ABSTRACT
El propósito de este trabajo es analizar la aportación del estudio con leucocitos marcados con 99mTcHMPAO en la valoración pronóstica de los enfermos con pancreatitis aguda. Para ello, hemos comparado los métodos habituales de evaluación pronóstica, la tomografía computarizada (TC) y la escala clínica de Ranson con los hallazgos gammagráficos en 23 pacientes consecutivos, con diagnóstico de pancreatitis aguda leve o severa. Todos los pacientes con diagnóstico de pancreatitis severa (6 pacientes), presentaron captación y esta fue mayoritariamente poco intensa. 9 de los pacientes con diagnóstico de pancreatitis leve (17 pacientes) mostraron captación, también predominantemente poco intensa. Al comparar el índice de severidad de la TC con los resultados de los leucocitos, el único paciente con índice de severidad alto mostró captación de grado 3. Sin embargo, en más de la mitad de los pacientes con índice de severidad bajo se encontró captación, generalmente poco intensa. Al comparar el grado de captación con el nivel de gravedad según la clasificación de Ranson, se observó un predominio de la captación leve tanto en los pacientes con pancreatitis leve como en los pacientes con pancreatitis severa. Antes estos resultados, pensamos que la ausencia de captación en el estudio con leucocitos en pacientes con pancreatitis aguda, puede interpretarse como signo de buen pronóstico. El hallazgo de captación en área pancreática tiene un significado incierto y es necesario el estudio con muestras de mayor tamaño. (AU)
Subject(s)
Middle Aged , Adult , Aged , Male , Female , Humans , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Pancreatitis , Prospective Studies , Acute Disease , Leukocytes , Pancreatitis , Severity of Illness IndexABSTRACT
This study aims to evaluate the contribution of the 99mTc-HMPAO labelled leukocyte in the prognostic assessment of patients with acute pancreatitis. We have compared the usual methods of prognostic evaluation (computed tomography CT and the Ranson clinical score scale) with the scintigraphic findings in 23 consecutive patients with a clinical diagnosis of mild or severe acute pancreatitis. All 6 patients with severe pancreatitis showed an uptake which was mostly mild. 9/17 patients with mild pancreatitis showed uptake, which also frequently had a low intensity. When the severity index of CT was compared with the leukocyte results, the only patient with a high severity index showed a grade 3 uptake. However, in over 50% of the patients with a low severity index, uptake, generally having a low intensity, was found. When the uptake degree was compared with the Ranson score level, we observed a predominance of mild uptake in both patients with mild and severe pancreatitis. Considering these results, we believe that the lack of uptake in the leukocyte study in a patient with acute pancreatitis can be interpreted as a good prognosis sign. The significance of the finding of uptake in the pancreatic area is uncertain and studies should be performed in larger sized samples.
Subject(s)
Leukocytes/diagnostic imaging , Pancreatitis/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Acute Disease , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Radionuclide Imaging , Severity of Illness IndexSubject(s)
Thromboembolism/diagnostic imaging , Algorithms , Angiography , Angiography, Digital Subtraction , Blood Gas Analysis , Electrocardiography , Humans , Iodine Radioisotopes , Prospective Studies , Pulmonary Embolism/diagnosis , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/physiopathology , Pulmonary Gas Exchange , Radionuclide Imaging , Thromboembolism/etiology , Thromboembolism/physiopathology , Thrombophlebitis/diagnostic imagingABSTRACT
The aim of this study is to evaluate gastric emptying change in patients with gastroesophageal reflux (GER). To this purpose, 36 patients with GER diagnosis and 18 control subjects have been studied. GER diagnosis was achieved by means of endoscopy, biopsy and 24 h continuous pH monitoring. Gastric emptying studies were performed on a two day basis, similar labelling meals were provided to patients and control subjects. Those consisted in a one-egg omelette, chicken (110 gr) and orange juice (200 ml). On first day liquid phase was labelled with 99mTc-diethylenetriamine pentaacetic acid (99mTc-DTPA), and on second day, the solid phase was labelled with 99mTc-sulfur colloid in the omelette (Labelling efficiency was 85.3 +/- 3.2%). The studies were carried out by imaging static anterior and posterior views every 20 minutes for a total of 180 minutes. Images were quantified obtaining solid and liquid gastric emptying curves. No statistical significative difference between patients and control subjects gastric emptying results were found. We can conclude that gastric emptying is not a main factor in the pathogenesis of gastroesophageal reflux.
