sodium-pertechnetate-tc-99m and Acute-Disease

Topics: Acute Disease; Adult; Age Factors; Analgesics; Epididymitis; Genital Diseases, Male; Gonorrhea; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Technetium; Testicular Neoplasms; Testis; Tetracycline; Trachoma; Ultrasonography

The aim of this study was to investigate the potential role of a technetium 99m-labeled antigranulocyte murine antibody Fab' fragment (sulesomab) as a diagnostic imaging agent in children with suspected acute nonclassic appendicitis.. Serial planar images at 15 to 30 minutes, 1, 2, and 4 hours and single-photon emission computed tomography (SPECT) images were acquired after sulesomab injection. In 40 children with suspected acute nonclassic appendicitis, imaging results were confirmed surgically in 21 patients, whereas 19 nonsurgical patients resolved presenting signs and symptoms and were considered to not have appendicitis.. Sulesomab imaging had 95% sensitivity, 90% specificity, 95% negative predictive value, and 90% positive predictive value for acute appendicitis. In 78% of patients, sulesomab accurately detected or excluded acute appendicitis and would have changed management plans. No patients had adverse events, and no human antimurine antibody response occurred in 18 evaluable patients.. Sulesomab was well tolerated with no side effects and with no apparent immunogencity. Appendicitis was rapidly and accurately detected. In pediatric patients with suspected nonclassic appendicitis, management decisions incorporating sulesomab imaging provided benefit in separating surgical from nonsurgical patients.

Topics: Acute Disease; Adolescent; Animals; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antigens, Neoplasm; Appendectomy; Appendicitis; Artifacts; Case Management; Cell Adhesion Molecules; Child; Child, Preschool; False Negative Reactions; False Positive Reactions; Female; Granulocytes; Humans; Immunoglobulin Fab Fragments; Laparotomy; Male; Mice; Predictive Value of Tests; Radioimmunodetection; Radiopharmaceuticals; Reagent Kits, Diagnostic; Rupture, Spontaneous; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed, Single-Photon

Neuropsychiatric symptoms in the acute thyrotoxic phase of Graves' disease suggest involvement of brain processes. Short-echo-time proton MRS was used to measure the cerebral metabolite profile in newly diagnosed and untreated Graves' disease. Sixteen patients with Graves' disease and 18 age- and sex-matched healthy volunteers were studied. The patients had significantly reduced total choline and myo-inositol in the acute phase of Graves' thyrotoxicosis compared with the healthy volunteers.

Topics: Acute Disease; Adult; Brain; Choline; Female; Frontal Lobe; Graves Disease; Humans; Inositol; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Occipital Lobe; Parietal Lobe; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Gland; Thyrotoxicosis

Previous studies have demonstrated low yield and conflicting results as to the ability of technetium-99m labeled red blood cell (TRBC) scintigraphy to accurately localize the site of bleeding in acute lower gastrointestinal hemorrhage. Our objective was to evaluate the accuracy of TRBC scintigraphy in clinical day-to-day practice at our institution and to determine predictors of a positive test.. A retrospective medical records review of all patients who underwent TRBC scintigraphy over a 5-year period was conducted at a single academic medical center. The site of bleeding found on TRBC scintigraphy was correlated with the endoscopic, angiographic, surgical, and pathologic findings in each patient.. A total of 127 scans were performed in 115 patients. Forty-nine scans were positive (39%) and 78 were negative (61%). Forty-two patients had further evaluation after a positive scan, and the bleeding site was confirmed to be accurate in 20 of 42 patients (48%). A contradictory bleeding site was found in 5 of 49 positive scans (10%). Patients transfused greater than 2 units of packed red blood cells within 24 hours preceding the TRBC scan were twice as likely to have a positive scan (64%) than those transfused 2 units or less (32%) (P = 0.002). Multivariate analysis demonstrated that the number of units of blood transfused within 24 hours prior to the TRBC scan and the lowest recorded hematocrit were significantly different between patients with positive and negative scans. There was no difference in the rate of endoscopy between patients with a positive or negative scan result.. TRBC scintigraphy has a relatively low yield in the evaluation of acute lower gastrointestinal bleeding. Objective selection criteria such as number of units of packed red blood cells transfused prior to obtaining the scan may increase the overall yield.

