Subject(s)
Diagnostic Imaging , Hearing Loss, Sudden/etiology , Meniere Disease/etiology , Vestibular Diseases/diagnosis , Brain Stem/pathology , Cerebellum/pathology , Diagnosis, Differential , Hearing Loss, Sudden/diagnosis , Humans , Magnetic Resonance Imaging , Meniere Disease/diagnosis , Predictive Value of Tests , Tomography, X-Ray ComputedSubject(s)
Diagnostic Imaging , Low Back Pain/etiology , Peripheral Nervous System Diseases/diagnosis , Radiculopathy/etiology , Spinal Diseases/diagnosis , Spinal Nerve Roots , Acute Disease , Diagnosis, Differential , Humans , Low Back Pain/diagnosis , Lumbar Vertebrae/pathology , Predictive Value of Tests , Radiculopathy/diagnosis , Spinal Nerve Roots/pathologyABSTRACT
The scintigraphic findings in a rare case of a unilateral matched ventilation perfusion defect, Swyer-James (Macleod's) syndrome, are presented. A 40-year-old man underwent ventilation/perfusion imaging for acute onset of dyspnea. The scan showed markedly diminished ventilation, vascular flow, and perfusion unilaterally on the left hemithorax. Chest radiography showed hyperlucency of the left lung. Pulmonary angiography showed left-sided hypovascularity, and the CT scan of the chest showed apical bullae and peribronchial thickening of the left lung. Ventilation/perfusion imaging and other radiologic assessment, along with the patient's medical history, confirmed the diagnosis of the Swyer-James syndrome. This condition should be considered as a differential diagnosis in a patient with unilaterally matched ventilation/perfusion deficits without an obvious etiology.
Subject(s)
Bronchiectasis/diagnostic imaging , Lung Diseases, Obstructive/diagnostic imaging , Lung/diagnostic imaging , Pulmonary Emphysema/diagnostic imaging , Ventilation-Perfusion Ratio , Adult , Angiography , Diagnosis, Differential , Dyspnea/diagnostic imaging , Humans , Lung/blood supply , Male , Pulmonary Circulation , Radionuclide Imaging , Syndrome , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To evaluate the effects of myocardial viability assessment with positron emission tomography on cardiac revascularization decision-making and consequential outcomes of patients with multivessel coronary artery disease. METHODS: Thirty-three patients with multivessel coronary disease and heart failure were studied in this series, using 13NH for myocardial perfusion and F-18-deoxy-glucose for myocardial metabolism. Viable myocardium (mis-matched perfusion-metabolism) was visually and quantitatively analyzed in anterior, apical, septal, inferior, and lateral segments of the left ventricle. Left ventricular ejection fraction (LVEF) was also measured with first-pass radionuclide angiocardiography. RESULTS: Based on the assessment of myocardial viability, 19 patients (group A) with sufficient viable myocardium underwent revascularization (coronary bypass graft and/or angioplasty), and 14 patients (group B) without sufficient viable myocardium received conservative medical treatment. During an average of 17-month follow-up, there were 2 (10.5%) deaths in group A and 2 in group B (14.3%) deaths (P > 0.5). Patients with revascularization showed significantly improved average LVEFs post-revascularization, without revascularization procedure-related mortality; patients with medical treatment had an initial average LVEF of 25% and class II-III (NYHA) average cardiac function with a survival rate of 86% in average, which was better than that reported in literature. CONCLUSION: Positron emission tomography is useful in myocardial viability assessment for cardiac revascularization decision-making through precisely selecting suitable patients for revascularization and avoiding operations on those who will not benefit, which results in promising effects on outcomes of patients with multivessel coronary disease and severe left ventricular dysfunction.
Subject(s)
Coronary Disease/therapy , Heart/diagnostic imaging , Tomography, Emission-Computed , Adult , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Coronary Disease/diagnostic imaging , Female , Humans , Male , Middle Aged , Tissue Survival , Treatment OutcomeABSTRACT
The integration of multiple imaging modalities in the assessment of musculoskeletal neoplasia is complex. Although no two instances are identical, certain guidelines can be gleaned from our experience as well as that reported in the literature. Assessment of most soft tissue masses is best carried forth with a combination of conventional radiography and magnetic resonance imaging (MRI). Screening skeletal scintigraphy without localizing symptomatology that includes axial and appendicular skeleton is best carried out initially with bone scintigraphy. Screening the axial skeleton in the presence of clinical symptomatology or a strong suspicion of axial skeletal metastases or pathology is best implemented as a total spine screening examination with MRI and specialized pulsing sequences. Computed tomography is reserved primarily for assessment of cortical and juxtacortical lesions, fracture fragment positioning and/or configuration, and characterization of lesion matrix calcification or ossification when conventional radiographs are indeterminate. Although physical examination and conventional radiography still remain the initial medical algorithms used to evaluate possible musculoskeletal neoplasia, primary skeletal tumors may require multimodality imaging to segregate aggressive and nonaggressive processes. In this multimodality scenario, bone scintigraphy has a critical role in assisting with differentiation between malignant and benign neoplasms.
Subject(s)
Bone Neoplasms/diagnosis , Bone and Bones/diagnostic imaging , Magnetic Resonance Imaging , Bone Neoplasms/secondary , Female , Health Care Reform , Humans , Male , Muscular Diseases/diagnosis , Radionuclide Imaging , Soft Tissue Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
Magnetic resonance imaging can provide unique advantages in evaluation of foot and ankle disorders. Among these advantages are lesion localization, sensitivity in differentiation, and evaluation of ligaments, tendons, and osseous abnormalities.
