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1.
Diagn Cytopathol ; 21(2): 125-8, 1999 Aug.
Article in English | MEDLINE | ID: mdl-10425051

ABSTRACT

We report on a case of embryonal rhabdomyosarcoma in an 11-yr-old boy investigated for mild chest pain after trauma. Chest radiography showed a massive right pleural effusion. Cytological analysis of the pleural fluid demonstrated the presence of malignant small undifferentiated cells. The rhabdomyoblastic nature of the cells was confirmed by positive immunostains of HHf35 actin, desmin, and skeletal muscle myosin; histological examination of a core biopsy confirmed the diagnosis of rhabdomyosarcoma. Computed tomography and gallium scan revealed the presence of an extensive anterior and lower chest wall mass involving the mediastinum, as well as retroperitoneal lymphadenopathy. Massive pleural effusion is a frequent presentation in malignant disease, but is rare in rhabdomyosarcoma. The immunochemical stain studies performed on cytological smears in this case proved to be very useful for making the definitive and accurate diagnosis. Diagn. Cytopathol. 1999;21:125-128.


Subject(s)
Cytodiagnosis , Pleural Effusion, Malignant/pathology , Rhabdomyosarcoma, Embryonal/pathology , Thoracic Neoplasms/pathology , Child , Humans , Male , Tomography, X-Ray Computed
2.
Clin Imaging ; 22(1): 45-7, 1998.
Article in English | MEDLINE | ID: mdl-9421655

ABSTRACT

A completely contracted gallbladder is occasionally seen in patients with acute hepatitis. We have observed that postprandial examination in these patients shows the gallbladder filling with bile to a degree that permits an adequate diagnostic examination. This simple procedure may prevent having to recall the patient for follow-up examination.


Subject(s)
Gallbladder Diseases/diagnostic imaging , Gallbladder/physiopathology , Hepatitis A/complications , Postprandial Period , Acute Disease , Adolescent , Biliary Tract/diagnostic imaging , Female , Follow-Up Studies , Gallbladder/diagnostic imaging , Gallbladder Diseases/complications , Hepatitis A/diagnosis , Humans , Male , Muscle Contraction , Muscle, Smooth/physiopathology , Radionuclide Imaging , Radiopharmaceuticals , Technetium Tc 99m Disofenin , Ultrasonography
3.
Pediatr Radiol ; 25 Suppl 1: S62-4, 1995 Nov.
Article in English | MEDLINE | ID: mdl-8577557

ABSTRACT

Brucellosis is an infectious disease transmitted from various animal hosts to man. In children the most common route of infection is unpasteurized milk or milk products. Brucellosis affects the urinary tract uncommonly, most frequently causing orchioepididymitis. We report the case of a 4-year-old boy with brucellosis who developed acute focal bacterial nephritis (AFBN), documented by sonography, gallium scan, and computed tomography. After appropriate treatment his symptoms and his sonographic abnormality resolved completely. To the best of our knowledge, this is the first report of the association of AFBN and brucellosis.


Subject(s)
Brucellosis/complications , Focal Infection/microbiology , Nephritis/microbiology , Acute Disease , Brucella/isolation & purification , Child, Preschool , Diagnostic Imaging , Focal Infection/diagnosis , Humans , Male , Nephritis/diagnosis
5.
J Nucl Med ; 33(10): 1774-80, 1992 Oct.
Article in English | MEDLINE | ID: mdl-1403143

ABSTRACT

Quantitative bone scintigraphy (QBS), which measures 99mTc-MDP uptake expressed as percent of injected dose per cc, indicates bone metabolism. It is measured in the bones of patients before and after radiation treatment and then compared to normal controls. QBS was performed in a group of 22 normal individuals and was measured twice, 2-10 mo (mean 4.9) apart. There was no significant difference between the two measurements. QBS was performed also in 28 patients before, immediately after and at certain time intervals after radiation therapy for cancer. Both the irradiated and the nonirradiated bones showed significant decreases in bone metabolism at 2-18 mo (mean 8.8) after irradiation. In addition, increases and decreases of 99mTc-MDP uptake were similar in the irradiated and in the nonirradiated bones, and there were significant correlations of the QBS values in the different bones of each individual patient. The etiology of the changes in bone metabolism in the nonirradiated bones is not yet fully understood, but it appears to be the result of a systemic effect of radiation.