Topics: Acute Disease; Colonic Diseases; Erythrocytes; Gastrointestinal Hemorrhage; Humans; Multivariate Analysis; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Sodium Pertechnetate Tc 99m

Technetium-99m-labeled red blood cell scintigraphy, commonly used in the evaluation of acute lower gastrointestinal hemorrhage, often fails to demonstrate a source of bleeding. It would be helpful to characterize a subset of patients more likely to have a positive scan. This study was undertaken to determine whether hemodynamic instability can predict tagged red blood cell scan positivity.. The records of 50 consecutive patients who underwent tagged red blood cell scanning for the evaluation of acute lower gastrointestinal bleeding were reviewed retrospectively.. Patients presenting with a heart rate >100 beats per minute or a systolic blood pressure <100 mmHg up to 24 hours before undergoing tagged red blood cell scanning were considered hemodynamically unstable. Thirteen of 21 unstable patients (62 percent) had positive scans, whereas only 6 of 29 stable patients (21 percent) had positive scintigraphy (odds ratio, 6; 95 percent confidence interval, 1.79-22.1).. Hemodynamic instability in the setting of acute lower gastrointestinal bleeding may be a predictor of positive tagged red blood cell scanning. Incorporating this into the diagnostic algorithm used to evaluate patients with acute lower gastrointestinal bleeding may allow physicians to reserve red blood cell scintigraphy for patients who have demonstrated transient hemodynamic compromise.

Topics: Acute Disease; Aged; Algorithms; Erythrocytes; Female; Gastrointestinal Hemorrhage; Hemodynamics; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sodium Pertechnetate Tc 99m

Since the early 1970s testicular scintigraphy has been used to diagnose the cause of acute scrotal pain. The advent of Doppler sonography further enhances diagnosis by providing simultaneous real-time scrotal imaging with superimposed testicular blood flow information.. To assess the diagnostic value of Doppler sonography in patients with acute scrotal pain and scintigraphic findings suggestive of testicular torsion.. Seventy-five patients with acute scrotal pain underwent testicular scintigraphy and Doppler sonography. All patients who had scintigraphic findings suggestive of testicular torsion were included in the study and their files were retrospectively reviewed.. Twenty-seven patients had scintigraphic findings suggestive of testicular torsion. Radionuclide scintigraphy accurately detected all cases of testicular torsion. However, abscess, hematoma, hydrocele and other conditions simulated testicular torsion on scintigraphy, lowering the test specificity. These pathologies were clarified by Doppler sonography that was 95% specific and 86% sensitive for testicular torsion.. Doppler sonography should be used as the first-line modality in the evaluation of patients with suspected testicular torsion. Scintigraphy should be performed only in certain settings of equivocal sonographic findings to prevent false negative sonographic diagnosis.

Topics: Acute Disease; Adolescent; Adult; Artifacts; Blood Flow Velocity; Child; Child, Preschool; Diagnosis, Differential; Diagnostic Errors; Humans; Infant; Male; Mass Screening; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Time Factors; Ultrasonography, Doppler

Mucociliary transport and absorption of maxillary mucosa were studied in patients with different forms of maxillary sinusitis. Radionuclide dynamic maxillary scintigraphy specified functional characteristics of maxillary mucosa in respect to the form of its inflammation.

Topics: Acute Disease; Adult; Chronic Disease; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Mucociliary Clearance; Mucous Membrane; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

Topics: Acute Disease; Administration, Inhalation; Adult; Chagas Cardiomyopathy; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Lupus Vulgaris; Pulmonary Embolism; Radionuclide Imaging; Radiopharmaceuticals; Rare Diseases; Respiratory Distress Syndrome; Sodium Pertechnetate Tc 99m; Ventilation-Perfusion Ratio

Torsion of the testis is a urologic emergency that requires early diagnosis and prompt surgical treatment for testicular survival. However, the early differential diagnosis of acute testicular torsion from epididymitis or orchitis is often difficult. The aim of this retrospective study was to evaluate and compare the value of Tc-99m pertechnetate radionuclide imaging and ultrasonography in the differentiation of acute testicular torsion and inflammatory testicular diseases.. Twenty patients (age range, 5 to 38 years) with possible acute testicular torsion from July 2000 to July 2001 were enrolled in this study. Ultrasonography was performed in all patients in the emergency room. Within 3 hours of ultrasonography, radionuclide imaging was also performed after intravenous injection of 5 to 15 mCi Tc-99m pertechnetate in the forearms. All of the patients with clinically suspected acute testicular torsion underwent surgery. The surgical findings and pathologic reports of these patients were reviewed and definite diagnoses were established. None of the other patients had surgery and were followed clinically for at least 1 month after ultrasonography and radionuclide imaging.. Four patients with testicular torsion, 13 patients with inflammatory testicular disease, and three healthy persons had a final surgical and pathologic diagnosis or clinical follow-up, and all were accurately diagnosed by Tc-99m pertechnetate radionuclide imaging. In contrast, ultrasonography was less accurate in the diagnosis and differentiation of acute testicular torsion from inflammation. Only 1 of 4 patients with testicular torsion, 5 of 13 patients with inflammatory testicular disease, and 2 of 3 healthy persons were diagnosed by ultrasonography.. The results indicate that Tc-99m pertechnetate radionuclide imaging is a more useful and accurate imaging method than ultrasonography in the detection and differentiation of acute testicular torsion from inflammatory testicular disease in patients with acute scrotal pain.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Epididymitis; Follow-Up Studies; Humans; Male; Orchitis; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Ultrasonography

