[Indium 111-labeled antibodies in the detection of colorectal carcinoma]. / (111)In obelezena antitela u otkrivanju kolorektalnog karcinoma.

The aim of the study is detection of the recurrences and metastases of colorectal carcinomas using (111)In labelled antibodies B72.3 in 14 patients. With tomography, we can access better distinction of tumour in comparison to other structures and estimation of its size. Other imaging methods (CT, US) have advantage in detection of liver metastases, while immunoscintigraphy is more specific for the assessment of malignant abdominal tumours and extrahepatic metastases. The first results point out that Oncoscint CR-103 can be useful in diagnosis of recurrences and metastases of colorectal carcinoma, viability assessment after radiotherapy and in the choice of the adequate surgical treatment in dependence of the spread of the disease.

Pharmacological radionuclide ventriculography for detection of myocardial contractile reserve in patients after myocardial infarction: head-to-head comparison of low dose dobutamine and low dose dipyridamole.

BACKGROUND: Low dose pharmacological stress echocardiography with either dobutamine or dipyridamole infusion has been proposed for recognition of myocardial viability. However, dependence on adequate acoustic window, observer experience, and the mild degree of wall motion changes make the viability assessment by stress echocardiography especially bothersome. The objective of the study was to evaluate the ability of low dose dobutamine and low dose dipyridamole radionuclide ventriculography to detect contractile reserve in patients after myocardial infarction and functional recovery after coronary angioplasty. METHODS: The study group consisted of 20 consecutive patients (52 +/- 10 years, 17 male, 3 female) with previous myocardial infarction and resting regional dyssynergy, in whom diagnostic cardiac catheterization revealed significant one-vessel coronary artery stenosis suitable for angioplasty. Each patient underwent equilibrium 99m-Tc radionuclide ventriculography which was performed at rest and during low dose dipyridamole (0.28 mg/kg over 2 minutes) and low dose dobutamine infusion (up to 10 mcg/kg/min). Left ventricular global and regional ejection fractions were determined. Increase of regional ejection fraction for > 5% (inferoapical and posterolateral regions) or > 10% (anteroseptal regions) during low dose dobutamine and dipyridamole in infarcted regions, as well as in the followup period, was considered as index of contractile reserve. After 8 weeks of successful angioplasty, resting radionuclide ventriculography was repeated in all patients in order to identify functional recovery of the infarct zone. RESULTS: Out of the 180 analyzed segments (20 x 9), 90 regional ejection fractions have shown depressed contractility. The mean of the regional ejection fractions showing depressed contractility increased from the resting value of 34 +/- 12% to 42 +/- 14% in the follow-up period (p = 0.06). Of the 90 with baseline dyssynergy, 46 were responders during low-dose dobutamine (51%), whereas 32 segments were responders (36%, p = 0.05 vs. dobutamine) during low dose dipyridamole. Positive predictive value of dobutamine and dipyridamole for predicting functional recovery was 72% and 75% (p = ns), respectively. Negative predictive value of dobutamine and dipyridamole was 48% and 69% (p = 0.05), respectively. In the group of patients with most severe dyskinesia (regional ejection fraction < 35%, 42 segments) positive predictive value was 73% and 82%, while negative predictive value was 42% and 64% for low dose dobutamine and low dose dipyridamole respectively (p = ns). CONCLUSION: Although low dose dobutamine induced higher rate of positive responses during radionuclide ventriculography imaging, dipyridamole radionuclide ventriculography has shown superior, particularly negative, prognostic value for predicting functional recovery of infarcted regions.

201Tl reinjection and late redistribution in the detection of viable myocardium.

Nonreversible (NRD) myocardial perfusion defects following stress-rest (S/R) 201Tl studies may often be found in ischemic areas. 201Tl reinjection immediately following S/R scintigraphy and 24h (late) redistribution has been shown to identify late reversible defects (LRD) indicative of viable myocardium. Twenty two patients with CAD were studied. All subjects underwent S/R 201Tl (37MBq) 24h later (1 group). Six out of 22 patients had late scintigraphy without new doses of 201Tl. Ischemia was considered present when the poststress count density was less for more than 25% than the resting count density. Out of 29 NRDs. 15 segments exhibited late reversibility following 201Tl reinjection reflecting viability (II group). One out of 8 NRDs demonstrated late reversibility following late redistribution imaging (II group). Thus, 201Tl reinjection following S/R imaging appeared to be more effective in maximizing the detection of viable myocardium than late redistribution. It is equally useful in patients with NRD following S/R scintigraphy and no history of prior myocardial infarction (MI) or those who had MI.

[Noninvasive diagnosis in the detection of pulmonary hypertension and chronic cor pulmonale as a late sequelae of pulmonary embolism]. / Neinvazivna dijagnostika u detekciji plucne hipertenzije i hronicnog plucnog srca kao pozne posledice plucne embolizacije.

A patient with symptoms of coronary artery disease is presented. ECG changes, chest X-ray, echocardiography as well as ventilation-perfusion study excluded coronary artery disease and confirmed cor pulmonare chronicum and pulmonary hypertension. Patophysiological aspects and clinical symptoms are also discussed.