Subject(s)
Bone and Bones/metabolism , Bone and Bones/radiation effects , Neoplasms/radiotherapy , Tomography, Emission-Computed, Single-Photon/methods , Bone and Bones/diagnostic imaging , Female , Humans , Male , Middle Aged , Prospective Studies , Technetium Tc 99m Medronate
6.
Clin Nucl Med ; 17(4): 294-9, 1992 Apr.
Article in English | MEDLINE | ID: mdl-1572118

ABSTRACT

Two hundred and twenty five liver hemangiomas in 166 patients were studied with Tc-99m labeled RBC and are the basis for this atlas. All hemangiomas showed various presentations of the perfusion blood pool mismatch, which is the basis for diagnosis. The size of the hemangiomas was the factor that determined the mixing of the Tc-99m RBC with the blood and, hence, the sequence of visualization of the lesion. Hemangiomas may appear as multiple lesions on liver scan and imitate metastases. Ninety-five hemangiomas appeared in 36 patients as multiple focal abnormalities. Hemangiomas are extremely variable in size. They may be huge (31 hemangiomas) and sometimes occupy most of the abdomen. Or they can be very small and are then detected only by SPECT (two cases). Thrombosed large hemangiomas appear as focal defects on Tc-99m RBC.


Subject(s)
Hemangioma/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Erythrocytes , Hemangioma/epidemiology , Humans , Israel/epidemiology , Liver Neoplasms/epidemiology , Radionuclide Imaging , Retrospective Studies , Technetium
7.
J Nucl Med ; 32(6): 1157-61, 1991 Jun.
Article in English | MEDLINE | ID: mdl-2045928

ABSTRACT

Bone metabolism was assessed in vivo and noninvasively using quantitative SPECT. The effect of endocrine abnormalities on bone metabolism was studied in 27 patients with primary hyperparathyroidism (HPT) and 12 patients with thyrotoxicosis (TTX). Quantitative bone scintigraphy (QBS) values of 99mTc-MDP uptake were compared to normal values matched for sex and age. Bones with significantly increased QBS values indicating increased bone metabolism were identified in the two patient groups. Fifty-one percent of the bones in patients with HPT and 78% in patients with TTX showed significantly increased QBS values. Increase in bone metabolism was highest in the femoral shaft. Seven patients with HPT and five with TTX were successfully treated. Six patients with HPT and four patients with TTX showed significant decrease of bone metabolism with normal QBS values after three months. The results indicate that QBS can be used to evaluate bone metabolism and its response to treatment in individual bones in patients with endocrine abnormalities.


Subject(s)
Bone and Bones/metabolism , Hyperparathyroidism/metabolism , Thyrotoxicosis/metabolism , Tomography, Emission-Computed, Single-Photon , Adult , Aged , Bone and Bones/diagnostic imaging , Female , Humans , Hyperparathyroidism/diagnostic imaging , Male , Middle Aged , Technetium Tc 99m Medronate , Thyrotoxicosis/diagnostic imaging
8.
Int Orthop ; 15(2): 155-9, 1991.
Article in English | MEDLINE | ID: mdl-1917192

ABSTRACT

We report our use of linear sonography in evaluating painful and irritable hips. Images were correlated with the clinical course and outcome, and other methods of diagnostic imaging. Sonography demonstrated the anatomical structures of the hip, the joint space and capsule. A significant increase of joint space due to the progressive development of intra-articular fluid was found in patients with transient synovitis, septic arthritis and osteomyelitis of the femoral neck. Sonography and CT scanning appear to be the most reliable methods of making an early diagnosis of various hip disorders. Both allow serial examination for evaluating the patients' clinical progress. Sonography has the advantages of being noninvasive, cheap, easy to use, and devoid of irradiation or any other known complications.


Subject(s)
Hip Joint/diagnostic imaging , Pain/diagnostic imaging , Adolescent , Adult , Arthritis, Infectious/diagnostic imaging , Child , Child, Preschool , Female , Femur Neck/diagnostic imaging , Humans , Joint Diseases/diagnostic imaging , Male , Osteomyelitis/diagnostic imaging , Synovitis/diagnostic imaging , Ultrasonography
9.
Clin Nucl Med ; 15(5): 334-45, 1990 May.
Article in English | MEDLINE | ID: mdl-2340678

ABSTRACT

The appearance of normal Ga-67 SPECT images in the coronal, sagittal and transaxial planes is described. The normal tomographic appearance of bone, liver, spleen, and gut is shown and compared with disease involvement above and below the diaphragm.


Subject(s)
Lymphoma/diagnostic imaging , Gallium Radioisotopes , Humans , Retrospective Studies , Tomography, Emission-Computed, Single-Photon
10.
Radiology ; 175(2): 515-9, 1990 May.
Article in English | MEDLINE | ID: mdl-2183289

ABSTRACT

The results of planar and single photon emission computed tomography (SPECT) gallium-67 scintigraphy performed before and after treatment were compared in 77 patients with lymphoma at 240 sites. Before treatment, the sensitivity of planar scintigraphy was 78% and the specificity was 97%; after treatment, 84% and 96%, respectively. Before treatment, SPECT had a sensitivity of 85% and a specificity of 98%; after treatment, 92% and 99%, respectively. In addition, SPECT allowed better anatomical localization and showed the entire extent of lesions at 36 sites. SPECT was of special value after treatment in excluding disease at 16 sites with residual masses seen at computed tomography (CT). Long-term follow-up in these patients showed that their condition was in complete remission and that the CT appearance of a residual mass does not always mean residual cancer. Thus, Ga-67 SPECT is a suitable imaging technique for monitoring the response of lymphoma to treatment.


