technetium-tc-99m-exametazime and Dilatation--Pathologic

We report a rare case of unusual widening of perivascular spaces (Virchow-Robin spaces). MR images showed multiple small round cystic areas along the perforating medullary arteries with signal intensity identical to the cerebrospinal fluid predominantly in the right cerebral white matter. Tc-99m HMPAO SPECT images showed no remarkable laterality and no definite ischemic lesion, and the neurological status of the patient was not remarkable. MR was a diagnostic examination and Tc-99m HMPAO SPECT was a useful supplementary examination in the evaluation of this case of unusual widening of Virchow-Robin spaces.

Topics: Aged; Cerebral Arteries; Dilatation, Pathologic; Humans; Magnetic Resonance Imaging; Male; Radiopharmaceuticals; Subarachnoid Space; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Forty-one children (15 girls, 26 boys; ages 3.0 +/- 2.1 years) with Kawasaki disease (KD) were included in our study. The diameters of a total of 82 coronary arteries (CA), comprising 41 left (LCA) and 41 right (RCA), were computed by two-dimensional echocardiography (2D-Echo). If the diameter of the CA was > or = 20 mm, it was considered as dilated. The severity of the carditis was evaluated by [99mTc]HMPAO-labeled white blood cell (WBC) heart scans (Tc-WBC) carried out in all cases. On the basis of the results the children were divided into three groups. Group A children had the most severe carditis where the heart uptake was greater than the bone uptake; 11 of 32 (34.3%) of the CA in 16 cases were dilated. Group B had carditis of medium severity where the heart uptake was equal to the bone uptake; 11 of 28 (39.3%) of the CA in 14 cases were dilated. Group C had mild carditis where the heart uptake was less than the bone uptake; 9 of 22 (40.9%) of the CA in 11 cases were dilated. There were no significant differences among the three groups (p = 0.87 by a chi-squared test). We conclude that no definite relationship exists between the severity of carditis and the dilatation of the CA in children with KD.

Topics: Cardiomyopathy, Dilated; Child, Preschool; Dilatation, Pathologic; Echocardiography; Female; Humans; Infant; Leukocytes; Male; Mucocutaneous Lymph Node Syndrome; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Severity of Illness Index; Technetium Tc 99m Exametazime