sodium-pertechnetate-tc-99m and Androgen-Insensitivity-Syndrome

The paper presents the successful application for the first time in Bulgaria of the new hybrid imaging technique--tomographic scintigraphy combined with computed tomography--SPECT/CT for visualization and localization of the testis by injection of 99mTc-pertechnetate with activity of 185 MBq. The study was performed on a girl with 46XY karyotype and lack of sensitivity to androgens, known in gynecology as "testicular feminization syndrome" or Morris syndrome. Until now testicular scintigraphy has been used mainly as a very accurate technique for rapid diagnosis in cases of testicular torsion, acute epididymitis or after trauma. We found no published data in the literature concerning the use of hybrid SPECT-CT for testicular localization in Morris syndrome. Our experience is this case allows us to recommend SPECT/CT as a fast, accurate, noninvasive method with potential to be used for localization, visualization and perfusion of testicular tissue before performing surgery in cases of Morris syndrome.

Topics: Adolescent; Androgen-Insensitivity Syndrome; Female; Humans; Male; Sodium Pertechnetate Tc 99m; Testis; Tomography, Emission-Computed, Single-Photon

The authors examined 15 patients with the syndrome of Morris by gamacamarated scintigraphy and they succeeded in depicting the gonads, found in the abdomen and their topographic localization. Grave structural changes were established in the testes during the performance of gamacamerated scintigraphy, but in 3 patients only one testis was depicted, which suggested atrophy and lack of functional parenchyma in the gonad, which was not discovered. Conclusive scintigraphic examination of topographic localization as well as of structural disturbances of the parenchyma of the testis replaced testicular biopsy, which requires laparotomy. Gamacamerated scintigraphy could establish malignant growth of the gonad and could help to remove it in time by operation.

Topics: Adolescent; Adult; Androgen-Insensitivity Syndrome; Child; Child, Preschool; Gamma Cameras; Humans; Male; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Syndrome; Testis