Subject(s)
Gallium Radioisotopes , Hodgkin Disease/diagnostic imaging , Lymphoma, Non-Hodgkin/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Hodgkin Disease/therapy , Humans , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Sensitivity and Specificity
11.
J Nucl Med ; 31(3): 365-8, 1990 Mar.
Article in English | MEDLINE | ID: mdl-2308008

ABSTRACT

Two patients with treated lymphoma demonstrated a residual mass on CT following treatment. In both cases gallium-67 (67Ga) scintigraphy demonstrated increased uptake in the original tumor mass and no uptake in the mass after treatment. In both cases the entire residual tumor mass was resected and found to contain no cancer tissue. This is further evidence of the role 67Ga scintigraphy may play in monitoring response of lymphoma patients to treatment. In contrast, other imaging modalities such as ultrasound, plain film x-rays, or CT only show the presence of a mass but not its nature.


Subject(s)
Abdominal Neoplasms/diagnostic imaging , Gallium Radioisotopes , Lymphoma, Non-Hodgkin/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Abdominal Neoplasms/drug therapy , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Lymphoma, Non-Hodgkin/drug therapy , Male , Tomography, X-Ray Computed
13.
Pacing Clin Electrophysiol ; 13(1): 123-7, 1990 Jan.
Article in English | MEDLINE | ID: mdl-1689027

ABSTRACT

In contrast to the more common electrocardiographic patterns seen in acute rheumatic fever, such as first-degree heart block, the appearance of left bundle branch block is rare. An adult patient with acute rheumatic fever presented with left bundle branch block on admission, subsequently had sudden cardiac arrest. She was resuscitated successfully and required temporary pacing. An echocardiogram and radionuclide ventriculography were compatible with interventricular septal involvement in the rheumatic carditis. After 20 days of steroid therapy, the left bundle branch block pattern of the electrocardiogram disappeared. A possible mechanism for the development of complete heart block in acute rheumatic fever is discussed. It is suggested that patients with acute rheumatic carditis who have electrocardiographic manifestations of prolonged P-R interval and left bundle branch block should be managed with prophylactic pacing.


Subject(s)
Bundle-Branch Block , Rheumatic Heart Disease , Acute Disease , Adult , Bundle-Branch Block/diagnosis , Electrocardiography , Female , Humans , Rheumatic Heart Disease/diagnosis , Tachycardia/diagnosis
14.
Child Nephrol Urol ; 10(3): 150-3, 1990.
Article in English | MEDLINE | ID: mdl-2285921

ABSTRACT

A case of acute focal bacterial nephritis in a child is presented. Imaging findings for various modalities are discussed (nuclear medicine, ultrasound, computed tomography, and conventional radiology) with a suggestion for optimal imaging strategy in these cases.


Subject(s)
Bacterial Infections/diagnosis , Diagnostic Imaging , Nephritis/microbiology , Acute Disease , Child , Female , Humans , Nephritis/diagnosis
15.
J Nucl Med ; 30(2): 240-5, 1989 Feb.
Article in English | MEDLINE | ID: mdl-2786933

ABSTRACT

A quantitative single photon emission computed tomography (SPECT) technique for measuring radiopharmaceutical uptake in humans has been applied to bone scintigraphy. The method was validated by comparing SPECT measured percent of injected [99mTc]MDP in 16 normal skulls with well counter measurements of samples of the same bones obtained at surgery. A very good correlation (r = 0.96) was found. A very good interobserver correlation (r = 0.99) and agreement were also obtained when using quantitative bone scintigraphy (QBS). Control SPECT studies of uptake in the right and left iliac bones and the right and left sacroiliac regions in each patient showed no significant differences between the contralateral sides. Studies done in seven subjects at 2 and 4 hr after the same injection and in nine subjects 4 to 8 mo later in the same subjects showed a very good agreement and no significant differences between the two measurements were found. QBS is suggested as an accurate and reproducible index for assessment of the mass of remodeling bone. Preliminary results showed differences in QBS of normal subjects at different ages. A group of 68 young patients aged 18-26 yr showed a significant higher QBS (p less than 0.001) when compared to an older group of 62 patients aged 50-85 yr. There was, however, a wide range of uptake values for the same bone in the same group, suggesting that the method should best be used for following individual patients over time.


