sodium-pertechnetate-tc-99m and Postoperative-Complications

Topics: Aged; Female; Follow-Up Studies; Humans; Hyperthyroidism; Iodine Radioisotopes; Male; Middle Aged; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Thyroid Gland; Thyroidectomy

Dacryoscintigraphy is a grossly underutilized nuclear medicine procedure for assessing the patency of nasolacrimal ducts. It is an alternate noninvasive modality requiring no added expertise when compared with dacryocystography, an invasive radiological counterpart. Dacryocystorhinostomy (DCR) is a surgical procedure in which a patent rhinostomy is made so that a low-pressure lacrimal bypass system is created, thus relieving epiphora, dacryocystitis or mucocele. DCR has been accepted as a highly successful procedure in the management of epiphora from nasolacrimal duct obstruction; however, adverse local effects can reproduce epiphora. This study highlights the utility and simplicity of dacryoscintigraphy in the postoperative setting of DCR, apart from showcasing its high sensitivity and accuracy in localizing the sites of lacrimal drainage obstruction.. Fifty-five postoperative patients of DCR were screened. Ten volunteers constituted the control group. One drop (10 μl) of technetium pertechnetate (TcO4) was instilled simultaneously in the outer canthus of both eyes (50-100 μCi). Upright dynamic (8 min) and anterior static images of the eyes (up to 20 min) were acquired on a gamma camera fitted with a high-resolution collimator. Physiological interventions that were used in this study were eye blinking, saline intervention, and lacrimal sac massaging.. Out of 40 symptomatic DCR patients, 22 had complete obstruction at the presac level and 18 patients had partial obstruction. Quantitative parameters like tear transit time and lacrimal sac half-life were also calculated. After massage of the lacrimal sac, progression of the tracer was observed in five patients. Premassage and postmassage tear column measurements showed a relative increase of 30.1%. Massage of eight clinically normal ducts showed a relative increase of 2.4% (P=0.06). Statistical analysis using the Fisher test shows very significant concordance between clinical symptoms and dacryoscintigraphy findings in postoperative DCR patients (P<0.0001). The modified McNemar's pair test did not show statistically significant differences between dacryoscintigraphy and the syringing irrigation test.. Dacryoscintigraphy is a simple and easy-to-perform investigation providing high sensitivity in epiphora detection in patients after DCR. Interventions play a role in further enhancing the sensitivity of the technique. This study demonstrates the utility of dacryoscintigraphy in detecting subclinical and partial lacrimal duct obstruction with good patient compliance. It provides an easy and effective way of screening families, enabling an early diagnosis. During imaging, a high-resolution collimator is found to be an efficient substitute for the conventional pinhole collimator.

Topics: Adolescent; Adult; Aged; Case-Control Studies; Dacryocystorhinostomy; Female; Humans; Lacrimal Apparatus Diseases; Male; Middle Aged; Nasolacrimal Duct; Postoperative Complications; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Treatment Outcome; Young Adult

The objective is to evaluate the technique of microvascular autologous submandibular gland transfer for the treatment of severe keratoconjunctivitis sicca. From August 1999 to April 2002, 38 patients with severe keratoconjunctivitis sicca were treated by autologous submandibular gland transfer to the temporal region of the skull. The related vessels were anastomosed to the superficial temporal artery and vein. When the vein was too small, venous bridging was applied. Prior to cutting off the gland, the facial artery was preserved and infused with heparin in normal saline after the gland had been freed to allow inspection of the blood oozing from the three veins. This would be helpful in the selection of a relevant vein for anastomosis. Wharton's duct was transplanted to the upper lateral conjunctiva fornix, and the gland was left denervated. Postoperative scintigraphy with Tc99m pertechnetate, follow-up studies, and management of complications were performed. The transplantations were successful in 33 cases, their symptoms of xerophthalmia disappeared. The discomfort resulting from bright light and wind was also relieved. These patients could stop applying artificial tears. In five patients the transplanted glands did not survive. Epiphora occurred in eight cases. They were successfully treated by reducing the size of the graft. Obliteration of Wharton's duct took place in two cases and was treated by the reconstruction of the duct or duct orifice. Microvascular autologous submandibular gland transfer is a lasting and effective solution for severe cases of keratoconjunctivitis sicca.

