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2.
Australas Radiol ; 44(4): 468-70, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11103551

ABSTRACT

Hereditary telangiectasis is an uncommon condition and is thus not usually considered in the differential diagnosis of porta hepatis lymphadenopathy causing biliary tree obstruction. The present case illustrates a patient in whom tortuous vessels in the porta hepatis simulated masses on delayed contrast-enhanced CT with subsequent referral for biopsy.


Subject(s)
Telangiectasia, Hereditary Hemorrhagic/diagnostic imaging , Aged , Cholestasis, Intrahepatic/diagnosis , Diagnosis, Differential , Female , Humans , Lymphatic Diseases/diagnosis , Tomography, X-Ray Computed , Ultrasonography
3.
J Clin Ultrasound ; 28(1): 53-7, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10602108

ABSTRACT

Subcapsular hematomas of the liver in neonates uncommonly present as an abdominal mass without clinical signs of bleeding. We report a case in which sonography 10 days after birth demonstrated 2 large hepatic lesions that were initially considered to be tumors. The diagnosis of subcapsular liver hematoma was es tablished by serial ultrasound examinations, which demonstrated rapid diminution of the lesions. A history of difficult umbilical venous catheter insertion was then obtained retrospectively.


Subject(s)
Hematoma/diagnostic imaging , Hematoma/pathology , Infant, Premature , Liver Diseases/diagnostic imaging , Liver Diseases/pathology , Ultrasonography, Doppler, Color/methods , Catheterization/methods , Diagnosis, Differential , Follow-Up Studies , Hematoma/therapy , Humans , Infant, Newborn , Liver Diseases/therapy , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Liver Neoplasms/therapy
4.
Clin Nucl Med ; 24(2): 105-8, 1999 Feb.
Article in English | MEDLINE | ID: mdl-9988067

ABSTRACT

BACKGROUND: Interstitial lung disease (ILD) is characterized by inflammation within the alveolar walls and interstitium of the lungs. This causes increased alveolar-capillary membrane permeability. The diagnosis is made by clinical features, chest roentgenography, lung function tests, and high-resolution CT, and it is confirmed by lung biopsy. Radionuclide aerosol tracers such as Tc-99m DTPA show increased lung clearance in ILD. The clearance rate of microaerosol pertechnegas (modified Technegas) from the lungs in the assessment of ILD was evaluated. METHODS: Thirty-two patients (22 with ILD and 10 with non-ILD) were evaluated with pertechnegas. Pertechnegas is formed by adding 3% oxygen to technegas, a microaerosol ventilation agent. Regions of interest were then drawn around the lungs, and clearance rates were determined from the best exponential fit. RESULTS: The mean clearance rate of pertechnegas was significantly increased in ILD and measured 5.78 +/- 2.2 minutes compared with non-ILD, which measured 8.53 +/- 2.42 minutes (P < 0.001). The sensitivity and specificity rates of pertechnegas clearance (less than 8 minutes) in ILD were 90% and 60%, respectively. When combined with chest roentgenography, the sensitivity and specificity rates increased to 100% and 90%, respectively. CONCLUSIONS: Pertechnegas is highly effective in determining the presence of active ILD. It differentiates between active ILD and non-ILD, and it is highly sensitive and specific when combined with chest roentgenography. Its potential role in the management of ILD merits further investigation.


Subject(s)
Lung Diseases, Interstitial/diagnostic imaging , Lung/diagnostic imaging , Pulmonary Fibrosis/diagnostic imaging , Sodium Pertechnetate Tc 99m , Adult , Aged , Blood-Air Barrier/physiology , Female , Graphite , Humans , Male , Middle Aged , Permeability , Radionuclide Imaging , Radiopharmaceuticals , Sensitivity and Specificity , Sodium Pertechnetate Tc 99m/pharmacokinetics
5.
Clin Nucl Med ; 21(12): 960-3, 1996 Dec.
Article in English | MEDLINE | ID: mdl-8957612

ABSTRACT

A 50-year-old man had metastatic pheochromocytoma to the left frontal bone. The primary adrenal tumor was removed 12 years previously. Bone scanning and diagnostic I-131 and I-123 MIBG imaging showed metastatic lesions in the right femur and midthoracic spine. However, post-therapy I-131 MIBG scanning showed extensive and widespread metastatic disease. Post-therapeutic I-131 MIBG whole-body scanning was necessary to more fully assess the extent of metastatic pheochromocytoma.


