technetium-tc-99m-medronate and Acute-Kidney-Injury

The real place of isotopic imaging in intensive care patients remains still unclear. This review aimed to consider the indications of isotopic imaging for improved diagnosis and therapy and to specify its place among the other techniques of exploration. Pulmonary perfusion and ventilation scintigraphies are valuable for the diagnosis of pulmonary embolism (PE). A "high probability" scintigraphy of the lungs ascertains the diagnosis of PE and allows to start a specific treatment without requiring a pulmonary angiography. This is not the case in the presence of a history of previous PE or if the arguments for a PE are only weak. A normal lung scintigraphy eliminates the diagnosis of a clinically significant PE all the more as an exploration of good quality of the lower limb veins remains negative. In the opposite a "non diagnostic" scintigraphy justifies a pulmonary angiography in intensive care patients. The diagnosis of myocardial contusion is made uneasy as the clinical symptoms, the ECG, the cardiac enzymes and the chest X-ray are only of limited value. Isotopic explorations of the heart could provide additional valuable data or be an alternative for 2 D echocardiography. The comparison of CPK-MB concentrations with a myocardial scintigraphy using thallium 201 is given as being very reliable, with positive and negative predictive values higher than 80%. An exploration restricted to the cardiac ejection fractions is only of limited value. In the future, an improvement will perhaps be obtained with tracers such as MIBI labelled with technetium 99m, which allow the simultaneous assessment of myocardial perfusion and the ventricular ejection fractions as well. The localisation of centres of infection, especially when intra-abdominal, remains difficult in intensive care patients. Isotopic imaging, especially the scintigraphies with labelled polynuclears, could allow in combination with conventional imaging techniques (computed tomography and 2 D echocardiography) to prevent from errors in diagnosis. An array of arguments is essential for ascertaining the presence of an abscess. Scintigraphies with leucocytes labelled with indium 111 or technetium 99m are qualified as having a sensitivity and a specificity greater than 90%. The conventional techniques of measurement of the cerebral blood flow (CBF) using xenon 133 require a special equipment or are invasive. Other cerebral tracers, such as cyclic amines (HMPAO) labelled with technetium 99m and administrable b

Topics: Acute Kidney Injury; Cerebrovascular Circulation; Critical Care; Decision Trees; Gallium Radioisotopes; Humans; Indium Radioisotopes; Infections; Myocardial Ischemia; Pulmonary Embolism; Radionuclide Imaging; Technetium Tc 99m Medronate

We describe a patient with bilobar pneumonia and acute renal failure, whose unusual skeletal muscle uptake on technetium methylenediphosphonate bone scan led to the diagnosis of rhabdomyolysis. The clinical and serologic findings were most consistent with Legionnaires' disease. Radioisotope scanning may occasionally be useful in the diagnosis and management of muscle disease, particularly myositis and rhabdomyolysis.

Topics: Acute Kidney Injury; Adult; Bone and Bones; Female; Humans; Legionnaires' Disease; Pneumonia; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

To describe the prevalence of and risk factors for renal infarction (RI) in patients with cardiac amyloidosis.. We evaluated 87 patients with cardiac amyloidosis who underwent renal technetium-99m-labeled dimercaptosuccinic acid scintigraphy in the Amyloidosis Referral Center of Henri-Mondor Hospital from October 1, 2015, through February 28, 2018.. Three groups of patients were identified according to the underlying amyloidosis disorder: AL amyloidosis in 24 patients, mutated-transthyretin amyloidosis in 24 patients, and wild-type transthyretin amyloidosis in 39 patients. Patients with wild-type transthyretin amyloidosis were older (P<.001), more likely to be men (P=.02), to have arrhythmic heart diseases (P<.001), and to be receiving anticoagulation treatment (P<.001). Patients with AL amyloidosis had significantly higher N-terminal pro-B-type natriuretic peptide levels (P=.02) and were more likely to have nephrotic syndrome (P<.001). Renal infarction was detected in 18 patients (20.7%), at similar frequencies in the various groups. Baseline urinary protein to creatinine ratio was the only parameter for which a significant difference (P=.03) was found between patients with and without RI diagnoses. The likelihood of RI diagnosis was 47.1% (8 of 17) in the presence of AKI and 14.5% (10 of 69) in its absence (P=.003). Overall, heart transplant-censored patient survival did not differ significantly between patients with and without RI (P=.64), but death- and heart transplant-censored renal survival was significantly lower in patients with RI (P<.001).. Our study suggests that prevalence of RI in patients with cardiac amyloidosis is higher than previously thought, regardless of the underlying amyloidosis disorder. Acute kidney injury in a patient with cardiac amyloidosis should alert clinicians to the possibility of RI.

