaluar la respuesta al tratamiento antibiótico por persistencia de clínica dolorosa.La gammagrafía planar con 67Ga mostró focos con captación patológica en los cuerpos vertebrales de L2 y de L4. Se realizó una SPECT-TAC de baja dosis de la región lumbar, obteniendo una imagen de espondilodiscitis activa en L3-L4 además de identificar un segundo foco en L2, que fue compatible con una hernia intraesponjosa de Schmorl.En este caso, la imagen híbrida de SPECT-TAC ha permitido evitar un falso positivo al localizar y caracterizar una lesión con captación patológica de 67Ga, mejorando la especificidad de la prueba y evitando un error diagnóstico(AU)

A 61-year-old male patient with microbiological diagnosis of L3-L4 spondylodiscitis and persist pain underwent a 67Ga scintigraphic study to assess the antibiotic treatment response.Pathological uptake foci in vertebral bodies of L2 and L4 were observed in the 67Ga planar scintigraphy. A SPECT low-dose CT of the lumbar spine was performed as part of anatomical correlated protocol, detecting an active spondylodiscitis in L3-L4 and a second uptake foci in L2 that was identify as a Schmorl's node.In this case the SPECT-CT hybrid image allowed us to avoid a false positive diagnosis to by locate and characterize an image with abnormal uptake of 67Ga, improving the test specificity and avoiding a wrong diagnosis(AU)

[67Ga SPECT/low-dose CT. A case report of spondylodiscitis and Schmorl's node]. / SPECT-TAC de baja dosis con 67Ga en un caso de espondilodiscitis y hernia de Schmorl.

A 61-year-old male patient with microbiological diagnosis of L3-L4 spondylodiscitis and persist pain underwent a (67)Ga scintigraphic study to assess the antibiotic treatment response. Pathological uptake foci in vertebral bodies of L2 and L4 were observed in the (67)Ga planar scintigraphy. A SPECT low-dose CT of the lumbar spine was performed as part of anatomical correlated protocol, detecting an active spondylodiscitis in L3-L4 and a second uptake foci in L2 that was identify as a Schmorl's node. In this case the SPECT-CT hybrid image allowed us to avoid a false positive diagnosis to by locate and characterize an image with abnormal uptake of (67)Ga, improving the test specificity and avoiding a wrong diagnosis.