ABSTRACT
Few studies have been published that describe the role of scintigraphy in the evaluation of the spectrum of pediatric thyroid disorders. Between 1978 and 1987, we studied 280 children with iodine-123 (123I) scintigraphy. Clinical information and follow-up were available in 246. We analyzed the indications for referral and determined whether the information obtained with this technique was useful in subsequent management. Indications for scintigraphy included hypothyroidism, neck masses, hyperthyroidism, and miscellaneous reasons. Scintigraphy was helpful in distinguishing anatomic from functional causes of hypothyroidism. It reliably identified the location of the thyroid gland in patients with neck masses. The functional status of thyroid nodules was readily assessed and was important in directing further treatment. Scintigraphy added little to the management of children with post-irradiation hypothyroidism without a palpable nodule, patients with Hashimoto thyroiditis or Graves disease when the clinical diagnosis was straightforward.
Subject(s)
Thyroid Diseases/diagnostic imaging , Thyroid Gland/diagnostic imaging , Child , Female , Humans , Iodine Radioisotopes , Male , Radionuclide Imaging , Retrospective Studies , Thyroid Diseases/epidemiology , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/epidemiologyABSTRACT
The authors reviewed 1 year of experience with planar and single photon emission computed tomographic (SPECT) bone scintigraphy in 162 young patients with symptoms of low-back pain possibly related to stress injury to the pars interarticularis or spondylolysis. Planar scintigraphy and SPECT revealed no abnormality in 91 patients (56%). All abnormalities detected on planar images were also detectable with SPECT. SPECT showed an abnormal focus of radiotracer uptake in the lumbar spine in 71 patients (44%). In 32 of these 71 patients, these findings were also evident with planar scintigraphy. In 39 of these 71 patients, use of SPECT. Correlation with contemporaneous radiographs was made in 72 cases (including computed tomography in 10 cases). SPECT can be used to detect stress injury not seen with planar bone imaging or radiography and is recommended in evaluation of low-back pain in young athletes.
Subject(s)
Athletic Injuries/diagnostic imaging , Back Pain/diagnostic imaging , Fractures, Stress/diagnostic imaging , Lumbar Vertebrae/injuries , Tomography, Emission-Computed, Single-Photon , Adolescent , Adult , Child , Diagnosis, Differential , Female , Humans , Lumbar Vertebrae/diagnostic imaging , Male , Retrospective Studies , Sclerosis , Spondylolysis/diagnostic imagingABSTRACT
Myocardial perfusion scintigraphy was performed with both 201Tl and a new six coordinate monocationic isonitrile complex of 99mTc, [99mTc]2-methoxyisobutylisonitrile (MIBI), on 11 infants who had undergone the arterial switch procedure for transposition of the great arteries. Unlike 201Tl which can show rapid and variable rates of washout from myocardium, 73% of the initial first-pass activity of the isonitrile complex in the myocardium remains 1 hr after intravenous administration. The images obtained with [99mTc]MIBI required a shorter recording time, entailed less radiation exposure to the patient, and were qualitatively at least as good as those obtained with 201Tl. No infant had perfusion abnormalities. The potential applications of the isonitrile complexes for myocardial perfusion scintigraphy in children are discussed.
Subject(s)
Heart/diagnostic imaging , Nitriles , Organometallic Compounds , Thallium Radioisotopes , Thallium , Female , Humans , Infant , Infant, Newborn , Lung/diagnostic imaging , Male , Radionuclide Imaging , Technetium , Technetium Tc 99m Sestamibi , Transposition of Great Vessels/diagnostic imaging , Transposition of Great Vessels/surgeryABSTRACT
Hepatobiliary scintigraphy has proven to be of great utility in distinguishing biliary atresia from other causes of neonatal cholestasis. Arteriohepatic dysplasia (Alagille's syndrome) is an uncommon entity characterized by typical facial features, pulmonary artery stenosis, and a liver disorder which presents during the neonatal period as progressive jaundice. Two neonates, who were later shown to have Alagille's syndrome, underwent hepatobiliary scintigraphy to rule out biliary atresia. Findings on the hepatobiliary scans from the two patients were similar to those usually associated with biliary atresia and both finally required surgical exploration to rule out biliary atresia. The findings on hepatobiliary scans in these patients with Alagille's syndrome are discussed and compared with those associated with other forms of neonatal cholestasis.
Subject(s)
Bile Ducts, Intrahepatic/abnormalities , Biliary Tract/diagnostic imaging , Cholestasis, Intrahepatic/diagnostic imaging , Organotechnetium Compounds , Biliary Atresia/diagnostic imaging , Child , Constriction, Pathologic/complications , Diagnosis, Differential , Female , Humans , Imino Acids , Infant , Male , Organometallic Compounds , Pulmonary Artery/pathology , Radionuclide Imaging , Syndrome , Technetium Tc 99m DisofeninSubject(s)
Ileum/abnormalities , Adolescent , Humans , Ileum/diagnostic imaging , Male , Radionuclide Imaging , Sodium Pertechnetate Tc 99mABSTRACT
The renal clearance of the technetium-99m complex of para[(biscarboxylmethyl)-aminomethylcarboxyamino]hippuric acid ([99mTc]PAHIDA), has been previously studied in rodents and falls between that of [99mTc]DTPA (diethylenetriaminepentaacetic acid) and iodine-131 (131I) orthoiodohippuran (OIH). To investigate the effect of species variation, the plasma clearance of [99mTc]PAHIDA was investigated in dogs. The plasma disappearance of the renal agent approached that of [99mTc]DTPA and was significantly less than that of OIH. Despite the structural similarities of the PAHIDA ligand and aminohippurate, the [99mTc]PAHIDA complex undergoes little, if any, tubular secretion in the canine kidney.