Subject(s)
Adrenal Gland Neoplasms/pathology , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Iodine Radioisotopes , Iodobenzenes , Pheochromocytoma/diagnostic imaging , Pheochromocytoma/secondary , Radiopharmaceuticals , 3-Iodobenzylguanidine , Antineoplastic Agents/therapeutic use , Bone Neoplasms/radiotherapy , Femoral Neoplasms/diagnostic imaging , Femoral Neoplasms/radiotherapy , Femoral Neoplasms/secondary , Frontal Bone/diagnostic imaging , Frontal Bone/radiation effects , Humans , Iodine Radioisotopes/therapeutic use , Iodobenzenes/therapeutic use , Male , Middle Aged , Pheochromocytoma/radiotherapy , Radionuclide Imaging , Radiopharmaceuticals/therapeutic use , Radiotherapy Dosage , Skull Neoplasms/diagnostic imaging , Skull Neoplasms/radiotherapy , Skull Neoplasms/secondary , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/radiotherapy , Spinal Neoplasms/secondary , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/radiation effects , Whole-Body Counting
8.
Australas Radiol ; 40(1): 2-5, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8838878

ABSTRACT

Seven cases of urachal anomalies are presented. The spectrum of the disorder and the criteria for ultrasound diagnosis are described. Six of seven cases were correctly diagnosed pre-operatively with diagnostic ultrasound, but one case with no cystic component was missed. The appearance of a fixed, midline, cystic, extraperitoneal swelling between the umbilicus and the bladder should suggest the diagnosis.


Subject(s)
Urachal Cyst/diagnostic imaging , Urachus/abnormalities , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Male , Ultrasonography , Urachal Cyst/pathology , Urachal Cyst/surgery , Urachus/diagnostic imaging , Urachus/pathology
11.
J Nucl Med ; 36(6): 1031-3, 1995 Jun.
Article in English | MEDLINE | ID: mdl-7769422

ABSTRACT

Myocardial bridging is an uncommon condition where a major coronary artery is bridged by a band of muscle and narrows during systole, particularly during rapid heart rates. We present a patient with typical angina and angiographically proven 60% systolic bridging of the left anterior descending artery distal to the first perforator. Postexercise SPECT 201TI scanning demonstrated a severe reduction of perfusion to the septum and a moderate reduction of perfusion to the anterior wall of the left ventricle. Redistribution images demonstrated good reversibility of the perfusion defects indicating reversible myocardial ischemia. This case provides additional supportive evidence that myocardial bridging may cause myocardial ischemia.


Subject(s)
Coronary Vessel Anomalies/diagnostic imaging , Thallium Radioisotopes , Tomography, Emission-Computed, Single-Photon , Adult , Angina Pectoris/diagnostic imaging , Angina Pectoris/etiology , Coronary Angiography , Coronary Vessel Anomalies/complications , Exercise Test , Heart/diagnostic imaging , Humans , Male
12.
Australas Radiol ; 38(3): 193-5, 1994 Aug.
Article in English | MEDLINE | ID: mdl-7945112

ABSTRACT

The source of sepsis in febrile patients can be a difficult diagnostic problem. Gallium-67 has been utilized as a diagnostic tool in the evaluation of these patients. A retrospective review was done of 47 patients who presented with pyrexia of unknown origin (27 patients), postoperative fever (11 patients), septicaemia (4 patients) and miscellaneous sepsis (5 patients). Whole body imaging with Gallium-67 gave an overall sensitivity and specificity of 86 and 77%, respectively, which compares favourably with previous studies. The sensitivity and specificity was similar in all patient subgroups. Gallium-67 allowed for more effective and directed use of organ-specific imaging modalities, such as computed tomography, ultrasound and guided intervention, in localizing and defining the source of sepsis. Where more than one possible source of fever was present. Gallium-67 scanning correctly identified the activity of the different foci. Gallium-67 scanning should be used early in the evaluation of patients presenting with fever of uncertain origin.


Subject(s)
Fever of Unknown Origin/diagnostic imaging , Gallium Radioisotopes , Fever of Unknown Origin/etiology , Humans , Radionuclide Imaging , Retrospective Studies , Sepsis/complications , Sepsis/diagnostic imaging
13.
Nucl Med Commun ; 15(3): 144-7, 1994 Mar.
Article in English | MEDLINE | ID: mdl-8190402

ABSTRACT

The accurate staging of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) in children has important therapeutic and prognostic implications. The presence of secondary bone involvement or primary malignant lymphoma of bone can be determined by both radiographic and radionuclide methods. We wished to compare the relative efficacy of bone and 67Ga scintigraphy for detecting the presence of bone involvement by malignant lymphoma. We evaluated 83 children (mean age 12 years) with histologically proven HD and NHL utilizing bone and 67Ga scintigraphy which were performed prior to treatment. Three of these patients had biopsy proven primary malignant lymphoma of bone. Bone scintigraphy detected 18 bone lesions in 13 patients and 67Ga scintigraphy detected the same 18 bone lesions and in addition 101 extraosseous lesions. Radiography confirmed the presence of focal bone lesions. Both osteolytic and osteoblastic lesions were identified. We conclude that bone scintigraphy is not necessary in the initial staging of children with malignant lymphoma unless there are specific osseous symptoms. 67Ga scintigraphy is the radionuclide method of choice in the initial staging of children with malignant lymphoma.


