technetium-tc-99m-exametazime and Rheumatic-Heart-Disease

The radionuclide investigation was performed 1-3 and 24 hours after injection of a radiopharm preparation and included the single photon emission computed tomography of the heart and scintigraphy of the whole body. Inflammation foci were found on the scans as hyperfixation foci of autoleukocytes labeled with 99mTc-HMPAO (hexamethylpropilene aminooxime). Four patients had abscesses with 0.8-1.5 cm diameter in projection of the aortal and mitral valves of the heart, and in 10 patients there were foci of inflammation and suppuration of extracardiac localization (in the area of the operation wound, anterior mediastinum, frontal sinuses, transverse colon, parietal pleura). The data obtained convincingly speak of high sensitivity and specificity of radionuclide diagnostic methods with the help of labeled elements of the whole blood in recognizing latent inflammatory and suppurative processes in cardiosurgical patients at the pre- and postoperative periods.

Topics: Adolescent; Adult; Aortic Valve; Endocarditis, Bacterial; Female; Focal Infection; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Leukocytes; Male; Middle Aged; Mitral Valve; Radionuclide Imaging; Radiopharmaceuticals; Rheumatic Heart Disease; Surgical Wound Infection; Technetium Tc 99m Exametazime

Myocardial imaging with 99Tcm-hexamethylpropylene amineoxime (HMPAO)-labelled white blood cells (Tc-WBC) was used to detect carditis and differentiate rheumatic fever (RF) and inactive rheumatic heart disease (IRHD). Ten cases of RF and 15 cases of IRHD were studied, and the results revealed 60% (6/10) of the cases of RF with carditis, but none of the cases (0/15) of IRHD with carditis. There was significant difference (P less than 0.05, by Fisher's test) between RF and IRHD. In our preliminary conclusion, Tc-WBC heart scanning may be a noninvasive method for evaluating the existence of carditis in cases of RHD and in the differentiation of RF and IRHD.

Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Female; Heart Diseases; Humans; Inflammation; Leukocytes; Male; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Rheumatic Fever; Rheumatic Heart Disease; Technetium Tc 99m Exametazime