Topics: Adolescent; Adult; Aged; Anastomosis, Surgical; Child; Conjunctiva; Female; Follow-Up Studies; Graft Survival; Humans; Keratoconjunctivitis Sicca; Lacrimal Apparatus Diseases; Male; Microsurgery; Middle Aged; Postoperative Complications; Radiopharmaceuticals; Salivary Ducts; Sodium Pertechnetate Tc 99m; Submandibular Gland; Temporal Arteries; Temporal Muscle; Transplantation, Autologous; Treatment Outcome; Veins

We evaluated selection bias in a prospective study of 1,162 consecutive patients with suspected pulmonary embolism. Of these, 983 were eligible, and 627 could actually be included. During two months extensive data were collected on all non-included patients. Finally, our patient characteristics were compared with those of the PIOPED study (1990) and the study of Hull et al. (1994). Compared with included patients, the non-included patients had more often non-diagnostic V/Q scans (50% vs. 36%, p <0.01) and were more often already hospitalized (31% vs. 22%, P = 0.04). The subgroup of patients not included due to refusal or inability to give informed consent (IC) was older (mean age 61 vs. 53 years, P <0.01), more often suffered from malignancies (26% vs. 11%, P <0.01) and frequently had non-diagnostic V/Q scans (57%) as compared to included patients. In our study, 54% of all patients screened was eventually included versus 27% in the PIOPED study. In the PIOPED study patients who had contra-indications for pulmonary angiography were excluded, while in the study of Hull et al. those with inadequate cardiorespiratory reserve were excluded. In studies on new diagnostic technologies, patient selection bias does occur. The potential for such a selection bias should be taken into account when diagnostic strategies are devised to improve their generalizability and acceptability.

Topics: Adult; Aged; Angiography; Comorbidity; Female; Humans; Incidence; Informed Consent; Male; Middle Aged; Patient Selection; Postoperative Complications; Predictive Value of Tests; Prospective Studies; Pulmonary Embolism; Radionuclide Imaging; Radiopharmaceuticals; Risk Factors; Selection Bias; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Thrombophlebitis; Tomography, X-Ray Computed; Treatment Refusal; Ultrasonography; Ventilation-Perfusion Ratio

Topics: Barium Sulfate; Child; Contrast Media; Esophageal Atresia; Esophageal Fistula; Gastroesophageal Reflux; Humans; Male; Postoperative Complications; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m

The purpose of this study was to assess the value of 99mTc-pertechnetate scanning in the diagnosis of gastric banding leaks.. Three patients with morbid obesity received laparoscopic adjustable silicone gastric banding (ASGB), but no significant weight reduction was obtained. To exclude band leakage as the cause, four scintigraphic procedures were performed, consisting of imaging the upper abdomen 30 min and 3 h after injection of 3 mL (111 MBq) pertechnetate solution into the ASGB reservoir. In one patient, the integrity of the ASGB device was first assessed radiologically after injection of a water-soluble contrast agent into the ASGB reservoir.. In two normally functioning ASGB devices, radiotracer was observed within the device on both early and late images. In two patients with a surgically proven small leak in the reservoir or the connecting tube, late images showed little tracer in the reservoir and the connecting tube. However, intense tracer accumulation was observed in the stomach as a result of resorption of pertechnetate in the subcutaneous or peritoneal blood vessels and subsequent gastric uptake. In one of the latter patients, radiographic assessment of the ASGB device revealed no abnormalities.. 99mTc-pertechnetate scanning is a valuable technique to diagnose small leaks in an ASGB device.

Topics: Adult; Female; Gastroplasty; Humans; Laparoscopy; Middle Aged; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Silicones; Sodium Pertechnetate Tc 99m

In most cases of shunted hydrocephalus, shunt malfunction is evaluated by clinical examination and neuro-imaging. However if there is a discrepancy between neurological examination and imaging, additional shuntography can be helpful in the evaluation of the shunt function. In our clinic, radionuclide-imaging shuntography using (99m)technetium-pertechnetate was performed in 85 children between 1992 and 1995. The results of shuntography were evaluated visually and from time-activity curves. Shuntography had a sensitivity of 96%, a specificity of 89%, and an accuracy of 93%, proved either by surgery or by clinical follow-up for 2-5 years. Corresponding to these results, we recommend the use of shuntography in cases with an uncertain shunt function before surgical revision.

Topics: Adolescent; Cerebral Ventricles; Cerebrospinal Fluid Shunts; Child; Child, Preschool; Clinical Protocols; Equipment Failure Analysis; Female; Follow-Up Studies; Humans; Hydrocephalus; Infant; Male; Peritoneal Cavity; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Reoperation; Rheology; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m

The aim of the work was to study the diagnostic value of 99mTc-tetrofosmin to localize anomalous parathyroid glands in patients with hyperparathyroidism.. We have studied 33 patients: 12 with primary and 21 with secondary hyperparathyroidism, 9 of them renal graft recipients. Sixteen patients underwent surgery, 12 with primary and 4 with secondary hyperparathyroidism. All patients were injected with 740 MBq of 99mTc-tetrofosmin. Subsequently at 15, 30 and 60 minutes images were acquired for 300 seconds using a pin-hole collimator. A pertechnetate thyroid scintigraphy was obtained in 7 cases (24-48 h later) when the thyroid activity made difficult the identification of parathyroid glands.. In the group of patients with primary hyperparathyroidism, all cases showed a focal uptake in lower right localization. In the secondary hyperparathyroidism group, 12 patients showed diffuse tracer uptake in two or more glands and histology confirmed hyperplasia in four of them. Seven cases showed a greater focal uptake in a gland: two of them were renal graft recipients and three were chronic renal failure cases in haemodyalisis, and two were evaluated postsurgery showing uptake in the remnant parathyroid gland. The two remaining patients had a normal scintigraphy and corresponded to two false negative cases. In conclusion, our results suggest that 99Tc-tetrofosmin may be used as a suitable tracer for preoperative detection and screening of anomalous parathyroid glands.

Topics: Adenoma; Adult; Aged; Aged, 80 and over; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Hyperplasia; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Parathyroid Glands; Parathyroid Neoplasms; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Thyroid Gland

Funiculus spermaticus is exposed to invasive surgical intervention during Inguinal hernia reconstruction. Division or mechanical trauma to the spermatic artery account for serious trophic changes in the testis which, in bilateral herniotomy in particular, give rise to azoospermia. Here utilization of gamma camera scintigraphy of testes is indicated insofar as it may establish the degree of structural changes in testes as a result of mechanical injury to the spermatic chord during herniotomy which, in turn, has important prognostic implications on the fertility potential of patients. Twenty-five patients aged 3 to 48 years are covered by the study. In four of them herniotomy is associated with ipsilateral cryptorchidism and because of that orchiopexy is resorted to. In seven cases complete atrophy of testes following herniotomy is established scintigraphically. The imaging of testes fails, and functional parenchyma is lacking. In case of testicular hypoplasia, gamma-camera scintigraphy yields important information on the blood flow and blood supply to testes, as well as on intercurrent changes taking place. The radionuclide indices undergo alterations consistent with the structural changes in the parenchyma of testes. The severer the structural changes, the lower the values of radionuclide indices.

Topics: Adolescent; Adult; Child; Child, Preschool; Cryptorchidism; Gamma Cameras; Hernia, Inguinal; Humans; Intraoperative Complications; Male; Middle Aged; Postoperative Complications; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Testis

Aortic surgery results in ischemia/reperfusion of the lower body. This may liberate inflammatory mediators that activate neutrophils, and may result in lung microvascular changes with increased permeability and respiratory failure. We studied circulating inflammatory mediators and the pulmonary leak index (PLI) of 67Ga, a measure of transvascular transferrin transport and permeability, in patients scheduled for elective aortic and peripheral vascular surgery, before and after surgery. Aortic surgery patients in Groups 1 (n = 10) and 2 (n = 7) were studied before and at a median of 2.5 and 21.0 h after surgery, respectively. A control Group 3 (n = 6) was studied before and at a median of 2.9 h after peripheral vascular surgery. The PLI (median) increased from a median of 9.1 (range, 6.6 to 14.7) before to a median of 23.4 (range, 18.7 to 86.4) x 10(-3)/min after surgery in Group 1 but not in the other groups (p < 0.001). The postoperative increase in circulating neutrophils and elastase-alpha 1-antitrypsin, a marker of neutrophil activation, was similar among the groups. Plasma levels of activated complement 3a and tumor necrosis factor (TNF-alpha) did not change in any of the groups. In contrast, plasma levels of interleukin-8 (IL-8) increased in Group 1 from < 3 (range, < 3 to 37) before to 324 (range, 36 to 868) pg/ml after surgery, but did not change in the other groups (p < 0.005). The decrease in plasma levels of angiotensin converting enzyme (ACE) was greater in Group 1 than in the other groups (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Aortic Diseases; Capillary Permeability; Citrates; Citric Acid; Erythrocytes; Female; Gallium Radioisotopes; Humans; Inflammation Mediators; Interleukin-8; Lung; Male; Middle Aged; Neutrophil Activation; Peptidyl-Dipeptidase A; Peripheral Vascular Diseases; Postoperative Complications; Radionuclide Imaging; Reperfusion Injury; Respiratory Distress Syndrome; Sodium Pertechnetate Tc 99m

Topics: Adult; Angina Pectoris; Coronary Artery Bypass; Dose-Response Relationship, Drug; Exercise Test; Hemodynamics; Humans; Male; Middle Aged; Myocardial Ischemia; Nifedipine; Postoperative Complications; Radionuclide Ventriculography; Sodium Pertechnetate Tc 99m; Verapamil

In varicose vein surgery, significant postoperative morbidity results from subcutaneous haematoma formation and limb swelling after saphenous vein stripping. We investigated the effectiveness of a high-compression short-stretch adhesive bandage compared with non-adhesive crêpe in reducing haemorrhage after stripping of varicose veins. Using 99mTc-labelled red blood cells, the degree of postoperative bleeding was assessed in 10 patients with bilateral varicose veins allocated for stripping and ligation. High-compression adhesive bandaging was applied to the experimental limb and a non-adhesive bandage to the contralateral control limb. Results show that adequate compression bandaging can decrease subcutaneous haematoma formation after stripping of varicose veins.

Topics: Adult; Bandages; Connective Tissue Diseases; Female; Hemorrhage; Humans; Male; Middle Aged; Postoperative Care; Postoperative Complications; Pressure; Sodium Pertechnetate Tc 99m; Varicose Veins

An extremely rare vascular complication, carotid artery aneurysm, developed 60 years after a torticollis operation. The patient's internal jugular vein was completely obstructed proximal to the subclavian vein. There was an associated incomplete obstruction of the ipsilateral common carotid artery on the right aspect of the neck--the site where resection of the whole sternocleidomastoid muscle had been performed when she was one year old. The patient had audible bruits over the right common carotid at the base of her neck but no signs of occlusive cerebrovascular disease. The diagnosis was made mainly with use of technetium radionuclide angiography. To the authors' knowledge, this is the first such report in the English or German literature.

Topics: Aneurysm; Carotid Artery Diseases; Female; Humans; Middle Aged; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Torticollis

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

A study is presented of the motor-emptying function of the stomach evaluated by dynamic gastric scintigraphy in 43 patients with duodenal ulcer before and after vagotomy. In the early postoperative period 35 patients showed an enhanced emptying of the stomach, 8--a delayed. It was established that the most unfavourable results of vagotomy (gastrostasis, unhealed and relapsing ulcers) were observed in patients with preoperative dyskinesia of the duodenum and registered duodenogastric reflux. This should be considered in selecting the method of operative intervention. B-II gastric resection should be preferred in patients with duodenal dyskinesia.

Topics: Gastric Emptying; Humans; Peptic Ulcer; Postoperative Complications; Radionuclide Imaging; Recurrence; Sodium Pertechnetate Tc 99m; Stomach; Time Factors; Vagotomy, Proximal Gastric

When early complications occur after a kidney transplant, radionuclide angiography may be useful in determining a possible vascular origin. The authors describe the case of a patient with anuria continuing 24 hours after transplantation. Radionuclide angiography showed a defect at the site of the renal graft, suggestive of arterial or venous thrombosis. Contrast angiography was performed immediately but showed no vascular abnormality; neither did radionuclide angiography performed the next day. The authors concluded that a spasm at the site of the renal artery anastomosis, overcome by contrast angiography, could explain this phenomenon.

Topics: Adult; Angiography; Anuria; Contrast Media; False Positive Reactions; Female; Graft Occlusion, Vascular; Humans; Kidney Transplantation; Postoperative Complications; Radionuclide Angiography; Sodium Pertechnetate Tc 99m

Radionuclide measurements of ejection fraction were used to assess immediate and late postoperative ventricular function after the use of either a pulmonary artery vent (group A) or a left ventricular vent (group B) in 20 patients undergoing aortic valve replacement for pure aortic stenosis. Ten patients were included in each group and anesthetic techniques, patient management, and septal temperatures were similar in all cases. No significant difference was found between the preoperative and immediate or 6-week postoperative ejection fractions, either taken overall or between the two groups (p greater than 0.05; Student's t test). No correlation was found between cross-clamp time, bypass time, or the occurrence of ventricular fibrillation and the immediate postoperative ejection fraction (p greater than 0.05; Student's t test). There was no significant difference in the incidence of ventricular fibrillation after each type of vent had been used (chi 1(0) = 3.32; p greater than 0.05). We did not demonstrate any abnormalities in regional wall motion associated with apical insertion of a left ventricular vent, and conclude that pulmonary artery and left ventricular vents are equally satisfactory in terms of postoperative ventricular performance.

Topics: Adult; Aged; Aged, 80 and over; Aortic Valve Stenosis; Catheterization; Female; Heart; Humans; Male; Middle Aged; Myocardial Contraction; Postoperative Complications; Pulmonary Artery; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stroke Volume

Experiments on 9 dogs were staged for a study of a method of early diagnosis of infectivity of vascular prostheses of the abdominal aorta with the help of 99m-Tc-labelled leukocytes. A sterile synthetic vascular prosthesis was used for prosthetics of the abdominal aorta in the 1st control group of animals, a prosthesis, previously infected with St. aureus, was used in the 2nd group, a sterile prosthesis with its subsequent infecting by i.v. injection of St. aureus was used in the 3rd group. The role of antibiotic therapy in infectivity of vascular prostheses was studied on the animals of the 3rd group. A radionuclide study with autologous 99m-Tc-labelled leukocytes was conducted using the Deina-2 camera (Picker). Visualization of the prostheses was unobserved in the 1st control group; in the 2nd group the accumulation of 99m-Tc-leukocytes in the zone of the prosthesis and its visualization on the 4th-5th min. were noted; in the 3rd group the prosthesis was visualized on the 10th-15th min. After antibiotic therapy in the 3rd group visualization of the prosthesis was undetectable. The proposed method permitted visualization of a zone of infection in the early postoperative period, observation of the time course of infection development, and assessment of the efficacy of antibiotic therapy.

Topics: Animals; Blood Vessel Prosthesis; Dogs; Equipment Contamination; Female; Indium Radioisotopes; Leukocytes; Male; Methods; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Staphylococcal Infections; Time Factors

A 35-yr-old patient developed severe acute tubular necrosis requiring hemodialysis. A [99mTc]dimercaptosuccinic acid scan of the kidneys showed no renal uptake at 4 or 24 hr, but the patient subsequently recovered normal renal function as judged by a normal serum creatinine. Based on this case report and a review of the literature, one cannot assume irreversible loss of function in patients with acute renal failure, based on the absence of radiopharmaceutical uptake by the kidneys.

Topics: Acute Kidney Injury; Adult; Blood Urea Nitrogen; Creatinine; Female; Hemorrhage; Humans; Hysterectomy; Kidney; Kidney Tubular Necrosis, Acute; Postoperative Complications; Pregnancy; Puerperal Disorders; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Thirty symptomatic patients with retained gastric antrum proved pathologically and/or by isotopic visualization were studied and treated from 1968 to 1983. The latent periods from the antral exclusion to the occurrence of anastomotic ulcers after a subtotal gastrectomy with Billroth's type II reconstruction varied from a few days to 19 years, with an average of 2.8 years. Fasting serum gastrin levels were normal in 14 of 21 patients and were intermittently high in some patients. The basal to maximal acid-output ratio was greater than 0.6 in 69% of the patients; primary cimetidine treatment was effective in three of five patients. Thirty-five operations on 27 patients were divided into six groups; all of these 27 patients eventually underwent resection of retained gastric antrum. We concluded that resection remains the best treatment for anastomotic ulcer related to retained gastric antrum. Additional truncal vagotomy did not provide additional benefit to these patients. Furthermore, cimetidine can be useful to control the symptoms for preoperative preparation or definitive treatment in high-risk patients.