81mKr is widely used as a ventilation agent to diagnose pulmonary embolism (PE). However, (81m)Kr is expensive, which limits its continuous availability. Technegas can be an alternative ventilation agent with the advantage of being less expensive and available daily. The aim of this study was to compare the value of technegas with that of (81m)Kr in the detection of PE.. Ninety-two consecutive patients (29 men; mean +/- SD, 53 +/- 17 y old) with at least one segmental perfusion defect (Hull criteria) were studied prospectively. Perfusion and ventilation (V/Q) lung scintigraphy with both technegas and (81m)Kr were performed within 24 h on all patients. V/Q lung scan results were classified as high probability for PE (normal ventilation study) or nondiagnostic (abnormal ventilation study). All V/Q lung scans were read by two experienced nuclear physicians in consensus. For the intra- and interobserver variabilities, two experienced observers independently read the V/Q lung scans.. (81m)Kr and technegas showed a good agreement (kappa, 0.68; 95% confidence interval [CI], 0.53-0.82). However, technegas significantly increased the number of nondiagnostic V/Q lung scans (P: = 0.035). In 15 patients, a discrepancy was found between (81m)Kr and technegas. False-positive V/Q lung scan results occurred in 4 of 12 patients (33%) with (81m)Kr and in 2 of 3 patients (66%) with technegas. The intra- and interobserver variabilities were 0.71-0.88 (95% CI, 0.56-1.0) for perfusion/(81m)Kr and 0.74-0.96 (95% CI, 0.58-1.0) for perfusion/technegas.. In comparison with (81m)Kr, technegas does not result in more false-positive V/Q lung scan results. The use of technegas, however, increases the number of nondiagnostic V/Q lung scan results, which would increase the demand for further additional testing to confirm or refute PE.

Topics: Acute Disease; Angiography; False Positive Reactions; Female; Humans; Krypton Radioisotopes; Lung; Male; Middle Aged; Observer Variation; Pulmonary Artery; Pulmonary Embolism; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed; Ventilation-Perfusion Ratio

We evaluated 99mTc-labeled anti-CD15 immunoglobulin M monoclonal antibody (LeuTech) for diagnosing acute appendicitis in patients with an equivocal clinical presentation. LeuTech avidly binds to circulating and sequestered human polymorphonuclear neutrophils in vivo, eliminating in vitro cell labeling and blood handling.. We studied 49 patients to evaluate the safety and efficacy of LeuTech imaging. 99mTc-labeled LeuTech was prepared on site using a lyophilized kit, 99mTc-labeled pertechnetate, and 2 different incubation techniques, 1 at room temperature and the other at 37 degrees C. The abdomen was serially imaged for up to 3 h after the intravenous administration of 370-740 MBq 99mTc-labeled LeuTech. Scans were read as positive or negative for acute appendicitis or other intraabdominal infection. The institutional diagnosis was established by surgery, other diagnostic studies, or 1-mo clinical follow-up.. Scans were positive for appendicitis in all 26 patients with appendicitis, for a sensitivity of 100%, and negative for appendicitis in 19 of 23 patients without appendicitis, for a specificity of 83%. Accuracy, positive predictive value, and negative predictive value were 92%, 87%, and 100%, respectively. Results were not different between the LeuTech preparations. The rate of laparotomies with negative findings in patients who underwent surgery was 10%. The average time from injection to LeuTech visualization in the appendix for cases positive for appendicitis was 9 min. No serious adverse reactions occurred.. LeuTech imaging is safe, rapid, and sensitive for diagnosis of appendicitis in equivocal cases. The potential advantages of LeuTech over currently available radiopharmaceuticals for infection imaging are ease of preparation, absence of blood handling, excellent image quality, no requirement for SPECT, and rapid diagnostic uptake.

Topics: Acute Disease; Adult; Animals; Antibodies, Monoclonal; Appendicitis; Female; Humans; Isotope Labeling; Lewis X Antigen; Male; Mice; Neutrophils; Radioimmunodetection; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m

Topics: Acute Disease; Animals; Antibodies, Monoclonal; Appendicitis; Emergency Service, Hospital; Humans; Lewis X Antigen; Mice; Radioimmunodetection; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

Acute suppurative thyroiditis is an uncommon condition. Most patients have preexisting oropharyngeal fistulae. Penetrating oropharyngeal injuries resulting from swallowed foreign bodies provide an acquired channel of infection spreading into the relatively resistant thyroid gland. The authors describe a patient with infective thyroiditis complicating retropharyngeal abscess caused by a chicken bone that perforated the upper esophagus. Transient thyrotoxicosis complicating acute suppurative thyroiditis is very rare. Pertechnetate and Ga-67 scans confirmed extensive inflammation of the thyroid gland and the release of hormones as the cause, as distinct from concurrent Graves' disease. Awareness of this unusual complication is important to avoid inappropriate treatment for hyperthyroid disease.