Topics: Acute Kidney Injury; Aged; Aged, 80 and over; Amyloid Neuropathies, Familial; Female; Heart Diseases; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Acute Kidney Injury; Bone and Bones; Humans; Laparoscopy; Magnetic Resonance Imaging; Male; Middle Aged; Nephrectomy; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

Metastatic calcification, a known complication of prolonged end-stage renal disease, is herein described for the first time in a 10-month-old boy with acute renal failure, manifesting as a painful and swollen arm. Imaging revealed diffuse calcification and technetium-99 methylene diphosphonate (99Tc-MDP) uptake around the humerus and axilla. Calcium and vitamin D restriction, followed by intravenous administration of sodium thiosulfate caused a full symptomatic, radio- and scintigraphic improvement.

Topics: Acute Kidney Injury; Calcinosis; Humans; Infant; Male; Radiopharmaceuticals; Technetium Tc 99m Medronate

We report computed tomography (CT) findings that demonstrated early disappearance of ectopic calcification in the bilateral posterior paraspinal muscles in a patient with rhabdomyolysis. A 37-year-old man with acute renal failure due to rhabdomyolysis caused by neuroleptic malignant syndrome underwent studies with CT and bone scintigraphy. First, bone scintigraphy showed high radiotracer uptake in bilateral posterior paraspinal muscles; then CT demonstrated ectopic calcification in those muscles. After 2.5 months, CT showed that the calcification had completely disappeared. Bone scintigraphy anticipated calcification, and CT demonstrated a unique course of early disappearance of the calcification.

Topics: Acute Kidney Injury; Adult; Biomarkers; Bone and Bones; Calcinosis; Humans; Male; Muscle, Skeletal; Neuroleptic Malignant Syndrome; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate; Time Factors; Tomography, X-Ray Computed

Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Muscle, Skeletal; Myoglobinuria; Polymyositis; Radionuclide Imaging; Radiopharmaceuticals; Recurrence; Rhabdomyolysis; Technetium Tc 99m Medronate

Topics: Acute Kidney Injury; Anti-Inflammatory Agents, Non-Steroidal; Bone and Bones; Diclofenac; Humans; Ibuprofen; Low Back Pain; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Clinical and scintigraphic findings are described in a patient with unexpected diffuse lung uptake on bone scan after a heroin overdose.. The patient's Tc-99m MDP bone scan is reviewed along with the pertinent clinical history and laboratory findings.. Marked diffuse and symmetric lung uptake is present on bone scintigraphy in a patient with a history of acute renal failure and a markedly elevated calcium-phosphate product but normal renal function and laboratory values at the time of the examination.. The incidental observation of metastatic calcification by bone scintigraphy is important, because it may aid in the diagnosis of a previously unsuggested elevated calcium-phosphate product, renal failure, or both. Furthermore, the intensity of tracer localization on bone tracer-specific imaging may help evaluate the activity of the metastatic calcification process.

Topics: Acute Kidney Injury; Adult; Bone and Bones; Calcinosis; Drug Overdose; Heroin; Heroin Dependence; Humans; Lung Diseases; Male; Narcotics; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyolysis; Technetium Tc 99m Medronate

During the examination of a young patient with acute renal failure, bone imaging was performed for evaluation of possible osteomyelitis. Marked soft tissue activity was seen on the bone scan. The patient admitted to recent intravenous cocaine use. Vasoconstriction from cocaine use was thought to induce rhabdomyolysis, which led to acute renal failure with myoglobulinuria.

Topics: Acute Kidney Injury; Adult; Bone and Bones; Cocaine; Humans; Male; Radionuclide Imaging; Rhabdomyolysis; Substance Abuse, Intravenous; Technetium Tc 99m Medronate

To evaluate the patterns of renal images and the diagnostic value as a screening test of the whole-body bone and renal scintigraphy with technetium-99m-methylene diphosphonate (99mTc-MDP) or -pyrophosphate (99mTc-PYP), we performed bone scintigraphy in 6 patients with acute renal failure (ARF) with severe loin pain and patchy renal vasoconstriction on postcontrast renal computed tomography (CT). All 6 patients were young and previously healthy but experienced severe loin pain after track events. Five took analgesics. Postcontrast renal CT showed patchy low-density areas or diffuse enhancement immediately after radiocontrast injection and then patchy wedge-shaped enhancement 24 or 48 h later, which subsequently disappeared 72 h later. On the whole-body bone scintigrams with 99mTc-MDP or 99mTc-PYP before obtaining renal CT, there was no increased uptake of isotope in the soft tissue, and multiple patchy increased accumulations of the isotope in the kidney were observed in 5 patients. In 2 patients, renal scintigraphies with technetium-99m-dimercaptosuccinate showed photon-deficient areas in the same areas of patchy isotope accumulation in the whole-body bone scintigraphies. Whole-body image and renal scintigraphy with bone-seeking agents may be useful as a screening test and in the search for the theoretical evidence of ARF with severe loin pain and patchy renal vasoconstriction.