Subject(s)
Bone and Bones/diagnostic imaging , Technetium Tc 99m Medronate , Tomography, Emission-Computed , Adult , Aged , Aged, 80 and over , Aging/metabolism , Bone and Bones/metabolism , Female , Humans , Male , Middle Aged , Reference Values
16.
J Nucl Med ; 29(8): 1341-6, 1988 Aug.
Article in English | MEDLINE | ID: mdl-3261329

ABSTRACT

Using a rotating gamma camera the normal single photon emission computed tomography (SPECT) anatomy of the skull was defined in eight subjects. The value of SPECT as compared with planar scintigraphy was assessed in 34 patients with known or suspected disease of the skull. Seven patients had normal planar scintigraphy and SPECT. In 12 of 27 patients with bone involvement SPECT and planar scintigraphy showed essentially the same findings. In 15 patients SPECT was superior to planar scintigraphy. In three of these patients SPECT detected lesions while planar scan was normal. In the other 12 patients SPECT showed better anatomic localization and defined the full extent of the lesion. This was most obvious in patients with involvement of sphenoid, petrous, clivus, maxilla, and zygomatic bones. Our findings confirm the potential of SPECT to detect lesions in deep bones that are overlapped by superficial bony structures that cannot be visualized clearly with planar scintigraphy.


Subject(s)
Skull/diagnostic imaging , Tomography, Emission-Computed/methods , Bone Diseases/diagnostic imaging , Cadaver , Evaluation Studies as Topic , Humans , Skull Fractures/diagnostic imaging , Skull Neoplasms/diagnostic imaging , Technetium Tc 99m Medronate , Tomography, Emission-Computed/instrumentation
17.
Radiology ; 163(3): 725-6, 1987 Jun.
Article in English | MEDLINE | ID: mdl-3575722

ABSTRACT

The lesion-to-nonlesion 24 hour/4 hour ratio of technetium-99m methylene diphosphonate (MDP) uptake was used to distinguish osteomyelitis from increased bone uptake caused by adjacent soft-tissue infection. In a prospective study, this ratio was measured in 38 patients with 41 sites of increased uptake that were suspected to be osteomyelitis. The mean ratio was 1.18 +/- 0.18 in patients with proved osteomyelitis, which was significantly higher (P less than .001) than that in patients with increased uptake resulting from soft-tissue infection (0.98 +/- 0.05). On the basis of a receiver operating characteristic curve, a ratio of 1.06 was selected as the cutoff for differentiating osteomyelitis from soft-tissue infection. This method resulted in a sensitivity of 82%, a specificity of 92%, and an accuracy of 85%, and it appears to be more reliable than three- and four-phase scintigraphy, which are subjective and nonquantitative techniques.


Subject(s)
Infections/diagnostic imaging , Osteomyelitis/diagnostic imaging , Technetium Tc 99m Medronate , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Radionuclide Imaging , Technetium Tc 99m Medronate/metabolism , Time Factors
18.
J Nucl Med ; 27(10): 1557-63, 1986 Oct.
Article in English | MEDLINE | ID: mdl-3760980

ABSTRACT

Gaucher's disease involves the liver, the spleen, and the bone. Liver-spleen and bone scintigraphy were used during an 8-yr period to evaluate changes caused by this disease. Patients were investigated with a liver-spleen scan for abdominal pain, mechanical discomfort, enlarged liver or spleen on physical examination, abdominal mass, abnormal liver function tests, and symptoms of hypersplenism. Fourteen liver-spleen scans were performed in nine patients. Liver scintigraphy showed various degrees of enlargement and inhomogeneous uptake. In two patients focal defects were detected. In one, focal defects were due to liver involvement with Gaucher's disease, but in the other they were caused by metastatic pancreatic carcinoma. The study was also useful in detecting splenic infarction and in following enlargement of the spleen after partial splenectomy. The main indication for bone scintigraphy in six patients was bone pain. This was found to be caused by either aseptic necrosis of the head of the femur, bone infarction, pathological fractures, or osteomyelitis. Loosening after total hip replacement was ruled out in three patients and missed in one patient. Scintigraphy appears to be a simple, sensitive test for evaluation of the liver, spleen, and bony skeleton in patients with symptomatic Gaucher's disease.


Subject(s)
Gaucher Disease/diagnostic imaging , Organotechnetium Compounds , Bone Diseases/diagnostic imaging , Femur Head Necrosis/diagnostic imaging , Hepatomegaly/diagnostic imaging , Humans , Phytic Acid , Radionuclide Imaging , Splenomegaly/diagnostic imaging , Technetium , Technetium Tc 99m Medronate
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