Topics: Acute Disease; Adult; Female; Foreign Bodies; Gallium Radioisotopes; Humans; Radionuclide Imaging; Radiopharmaceuticals; Retropharyngeal Abscess; Sodium Pertechnetate Tc 99m; Thyroiditis, Suppurative; Thyrotoxicosis; Tomography, X-Ray Computed

In this study, we evaluated the ability of submandibular gland scintigraphy to predict the prognosis of peripheral facial nerve paralysis.. Submandibular gland scintigraphy was performed in 78 patients with acute peripheral facial nerve paralysis. After injection of 180-370 MBq [99mTc]pertechnetate, serial 1-min images were acquired for 25 min. At 15 min after injection of radionuclide, ascorbic acid was administered intraorally to stimulate salivary secretion. Regions of interest were set manually on both submandibular glands, and time-activity curves were generated. The ratios of peak count density (PCR) and washout (WR) of the affected side to the normal side were calculated. Parameters of > or = 0.8 suggested normal affected submandibular function and indicated a good prognosis.. Complete recovery of facial nerve paralysis was observed in 52 of 78 patients. The sensitivity, specificity and accuracy of PCR for a good prognosis were 79%, 50% and 69%, and those of WR were 85%, 77% and 82%, respectively. Positive and negative predictive values for a good prognosis were 76% and 54% in PCR and 88% and 71% in WR, respectively. When WR obtained within 14 days of the onset was used, positive and negative predictive values for a good prognosis were 94% and 73%, respectively. None of the eight patients who had values of <0.8 for both parameters within 14 days of the onset recovered completely.. Submandibular gland scintigraphy can serve as a reliable indicator to predict the prognosis of acute peripheral facial nerve paralysis in its early symptomatic period.

Topics: Acute Disease; Adolescent; Adult; Aged; Ascorbic Acid; Child; Child, Preschool; Facial Paralysis; Female; Humans; Male; Middle Aged; Parkinson Disease; Predictive Value of Tests; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Submandibular Gland

Amlodipine improves exercise capacity in patients with chronic congestive heart failure (HF), but the mechanisms of this effect are unknown.. To test the hypothesis, in a canine model of acute, ischemic HF, that amlodipine increases vascular capacitance and reduces cardiac filling pressures.. Amlodipine was given to 13 anesthetized, splenectomized dogs (six controls and seven with HF). Aortic, left ventricular end-diastolic (LVEDP) and portal venous (Pportal) pressures, cardiac output, portal flow (ultrasonic probe) and intestinal blood volume (IBV, 99mTc blood-pool scintigraphy) were measured. Intestinal vascular conductance (= 1/resistance) and vascular capacitance (CAP) were measured before and 15 mins after repetitive 150 micrograms/kg dosages of amlodipine (maximum cumulative dosage, 1000 micrograms/kg). Pportal-IBV curves were obtained by impeding portal flow (pneumatic cuff), and change in CAP was defined by the change in IBV at Pportal = 7.5 mmHg. HF was induced by microsphere embolization of the left coronary artery.. CAP increased in the control group (+ 28%, P < 0.01) but decreased (-9%, P < 0.05) in the HF group. Left ventricular stroke work increased in the control group (P < 0.05), while it decreased (P < 0.05) in the HF group, suggesting a negative inotropic effect. In the control group, LVEDP increased after amlodipine was given (P < 0.05) but did not change significantly in the HF group.. In the acute experimental HF model, amlodipine failed to increase intestinal vascular CAP or decrease filling pressures, and may have had a negative inotropic effect. The experiment failed to demonstrate a beneficial hemodynamic effect of amlodipine in acute HF, and the mechanism of benefit of this agent in chronic HF remains unclear.

Topics: Acute Disease; Amlodipine; Analysis of Variance; Animals; Calcium Channel Blockers; Cardiovascular System; Disease Models, Animal; Dogs; Drug Evaluation, Preclinical; Heart Failure; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Time Factors; Vascular Capacitance; Vascular Resistance

In four patients, women aged 65 and 86 years and men aged 22 and 46 years, admitted with profuse loss of fresh blood per anum, acute haemorrhage in the lower gastrointestinal tract was diagnosed. A systematic diagnostic and therapeutic strategy increases the possibility of localising the bleeding site in such patients. Urgent colonoscopy after oral purge for cleansing the colon of stool is feasible, safe and often both diagnostic and therapeutic. Dependent on local expertise, erythrocyte scintigraphy and (or) mesenteric angiography can further improve the locating of the bleeding site. However, in 10% of the patients the bleeding site remains unclear. In these cases surgical intervention may be necessary. Additional peroperative endoscopy, injection of methylene blue via a selective catheter or the construction of multiple stomas can be helpful. Blind colon resections should be avoided. The localisations in the four patients were: angiodysplastic focus in the caecum, a superficially eroded vein in the ileum, a Meckel's diverticulum, and multifocal vasculitis.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Angiodysplasia; Angiography; Cecal Diseases; Colonoscopy; Diagnosis, Differential; Diagnostic Techniques, Surgical; Female; Humans; IgA Vasculitis; Ileum; Male; Meckel Diverticulum; Melena; Mesenteric Arteries; Middle Aged; Sodium Pertechnetate Tc 99m; Tomography, Emission-Computed