Topics: Acute Kidney Injury; Adolescent; Adult; Bone and Bones; Female; Humans; Kidney; Male; Pain; Renal Circulation; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed; Vasoconstriction

A case is reported of acute renal failure occurring after prolonged abdominal aortic bypass surgery in an overweight 69-year-old male patient. Preoperative serum creatinine concentration was normal. Surgery lasted for 6 h, and infrarenal aortic cross-clamping 2 1/2 h. The patient complained of important lumbar pain immediately after the operation. In the same time, oliguria and acute renal failure also developed (creatinine: 464 mumol.l-1; urea: 13 mmol.l-1). Rhabdomyolysis caused by the kidney-bridge was confirmed by the elevated blood creatine phosphokinase levels (16,000 IU.l-1 on the second postoperative day). A 99 m-Technetium methylene-diphosphonate imaging on the 10th postoperative day exhibited diffuse fixation in the paravertebral lumbar and thoracic muscles, extending from Th8 to L3. The acute renal failure regressed completely after haemodialysis.

Topics: Acute Kidney Injury; Aged; Back Pain; Beds; Blood Vessel Prosthesis; Humans; Intraoperative Complications; Lumbosacral Region; Male; Posture; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

Radionuclide imaging in a patient who had acute renal failure with severe loin pain and patchy renal vasoconstriction is described. The patient was studied 3h after the intravenous bolus injection of 25 mCi99mTc-methylene diphosphonate (99mTc-MDP). An intense patchy renal concentration of 99mTc-MDP was observed.

Topics: Acute Kidney Injury; Adult; Humans; Male; Pain; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Urography; Vasoconstriction

We used technetium Tc 99m medronate (methylene diphosphonate) scanning in the treatment of seven patients with rhabdomyolysis. In three patients the intense, diffuse, symmetric nature of the scans was suggestive of an underlying metabolic muscle disorder. The scans defined the extent of the muscle injury in three patients and demonstrated muscle injury that was not initially suspected in two patients. The scan also demonstrated clinically unsuspected metastatic pulmonary and gastric calcifications in one patient. All scans showed evidence of renal dysfunction. In conclusion, these cases demonstrate that Tc 99m medronate scanning helps to define the extent and location of muscle injury in rhabdomyolysis, and that diffuse muscle uptake of Tc 99m medronate may be associated with metabolic muscle disease.

Topics: Acute Kidney Injury; Adult; Aged; Bone and Bones; Follow-Up Studies; Humans; Male; Middle Aged; Muscles; Radionuclide Imaging; Rhabdomyolysis; Technetium Tc 99m Medronate

We report a case of myoglobinuria secondary to prolonged seizures. The child showed "hot kidneys" with bone scintigraphy. The disease entity and etiologies of nontraumatic rhabdomyolysis are discussed.

Topics: Acute Kidney Injury; Adolescent; Bone and Bones; Diphosphonates; Female; Humans; Kidney; Radionuclide Imaging; Rhabdomyolysis; Seizures; Technetium; Technetium Tc 99m Medronate

A patient with end-stage renal disease and hypercalcemia was referred for a radionuclide bone imaging study. Deposition of Tc-99m hydroxymethylenediphosphonate was apparent in the lungs and myocardium as well as in the skeleton. Renal uptake was also noted, despite anuria. Computed tomography demonstrated nephrocalcinosis but no myocardial calcification. The cause of myocardial uptake of tracer is unknown. Amyloidosis is suggested as a possibility but is not validated in this case.

Topics: Acute Kidney Injury; Aged; Bone and Bones; Diphosphonates; Female; Heart; Humans; Hypercalcemia; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Acute Kidney Injury; Adult; Bone and Bones; Calcinosis; Diphosphonates; Humans; Lung Diseases; Male; Muscular Diseases; Radionuclide Imaging; Stomach Diseases; Technetium; Technetium Tc 99m Medronate

Using compartmental analysis techniques, we modeled the biodistribution of Tc-99m(Sn)methylene diphosphonate in humans on a computer, and by selectively perturbing appropriate rate constants, we simulated changes in contrast between bone and soft tissue in a number of systemic disorders. The model predicts low contrast in patients with moderate to marked edema, obesity, congestive heart failure or decreased cardiac output states and high contrast with as little as 25% increase in bone avidity for the tracer. In acute renal failure without fluid-volume imbalance, image contrast should be normal. The model predicts greater contrast shortly after injection in patients with increased cardiac output, skeletal blood flow, or bone avidity; images made at these times would be indistinguishable. These simulations are in keeping with reports in the literature of bone images and bone-to-soft tissue ratios in many of these conditions, suggesting that modeling studies could play an important role image interpretation.

Topics: Acute Kidney Injury; Aged; Blood Circulation; Bone and Bones; Bone Development; Cardiac Output; Computers; Diphosphonates; Edema; Humans; Kidney Failure, Chronic; Middle Aged; Radiographic Image Enhancement; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technology, Radiologic

Topics: Acute Kidney Injury; Adult; Diphosphonates; Frostbite; Humans; Leg Injuries; Male; Myoglobinuria; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate