ABSTRACT
In this retrospective study, the data of bone scintigraphy performed in 21 children suspected of reflex sympathetic dystrophy (RSD) were analyzed. All of them had persistent pain in an extremity or a clinical suspicion of RSD. All children with strong suspicion of RSD showed diffuse hypoactivity at the level of the involved area on bone scintigraphy. This hypoactivity was clearly related to a decreased vascular supply. The specificity of this scintigraphic pattern is questionable, however, since two children without suggestive clinical signs for RSD had the same scintigraphic pattern.
Subject(s)
Bone and Bones/diagnostic imaging , Pain/etiology , Reflex Sympathetic Dystrophy/diagnostic imaging , Arm/diagnostic imaging , Child , Female , Humans , Leg/diagnostic imaging , Male , Radionuclide Imaging , Reflex Sympathetic Dystrophy/complications , Retrospective StudiesABSTRACT
This paper is devoted to the practical aspects of pediatric nuclear medicine, particularly the controversy about drug sedation. The authors conclude that drug sedation should be exceptionally used. There is an alternative way, consisting in an adequate approach of the patient: good information to the parents and the child; taking care of the child's environment, starting from the first contacts in the waiting room; specific education of technologists: this includes injections and blood sampling, but also proper handling of the child during the procedure and adequate psychological attitudes toward child and parents. Taking these factors into account, it is exceptional that a test has to be postponed because of the lack of collaboration of the patient; good quality images, using the recommended paediatric amounts of radioactivity can be achieved even for procedures of prolonged duration.
Subject(s)
Hypnotics and Sedatives , Radionuclide Imaging , Adolescent , Child , Child, Preschool , Humans , InfantABSTRACT
In our department, examinations of long duration are performed without sedation. It is exceptional that a test has to be postponed because of lack of cooperation by the patient. Good quality images, taking into account the recommended paediatric amounts of radioactivity, are achieved for procedures such as MIBG whole body scanning (10 min frame-1), gastro-oesophageal reflux studies (60 min acquisition), renography and furosemide challenge (45 min) or pinhole views for bone or renal DMSA studies (20-30 min). While drug sedation remains in some conditions the only way to obtain a satisfactory nuclear medicine examination in children, we still believe that in most cases this can be achieved by taking the emotional life of the child into account. For that purpose, people in charge of the paediatric procedure have to be adequately trained.
Subject(s)
Anxiety , Hypnotics and Sedatives/therapeutic use , Nuclear Medicine , Pediatrics , Tomography, Emission-Computed, Single-Photon , Bone and Bones/diagnostic imaging , Child , Furosemide , Gastroesophageal Reflux/diagnostic imaging , Humans , Kidney/diagnostic imaging , Parent-Child Relations , Radioisotope RenographyABSTRACT
In order to estimate the normal range of chromium-51 ethylene diamine tetra-acetic acid (EDTA) clearance in children, we selected a series of 256 patients with past or present urinary tract infection who showed, at the time of the clearance determination, normal technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy and normal left to right DMSA relative uptake. The clearance was calculated by means of either the simplified second exponential method or the 120-min single blood sample; Chantler's correction was used in order to correct for having neglected the first exponential. There was a progressive increase in clearance from the first weeks of life (mean value around 1 month: 55 ml/min/1.73 m2), with a plateau at around 18 months. Between 2 and 17 years of age, the clearance values remained constant, with a mean value of 114 ml/min/1.73 m2 (SD: 24 ml/min); this is similar to the level described for inulin clearance. No significant differences were observed between boys and girls, or between clearance values calculated with one or with two blood samples. Taking into account the hour of intravenous injection of the tracer, we did not observe any influence of the lunchtime meal on the distribution of the 51Cr-EDTA clearance values.
Subject(s)
Chromium Radioisotopes , Edetic Acid , Radioisotope Renography , Urinary Tract Infections/diagnostic imaging , Adolescent , Child , Child, Preschool , Female , Glomerular Filtration Rate/physiology , Humans , Infant , Kidney/physiology , Male , Organotechnetium Compounds , Reference Values , Succimer , Technetium Tc 99m Dimercaptosuccinic AcidABSTRACT
We have tried to evaluate the usefulness of an early 99Tcm-MAG3 image, obtained during the second minute after injection of the tracer, in predicting the renal alterations seen on a 99Tcm-DMSA scintigraph, in children clinically suspected of pyelonephritis. It appears that the accuracy of the MAG3 image is population dependent: when, in most of the patients of a study group, DMSA scintigraphy is either normal or very abnormal, the MAG3 image will correctly reflect the DMSA scintigraph. However, when the DMSA alterations are less pronounced, the early MAG3 image will miss the lesions in about 50% of the cases.