To compare the usefulness of conventional color Doppler ultrasound (US), unenhanced and contrast material-enhanced power Doppler US, and radionuclide imaging in a model of acute testicular torsion.. Twenty rabbits underwent unilateral 360 degree testis torsion and contralateral orchiopexy. Gray-scale, color Doppler, and unenhanced and contrast-enhanced power Doppler US were performed 4-6 hours later. The side of torsion was determined, and intratestis flow was graded. Within 2 hours of US, technetium-99m pertechnetate was intravenously administered, the rabbits were killed, and the testes excised for radionuclide imaging.. Intratestis perfusion was detected in 85% of torsed testes at US and radionuclide imaging. The side of torsion was correctly diagnosed in 25% of cases with radionuclide imaging and in 60% of cases with US. Power Doppler US demonstrated significantly greater intratestis flow in pexed than in torsed testes. Although the numbers of correct diagnosis with the three US modalities were similar, flow grades within torsed and normal testes were significantly different.. Perfusion to torsed and normal testes was demonstrated equally well with color Doppler US, power Doppler US, and radionuclide imaging. Doppler US better depicted differences in intratesticular flow between torsed and normal testes.

Topics: Acute Disease; Animals; Contrast Media; Male; Polysaccharides; Rabbits; Radionuclide Imaging; Regional Blood Flow; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testis; Time Factors; Ultrasonography, Doppler, Color

In a retrospective analysis the diagnostic value of two scintigraphic methods was compared with each other.. 104 patients with acute or intermittent gastrointestinal haemorrhage were examined with 121 scintigraphic studies. We compared scintigraphic results with surgical findings, endoscopic results or final clinical diagnosis. We used two scintigraphic methods, colloid scintigraphy and in vivo/vitro red blood cell scintigraphy.. Our scintigraphic findings reached a sensitivity of 72% and a specificity of 100%. We calculated a sensitivity of 68% for colloid scintigraphy and a sensitivity of 79% for red blood cell scintigraphy. The correct localisation of bleeding was successful in 52 (98%) cases.. Our results demonstrate that red blood cell scintigraphy is the method of choice in detecting intermittent gastrointestinal hemorrhage. We believe that with new preparation kits for in vivo labelling red blood cell scintigraphy will become seriously competitive for the colloid scintigraphic method.

Topics: Acute Disease; Chronic Disease; Colloids; Erythrocyte Transfusion; Erythrocytes; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Radionuclide Imaging; Rectum; Retrospective Studies; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Technetium Compounds; Time Factors; Tin Compounds

To evaluate the effectiveness of testicular scintigraphy in differentiating testicular torsion from acute epididymitis.. 14 out of 17 patients previously screened by urologist were referred for testicular scintigraphy. Preoperative diagnosis was made based on dynamic and static image findings. Close follow-up was done and final diagnosis was confirmed on the basis of operative findings or relief of symptoms after conservative management.. Eight of the nine patients with a photopenic area in the hemiscrotum were confirmed surgically as having testicular torsion. One patient was diagnosed as having an inflammatory process. Relief from symptoms after conservative management was noted in three patients with increased activity on the affected side and in two others whose uptake patterns were not different from the unaffected side.. Testicular scintigraphy is effective in differentiating testicular torsion from acute inflammation when all other scrotal anomalies have been eliminated.

Topics: Acute Disease; Adolescent; Adult; Child; Diagnosis, Differential; Epididymitis; Humans; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion

The aim of this prospective study was to compare the effectiveness of colour Doppler ultrasound and testicular scintigraphy in the differential diagnosis of acute scrotum. Ten patients were investigated by clinical examination initially and by both techniques afterwards. Scintigraphy was performed in a blind fashion. According to the findings, 3 patients were categorized as acute ischaemia and 7 as inflammation. The 3 patients diagnosed as ischaemia underwent surgical exploration. Both imaging techniques predicted ischaemia (100%). In the inflammation group conservative therapy and follow-up were chosen. Ultrasonography alone established the correct diagnosis in 7/7, whereas scintigraphy in 5/7 of the patients.

