RESUMO
At the end of the eighties, Doppler equipment added to conventional ultrasonography a new dynamic dimension. On the basis of radiological (US, CT, barium studies), clinical, biological, surgical and/or pathological correlations in 30 cases, the following considerations were emphasized. In case of intestinal obstruction, viability of the obstructed segment is compromised when Doppler parietal flow remains undetectable. In Crohn's disease or ulcerative colitis, as well as in acute appendicitis, presence of Doppler parietal flow throughout the affected thickened segment indicates an acute condition; similarly, abnormally high mean portal velocity (30-48 cm/sec; normal: 15 +/- 7 cm/sec), and abnormally low resistive index in the superior mesenteric artery (0.58-0.78; normal: 0.908 = 0.026) are detected. In colonic diverticulitis, similar characteristics can be observed, but are subtle and usually predominant at the mesenteric side of the affected segment in moderate diverticulitis. These abnormal Doppler findings disappear with successful therapy.
Assuntos
Doenças Inflamatórias Intestinais/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Apendicite/diagnóstico por imagem , Colite Ulcerativa/diagnóstico por imagem , Doença de Crohn/diagnóstico por imagem , Diagnóstico Diferencial , Doença Diverticular do Colo/diagnóstico por imagem , Humanos , Ileíte/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagemRESUMO
Sucralfate is an effective medication for treatment of gastroduodenal ulcers, and 99mTc-labeled sucralfate has been found to adhere to ulcers. In this study, we examined the reliability of confirming the diagnosis of gastroduodenal ulcers--previously detected by endoscopy and histology--by means of sucralfate labeled with 99mTc, imaging 1 and 2 hr after oral administration. Eighteen out of 23 patients were positive by scintigraphy with this method (sensitivity = 78%). In five patients with gastroduodenal bleeding, the study was positive. The procedure was well tolerated and offered a noninvasive procedure that can be performed at the bedside in critically ill patients, and in follow-up of fragile patients.