RESUMO
PET (positron emission tomography) as a non-invasive imaging method for studying cardiac perfusion and metabolism has turned into the gold standard for detecting myocardial viability. The utilization of 18 FDG as a tracer for its identification permits to spot the use of exogenous glucose by the myocardium segments. By studying and comparing viability and perfusion results, for which the latter uses tracers such as 13N-ammonia, three different patterns for myocardial viability evaluation arise:. transmural concordant pattern, non-transmural concordant pattern, and the discordant pattern; the last one exemplifies the hibernating myocardium and proves the presence of myocardial viability. The importance of its detection is fundamental for the study of an ischemic patient, since it permits the establishment of and exact diagnosis, prognosis, and the best treatment option. It also allows foreseeing functional recovery of the affected region as well as the ejection fraction rate after revascularization treatment if this is determined as necessary. All these elements regarding viability are determinant in order to reduce adverse events and help improving patients' prognosis.
Assuntos
Coração , Isquemia Miocárdica , Miocárdio Atordoado , Miocárdio , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton Único , Circulação Coronária , Diagnóstico Diferencial , Isquemia Miocárdica , Miocárdio Atordoado , Prognóstico , Recuperação de Função Fisiológica , Compostos Radiofarmacêuticos , Volume SistólicoRESUMO
PET (positron emission tomography) as a non-invasive imaging method for studying cardiac perfusion and metabolism has turned into the gold standard for detecting myocardial viability. The utilization of 18 FDG as a tracer for its identification permits to spot the use of exogenous glucose by the myocardium segments. By studying and comparing viability and perfusion results, for which the latter uses tracers such as 13N-ammonia, three different patterns for myocardial viability evaluation arise:. transmural concordant pattern, non-transmural concordant pattern, and the discordant pattern; the last one exemplifies the hibernating myocardium and proves the presence of myocardial viability. The importance of its detection is fundamental for the study of an ischemic patient, since it permits the establishment of and exact diagnosis, prognosis, and the best treatment option. It also allows foreseeing functional recovery of the affected region as well as the ejection fraction rate after revascularization treatment if this is determined as necessary. All these elements regarding viability are determinant in order to reduce adverse events and help improving patients' prognosis.
Assuntos
Coração/diagnóstico por imagem , Isquemia Miocárdica/diagnóstico por imagem , Miocárdio Atordoado/diagnóstico por imagem , Miocárdio/metabolismo , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton Único , Circulação Coronária , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Isquemia Miocárdica/metabolismo , Miocárdio Atordoado/metabolismo , Prognóstico , Compostos Radiofarmacêuticos , Recuperação de Função Fisiológica , Volume SistólicoRESUMO
UNLABELLED: Our objective was to compare the neurologic and psychological sequelae of children with acute lymphoblastic leukemia (ALL) after three or more years without antineoplasic treatment who underwent cranial irradiation plus intrathecal methotrexate (Group 1) or just intrathecal methotrexate (Group 2). In both groups, a neurologic evaluation, electroencephalogram (EEG) and cranial computed tomography (CCT) were performed. Intellectual quotient and the Bender test were done for the psychological evaluation. Investigators did not know the kind of treatment of each patient. STATISTICS: Fisher's exact test and Mann-Whitney U. There were fourteen patients in group 1 and eight patients in group 2. Intellectual quotient was statistically lower in the first group (median 83.5) than in the second (90.5). Neurologic impairments were found in one patient of each group, alterations of the EEG were found in 6 and 4 in group 1 and 2, respectively, and in the CCT of two patients in group 2 without statistical difference. Children with ALL after cranial irradiation have a greater alteration of intellectual performance than children with intrathecal methotrexate. Neurologic alterations were seen in both groups.