Topics: Acute Disease; Child; Child, Preschool; Genital Diseases, Male; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Testis; Ultrasonography, Doppler, Color

Topics: Acute Disease; Adolescent; Humans; Male; Radionuclide Imaging; Reflex; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Thigh

To assess left ventricular (LV) diastolic function in scleroderma systematica (SS) with regard to SS course and skin lesion degree, a total of 24 SS patients were examined versus control subjects. Though cardiac symptoms manifested clinically only in 8 patients, parameters of LV diastolic function underwent changes in the majority of the examinees: the time to attaining maximal filling velocity increased, contribution of the first diastolic third to LV filling diminished, hemodynamic significance of the left atrial systole grew. More pronounced dysfunction of the myocardium occurred in patients with diffuse skin lesions, acute and subacute disease who also appeared to have reduced LV ejection fraction. The conclusion is made on frequent subclinical pattern of myocardial involvement in SS patients which runs primarily as LV diastolic dysfunction. Systolic disturbance emerge later or in more active forms.

Topics: Acute Disease; Adult; Chronic Disease; Diastole; Female; Gated Blood-Pool Imaging; Humans; Male; Middle Aged; Scleroderma, Systemic; Sodium Pertechnetate Tc 99m; Ventricular Function, Left

Radionuclide scintigraphy is commonly utilized as a screening examination before performing more invasive procedures in the work-up of patients with lower gastrointestinal (GI) bleeding. We reviewed our institutional experience with technetium-labelled red blood cell scintigraphy (TRCS) in detecting and localising acute lower GI bleeding. The study group included 72 patients who had 80 red cells scans over a five year period. Thirty-eight scans were positive (47.5%), and 42 were negative (52.5%). Sites of lower GI bleeding were confirmed by endoscopy, arteriography, surgery and/or pathology in 22 of the 38 positive scans. There were four false-negative scans (9.5%). The overall sensitivity and specificity of TRCS in detecting lower GI bleeding was 84.6% (22/26) and 70.4% (38/54), respectively. The accuracy of localization of bleeding sites in the patients with confirmed positive scans was 72.7% (16/22). Thirty mesenteric arteriograms were performed on patients in this series. Eleven arteriograms were performed after negative TRCS; one was positive. Technetium-labelled red blood cell scintigraphy appears to be a useful screening examination for patients with lower GI bleeding who are hemodynamically stable. This may avoid the potential morbidity of arteriography in patients who are not actively bleeding.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Colonic Diseases; Erythrocytes; False Negative Reactions; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Radionuclide Imaging; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Pyrophosphate; Time Factors; Tin Polyphosphates

Topics: Acute Disease; Adult; Diagnosis, Differential; Hernia, Inguinal; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion

To determine whether acute hypertension (HT) is a risk factor for damage to the blood-brain barrier in carotid angiography with nonionic contrast media.. Anesthetized rats received intravenous injections of technetium-99m-pertechnetate and horseradish peroxidase. Two groups of rats received metaraminol to raise their blood pressure to between 165 and 190 mmHg peak systolic and then received intracarotid injections of saline or iopamidol. Two other groups remained normotensive and received intracarotid injections of saline or iopamidol. Animals were perfused with a fixative solution and their brains removed. Activity of extravasated Tc-99m-pertechnetate was determined to assess blood-brain barrier breakdown. Brains were then sectioned, treated histochemically to visualize extravasated horseradish peroxidase, and ranked visually according to horseradish peroxidase staining.. Extravasation of both tracers was significantly greater in the hypertensive group that received contrast media than in the other three groups.. Acute hypertension potentiates the blood-brain barrier-damaging effects of nonionic contrast media during carotid angiography in rats.

Topics: Acute Disease; Animals; Blood-Brain Barrier; Brain; Carotid Arteries; Histocytochemistry; Horseradish Peroxidase; Hypertension; Injections, Intra-Arterial; Iopamidol; Radionuclide Imaging; Rats; Rats, Sprague-Dawley; Sodium Pertechnetate Tc 99m

The scintigrams of 76 patients with gastrointestinal bleeding referred over an 8 year period have been reviewed together with their subsequent clinical course. Twenty-five patients had either 99Tcm-sulphur colloid or 99Tcm-labelled red cell scintigraphy to localize a source of active bleeding. Fourteen patients had 99Tcm-sulphur colloid scintigraphy, of which seven were false negatives, two were false positives and two were true positives. Eleven patients had 12 99Tcm-labelled red cell scintigrams, of which three were false negatives, one was a false positive and four were true positives. Fifty patients had 99Tcm-pertechnetate scintigraphy to look for ectopic gastric mucosa in Meckel's diverticula. There were 43 true negatives, two false negatives, two true positives and three false positives in this group. Our results emphasize the need for caution in interpreting nuclear medicine studies in patients with blood loss from the gastrointestinal tract.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Chronic Disease; Erythrocytes; False Negative Reactions; False Positive Reactions; Female; Gastrointestinal Hemorrhage; Humans; Infant; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Acute Disease; Aged; Humans; Male; Orchitis; Posture; Scrotum; Sodium Pertechnetate Tc 99m; Ultrasonography

The cause of hemispheric swelling and high intracranial pressure after acute subdural hematoma is unknown, yet this is a major cause of death related to this condition. To investigate whether vascular engorgement is the cause of this form of hemisphere swelling, we have autoradiographically mapped regional cerebral blood flow before and after removal of acute subdural hematoma in a rat model. Hyperemia was patchy and infrequent. The major cause of the significant hemisphere swelling seen after hematoma removal was enlargement of the zone of focal tissue ischemia and edema under the hematoma.