Topics: Adult; Aged; Cimetidine; Female; Follow-Up Studies; Gastrectomy; Gastric Juice; Humans; Iatrogenic Disease; Male; Middle Aged; Peptic Ulcer; Postoperative Complications; Pyloric Antrum; Radionuclide Imaging; Recurrence; Reoperation; Sodium Pertechnetate Tc 99m

50 patients after coronary artery bypass grafting were matched with 50 not-operated patients. After a follow-up period of four years they were investigated by first pass radionuclide angiography. Revascularized myocardial areas showed significantly higher regional ejection fraction during exercise and in territories with prior myocardial infarction. The results proved the hemodynamic benefits of coronary artery bypass grafting even in territories with poor myocardial function.

Topics: Angina Pectoris; Cardiac Output; Coronary Artery Bypass; Coronary Disease; Gold Radioisotopes; Humans; Myocardial Contraction; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Anuria is a frequent complication during the immediate post-transplantation period in kidney transplant recipients. Radioisotopic studies with 131I-Hippuran and 99mTc-pertechnetate allow correct differentiation between viable and non-viable grafts.

Topics: Anuria; Graft Survival; Humans; Iodohippuric Acid; Kidney; Kidney Transplantation; Postoperative Complications; Postoperative Period; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

We investigated the diagnostic accuracy of radionuclide global and regional left ventricular (LV) function after coronary revascularization. A consecutive series of 43 patients was studied. First-pass radionuclide angiograms were performed preoperatively (4 days +/- s.d. 3 days, range 1-18 days) and postoperatively (7 days +/- s.d. 3 days, range 3-19 days). Regional radionuclide LV function was assessed using the two-dimensional display of systole and the three-dimensional ejection fraction image. Electrocardiograms were obtained the day prior to surgery and every 8 h for the first three postoperative days. Creatine kinase (CK) and lactate dehydrogenase (LDH) isoenzymes were obtained the day prior to surgery and every 8 h for the first three postoperative days. In 39 patients who did not develop perioperative myocardial infarction by isoenzyme or ECG criteria, we found that 38 patients showed unchanged or improved global and regional LV function, while one patient without isoenzyme or ECG evidence of perioperative myocardial infarction developed a new septal wall motion abnormality. Thus, the specificity of the radionuclide radioventriculogram for new septal wall motion abnormalities was very high. In four patients who developed isoenzyme and ECG evidence of myocardial infarction, septal wall motion worsened in all four patients while global left ventricular ejection function fell significantly in three patients. Thus, the radionuclide radioventriculogram also had high diagnostic sensitivity. In summary, contrary to past and recent reports, this investigation demonstrated that the radionuclide radioventriculogram can be used to assess global and regional LV function after coronary artery bypass surgery and furthermore, that it reliably indicates the presence of a new postoperative myocardial infarction.

Topics: Adult; Cardiomyopathies; Coronary Artery Bypass; Heart Septum; Humans; Male; Middle Aged; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Forty consecutive asymptomatic patients with chronic aortic regurgitation who underwent three serial yearly rest and postexercise radionuclide angiograms were compared with 27 consecutive patients with chronic aortic regurgitation and aortic valve replacement who were studied preoperatively, 3 and 15 months postoperatively. Patients were divided into four subgroups based upon the resting left ventricular ejection fraction and the functional reserve on the initial study. Of the 40 medically treated patients, 19 (47.5%) and 24 (60%) demonstrated a response at least one type lower at 12 months and 24 months, respectively. Initial functional reserve, initial duration of exercise, and the change in exercise duration during the 24 months was not associated with changes in resting or postexercise left ventricular ejection fraction. A seesaw pattern was observed between the resting and the postexercise left ventricular ejection fraction as ventricular function deteriorated. We observed in the surgical groups a reversal of the seesaw interaction between the resting and postexercise ejection fraction seen in the medical patients. In the surgical groups the left ventricular end-diastolic pressure, initial functional reserve, initial duration of exercise, and change in exercise duration postoperatively were not predictors of improvement in left ventricular function at 15 months. Comparing medical and surgical serial data, we suggest yearly radionuclide angiographic determination of rest left ventricular ejection fraction in asymptomatic patients with chronic aortic regurgitation. When the rest ejection fraction is less than 50%, exercise angiography should be performed to determine functional reserve. When functional reserve is also abnormal, surgery should be recommended.