Subject(s)
Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Gallium Radioisotopes , Hodgkin Disease/diagnostic imaging , Lymphoma, Non-Hodgkin/diagnostic imaging , Adolescent , Adult , Child , Child, Preschool , Female , Hodgkin Disease/pathology , Humans , Lymphoma, Non-Hodgkin/pathology , Male , Radionuclide Imaging
14.
Australas Radiol ; 37(3): 270-1, 1993 Aug.
Article in English | MEDLINE | ID: mdl-8373331

ABSTRACT

A middle aged woman with a pyrexia of unknown origin was shown to have borderline lepromatous leprosy. Early gallium-67 scintigraphy demonstrated increased uptake in the subcutaneous tissues of the face and thighs. As a result of these findings skin biopsy was obtained from the right thigh which gave a diagnosis of borderline lepromatous leprosy. The authors have been unable to find other reports of gallium-67 scintigraphy in leprosy but the pattern of gallium-67 distribution should suggest the diagnosis.


Subject(s)
Gallium Radioisotopes , Leprosy, Borderline/diagnostic imaging , Leprosy, Lepromatous/diagnostic imaging , Adult , Facial Dermatoses/diagnostic imaging , Female , Humans , Pigmentation Disorders/diagnostic imaging , Radionuclide Imaging , Thigh
15.
Nucl Med Commun ; 14(2): 82-6, 1993 Feb.
Article in English | MEDLINE | ID: mdl-8381529

ABSTRACT

Renal cortical scintigraphy with 99Tcm-dimercaptosuccinic acid is an excellent imaging modality for the detection of renal cortical defects in children presenting with vesicoureteric reflux and urinary tract infections. Single photon emission computed tomography (SPECT) has proven increased sensitivity over planar scintigraphy for lesion detection in the heart, liver and brain. However, its role in the evaluation of renal cortical defects compared to planar scintigraphy has not been fully assessed. We wished to determine whether SPECT increases the sensitivity for detecting renal cortical defects in children compared to high-resolution planar scintigraphy. Forty-one children (90 renal units) with underlying vesicoureteric reflux and/or recently treated urinary tract infection (UTI) were evaluated. There was no statistically significant difference in the number of defects detected between a single-head SPECT system and high-resolution planar scintigraphy, 24 and 20, respectively (P = 0.54). There were four defects detected by SPECT not reported by planar scintigraphy; two of these were only seen retrospectively on planar scintigraphy. There were two children with renal cortical defects detected by SPECT and not by planar scintigraphy. All defects defected by planar scintigraphy were detected by SPECT. It is concluded that although the risk of missing renal cortical defects is low when using high-resolution, three-view planar scintigraphy, SPECT should be employed whenever feasible. Single photon emission computed tomography detected renal cortical defects in children not diagnosed by planar scintigraphy and hence patient management may be altered.


Subject(s)
Kidney Cortex/pathology , Organotechnetium Compounds , Succimer , Tomography, Emission-Computed, Single-Photon , Urinary Tract Infections/pathology , Vesico-Ureteral Reflux/pathology , Child , Child, Preschool , Female , Humans , Infant , Kidney Cortex/diagnostic imaging , Male , Middle Aged , Observer Variation , Ontario/epidemiology , Prospective Studies , Technetium Tc 99m Dimercaptosuccinic Acid , Urinary Tract Infections/diagnostic imaging , Urinary Tract Infections/epidemiology , Vesico-Ureteral Reflux/diagnostic imaging , Vesico-Ureteral Reflux/epidemiology
16.
Am J Cardiol ; 70(13): 1109-12, 1992 Nov 01.
Article in English | MEDLINE | ID: mdl-1414930

ABSTRACT

Familial hypercholesterolemia (FH), a genetic disease characterized by increased levels of total and low-density lipoprotein cholesterol in the blood, results in a markedly increased incidence of atherosclerosis and coronary artery disease in homozygotes and to a lesser extent in heterozygotes. The purpose of this study was to detect the presence of myocardial ischemia, particularly in heterozygotes, with stress single-photon emission computed tomography thallium-201 scanning and to determine if there were any differentiating variables between heterozygotes with normal and abnormal thallium-201 scans. Fifty-four patients (mean age 16 years; range 8 to 24) with FH were analyzed (4 homozygotes and 50 heterozygotes). Eleven heterozygotes and 3 homozygotes had abnormal thallium-201 scans. Family history, lipid profile, age and sex of heterozygotes with FH did not predict the presence of myocardial ischemia. The mean total cholesterol level in heterozygotes with normal thallium-201 scans was 7.68 +/- 2.29 mmol/liter (297 mg/dl), which was not significantly different from that in heterozygotes with abnormal scans (7.63 +/- 1.07 mmol/liter [295 mg/dl]; p = 0.91). The coronary angiography of 1 homozygote who had an abnormal thallium-201 scan demonstrated a 50% stenosis of the left anterior descending artery. Aggressive, repetitive plasma exchange was then instituted. The 11 heterozygotes with abnormal thallium-201 scans underwent more rigorous dietary and drug therapy. It is concluded that myocardial ischemia with stress in heterozygotes with FH can occur at a young age and that thallium-201 scanning should be performed early as a screening test and to guide patient management.


Subject(s)
Coronary Disease/diagnostic imaging , Hyperlipoproteinemia Type II/complications , Thallium Radioisotopes , Tomography, Emission-Computed, Single-Photon , Adolescent , Adult , Age Factors , Child , Coronary Disease/etiology , Coronary Disease/genetics , Exercise Test , Female , Heterozygote , Humans , Male , Medical History Taking
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