Topics: Acute Disease; Animals; Autoradiography; Brain Edema; Brain Ischemia; Brain Mapping; Cerebrovascular Circulation; Hematoma, Subdural; Male; Postoperative Complications; Radionuclide Imaging; Rats; Rats, Inbred Strains; Sodium Pertechnetate Tc 99m

In a retrospective study of patients with acute scrotal pain presenting to the hospitals of Southern Illinois University School of Medicine from January 1982 until September 1987, determination was made of the appropriate use of testicular scan for definitive diagnosis. Though the testicular scan is a highly sensitive and specific examination in the identification of testicular torsion, we believe its routine use in clinical practice is limited. Appropriate utilization of the examination requires its use in high-risk groups with equivocal physical findings or in patients with unusual presentations of age, anatomy, or neurologic deficit. The scan if used for routine screening of the acute scrotum would result in needless delays and unjustifiable expense when it is mandatory that the treatment be immediate surgical exploration.

Topics: Acute Disease; Adult; Child; Epididymitis; Humans; Male; Radionuclide Imaging; Retrospective Studies; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testis; Time Factors

The role of technetium-99m pertechnetate imaging in acute testicular torsion is well appreciated. Manual testicular detorsion under local anesthesia may be performed in the nuclear medicine clinic by the urology service immediately following initial diagnostic scintigraphy. Following manual testicular detorsion, continued images of the testes are obtained up to 30 minutes without having to reinject the patient with technetium-99m pertechnetate. Reperfusion of the affected testicle will be dramatically noted if the manual detorsion is successful. Four cases are presented to illustrate this.

Topics: Acute Disease; Adolescent; Adult; Humans; Male; Radionuclide Imaging; Regional Blood Flow; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testis

Twenty-five patients suffering from acute painful testicular processes were subjected to scintigraphy. Testicular torsion in the early and delayed phases were diagnosed with 100% accuracy, but one out of 7 cases of epididymitis was wrongly recognized as negative. Interoperative diagnosis in two cases of hydatid torsion proved the foregoing scintigraphic finding to have been wrong. Nevertheless, scintigraphy was found to be reliable in testicular torsion diagnosis.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Humans; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testicular Diseases; Ultrasonography

Based on the examination of 1050 patients the authors make a conclusion of great significance of renoscintigraphy, ultrasonic scanning and thermography for differential diagnostics of acute pyelonephritis, acute cholecystitis and pancreatitis.

Topics: Acute Disease; Adult; Aged; Calcium; Cholecystitis; Citrates; Citric Acid; Diagnosis, Differential; Humans; Kidney; Lumbosacral Region; Male; Pancreatitis; Pyelonephritis; Radionuclide Imaging; Skin Temperature; Sodium Pertechnetate Tc 99m; Thermography; Ultrasonography

A case of acute epididymitis evolved into testicular infarction. Scrotal scintigraphy identified the initial epididymitis and subsequent evolution into infarction.

Topics: Acute Disease; Adolescent; Epididymitis; Humans; Infarction; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Testis

The efficacy and merit of testicular imaging, utilizing Tc-99m pertechnetate, were studied prospectively in a group of patients who presented with acute onset of scrotal pain. Consecutive admissions were studied. All were managed according to the likelihood of the problem being testicular torsion, which was determined from the clinical history, physical examination and the routine laboratory data. The final diagnostic outcome, whether by surgical exploration or clinical progress with conservative treatment, is collated with the preoperative scintigraphic interpretations, made with respect to predefined criteria. Analysis of the pretreatment images obtained in 57 patients shows that the radionuclide study is highly reliable in cases of testicular torsion and epididymo-orchitis. It appears to be much less dependable, however, in the other acute scrotal conditions. Torsions that are intermittent in nature or corrected manually apparently can have variable presentations. Certain difficulties and potential pitfalls encountered in interpreting the scintigraphic studies are discussed.

Topics: Abscess; Acute Disease; Adolescent; Adult; Aged; Child; Epididymitis; Genital Diseases, Male; Humans; Male; Middle Aged; Orchitis; Pain; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testicular Hydrocele

It has been established that chronic hypothyroidism may affect cardiac function by several mechanisms. It is not known how long the patient has to be hypothyroid for cardiac involvement to develop. This study was undertaken to assess the effect of a short period of hypothyroidism (10 days) on cardiac function. Nine patients who had had total thyroidectomy, had received ablative radioiodine for thyroid cancer and were euthyroid on replacement therapy were studied while both euthyroid and hypothyroid. Cardiac assessment was performed by X-ray, ECG, echocardiography and gated blood-pool scans. After 10 days of hypothyroidism, the left-ventricular ejection fraction failed to rise after exercise in 4 of the 9 patients studied, which was significant (P less than 0.002). No significant changes in cardiac size or function at rest were detected. This functional abnormality in the absence of any demonstrable change in cardiac size and the absence of pericardial effusion with normal basal function suggest that short periods of hypothyroidism may reduce cardiac reserve, mostly because of alterations in metabolic function.