Topics: Adolescent; Adult; Aged; Aortic Valve Insufficiency; Cardiac Output; Child; Chronic Disease; Coronary Circulation; Female; Heart Rate; Heart Valve Prosthesis; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Contraction; Physical Exertion; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Topics: Adolescent; Brain Neoplasms; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Neoplasm Recurrence, Local; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Topics: Esophagitis, Peptic; Esophagoplasty; Gastrostomy; Humans; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m

Topics: Female; Gastrectomy; Humans; Male; Middle Aged; Postoperative Complications; Pyloric Antrum; Radionuclide Imaging; Recurrence; Sodium Pertechnetate Tc 99m; Stomach Ulcer; Technetium

Topics: Humans; Iodohippuric Acid; Kidney Transplantation; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium

Topics: Adolescent; Adult; Diabetes Mellitus; Heart; Humans; Middle Aged; Pancreas Transplantation; Postoperative Complications; Preoperative Care; Radionuclide Imaging; Risk; Sodium Pertechnetate Tc 99m; Technetium

With first-pass radionuclide angiography, it is possible to visualize sequentially the cardiovascular structures and to obtain computer-generated time-activity curves for regions of interest over these structures. Analysis of these curves permits the detection, localization, and quantitation of intracardiac shunts and shunts between the great arteries. The authors present the formulae used for the quantitative analysis and discuss clinical applications.

Topics: Ductus Arteriosus, Patent; Electrocardiography; Heart Defects, Congenital; Heart Septal Defects, Atrial; Heart Septal Defects, Ventricular; Hemodynamics; Humans; Infant; Infant, Newborn; Models, Cardiovascular; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Tetralogy of Fallot; Transposition of Great Vessels

131Iodine hippurate sequential scintigrams obtained after transplantation contain prognostic information about the long-term development of a graft. Results of 131 131iodine hippurate sequential scintigrams made within 48 hours after graft implantation were compared to the graft status 2 years after transplantation. Hippurate uptake and transport were rated on a 4-step scale. Disturbed hippurate uptake and abnormal tracer transit were associated with increased frequency of early graft destruction and with a high frequency of chronic rejection. The chi-square test demonstrated a significant relationship between results of the initial hippurate scintigrams and long-term graft development.

Topics: Adolescent; Female; Graft Rejection; Humans; Iodohippuric Acid; Kidney; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Male; Middle Aged; Postoperative Complications; Prospective Studies; Radioisotope Renography; Sodium Pertechnetate Tc 99m; Technetium

The utility of radionuclide labeled leukocytes in the demonstration of infection within vascular prostheses was examined. The infrarenal aorta was replaced with a 3 cm Dacron graft in 12 dogs. On the third postoperative day, six of the animals received an intravenous injection of 10(8) Staphylococcus aureus. Labeled leukocyte scans were performed at postoperative days one and three, and then weekly for 8 weeks with indium-111 and technetium-99 labeled autologous leukocytes. When scans showed focal uptake of isotope in the area of prosthetic material, the grafts were aseptically excised and cultured on mannitol-salt agar. Both control and infected animals had retroperitoneal isotope activity in the immediate postoperative period that disappeared by the end of the first week. By the eighth postoperative week, all of the animals that received the bacteremic challenge had both radionuclide concentration in the region of the vascular prosthesis and S. aureus cultured subsequently from the perigraft tissues. None of the control animals had either radionuclide or bacteriologic evidence of infection at the eighth postoperative week. The radiolabeled leukocyte scan is a highly sensitive and specific technique, clinically applicable for the diagnosis of vascular prosthetic infections.

Topics: Animals; Aorta; Blood Vessel Prosthesis; Dogs; Leukocytes; Postoperative Complications; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Staphylococcal Infections; Technetium