Topics: Acute Disease; Adult; Electrocardiography; Female; Heart; Humans; Hypothyroidism; Male; Middle Aged; Physical Exertion; Radioimmunoassay; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stroke Volume; Thyroid Hormones; Thyroidectomy

A comprehensive radionuclide study of pulmonary circulation disorders in 55 children with acute pyo-destructive pneumonia (at the age of 1 month to 13 years) revealed the degree of vascular network reduction, pulmonary regional specific activity and changes in the time of the blood flow in the pulmonary circulation microcirculatory channel. These indices of disturbed pulmonary hemodynamics in combination with the results of total perfusion deficiency can serve as diagnostic markers of pulmonary circulation pathology and define a tendency to the generalization of a pyo-destructive process or enhancement of the blood flow of compensatory nature as well as prognosis of a course of disease.

Topics: Acute Disease; Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; Pneumonia; Pulmonary Circulation; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Aggregated Albumin

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Humans; Infant; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion

Technetium-99m sodium pertechnetate scintigraphy is an established method for evaluating organ perfusion and can be applied to the investigation of suspected testicular ischaemia due to acute torsion. One hundred and six consecutive scrotal investigations have been analysed qualitatively and quantitatively using a computer-based comparison of the perfusion slopes over each testis. Decreased vascularity on the symptomatic side only occurs in torsion and quantitative analysis is needed to detect it reliably. Increased vascularity on the symptomatic side can usually be detected qualitatively and occurs in orchitis, tumours, trauma and resolved torsion. Distinction between the causes of increased vascularity is aided by the clinical data. A halo of increased activity surrounding a relatively cold centre was seen in chronic torsion, some tumours and hydrocoeles. The test is both sensitive and specific for acute torsion but its usefulness is limited if it is not available at all hours. The test is useful, also, in confirming a diagnosis that does not require emergency operation and in identifying chronic torsion which is an indication for contralateral orchidopexy.

Topics: Acute Disease; Adolescent; Adult; Aged; Child; Child, Preschool; Diagnosis, Differential; Humans; Male; Middle Aged; Perfusion; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Technetium; Testicular Diseases

Gastrointestinal blood pool scintigraphy, using a modified in-vivo red blood cell labelling technique with technetium-99, is a new, easily performed, non-invasive procedure. It is valuable in screening patients with acute or intermittent gastrointestinal blood loss in whom duodenoscopic and sigmoidoscopic findings are unhelpful. This paper reviews the value of this scintigraphic technique over the first eight months of its use in a major teaching hospital, and compares the results with other published data. The high sensitivity of this procedure, and its ability to demonstrate gastrointestinal bleeding very strikingly, are illustrated with several examples. If used and interpreted appropriately, scintigraphy is sensitive in detecting and localizing the bleeding site, and is very helpful in indicating the optimal timing of emergency contrast angiography. The study further supports the view that scintigraphy should be the initial diagnostic imaging procedure in this group of patients, and that emergency angiography should be reserved primarily for patients in whom there is scintigraphic evidence of continuing blood loss.

Topics: Abdomen; Acute Disease; Adult; Aged; Angiography; Erythrocytes; Female; Gastrointestinal Hemorrhage; Humans; Isotope Labeling; Male; Methods; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium

The technique of blood pool scanning was used to examine 15 hemophilic subjects. Employing an in vivo method for erythrocyte labeling with Technetium-99 m, a dynamic perfusion sequence is obtained using a scintillation camera positioned over the area to be examined. This demonstrates the vascularity of the tissue. Subsequently, equilibrium blood pool images of the area are obtained and analyzed with a densitometer to assess relative regional blood volume. In patients who were not bleeding but had chronic arthropathy, vascularity was not increased, and the blood volume of comparable joints was similar. By contrast, marked increases in vascularity and image density were observed in studies of acutely bleeding joints. Chronic hemarthroses were associated with persistent, but less marked increases in joint perfusion. Transient increases in joint vascularity were demonstrated after insertion of knee prostheses. In a patient with a thigh hematoma, the dimensions of the hemorrhage were clearly delineated. Since only a tracer dose of nuclide is infused intravenously, there are no allergic reactions or other side effects of the procedure. Blood pool scanning is a safe, non-invasive technique that augments clinical and radiographic evaluations, and provides a new dimension in the assessment of the hemophilic patient.

Topics: Acute Disease; Adolescent; Adult; Aged; Bioprosthesis; Child; Hemarthrosis; Hematoma; Hemophilia A; Hemorrhage; Humans; Knee; Knee Joint; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Thigh; Tin Polyphosphates