technetium-tc-99m-pyrophosphate and Chronic-Disease

Technetium-99 (99Tc) pyrophosphate bone scanning often identifies patients with osteomyelitis before roentgenographic findings appear. However, recent studies have shown that 99Tc bone scanning often gives false-negative results, especially in neonates. The accuracy of computed tomographic scanning and indium-111 leukocyte scanning for diagnosis of early osteomyelitis has not been established. 99Tc bone scanning often gives false-positive results in patients with other conditions leading to bone injury and repair, such as trauma or recent surgery, further limiting the usefulness of this imaging procedure. Newer imaging techniques have not been adequately evaluated to establish their specificity. Because of their high cost and unproved accuracy, these new imaging procedures should not be routinely applied until their usefulness has been established. Bone biopsy remains the procedure of choice for establishing the diagnosis in patients suspected clinically to have osteomyelitis with negative findings on roentgenography and 99Tc bone scanning. Although Staphylococcus aureus is the leading cause of osteomyelitis, other pathogens cause 30 to 40 percent of cases. Aspiration or biopsy of the involved bone is usually required to choose appropriate antibiotic therapy. Bone biopsy is essential in chronic osteomyelitis, since cultures of sinus drainage are unreliable. Osteomyelitis in diabetics with foot infection and in association with decubitus ulcers presents special problems. Radionuclide scanning often give false-positive results in these patients. Proper diagnosis usually requires careful assessment of clinical and roentgenographic findings. Although bone biopsy seems useful in diagnosing osteomyelitis underlying decubitus ulcers, its role in diabetic patients with foot infections is not established. I do not recommend biopsy of foot bones in diabetic patients, since culture of bone biopsy specimens often give unreliable results in these situations because of contamination with ulcer organisms.

Topics: Acute Disease; Bone and Bones; Chronic Disease; Costs and Cost Analysis; Diabetes Complications; Diagnostic Errors; Diphosphates; Foot Diseases; Humans; Osteomyelitis; Radiography; Radionuclide Imaging; Skin Ulcer; Staphylococcal Infections; Technetium; Technetium Tc 99m Pyrophosphate; Wound Infection

Perioperative myocardial infarction (POMI) is a complication of coronary artery bypass grafting (CABG) with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS) is used in the diagnosis of POMI; however it shows a limited sensitivity for subendocardial lesions. Cardiovascular magnetic resonance imaging (CMRI), in turn, has a high accuracy in the detection of myocardial necrosis.. To compare CMRI and MS for the detection of POMI after CABG.. A total of 24 patients with chronic coronary artery disease were studied using the delayed contrast enhanced CMRI and MS before and after CABG by analyzing the development of areas of perioperative myocardial necrosis (POMI). Biochemical markers of myocardial injury (CKMB and troponin I) were also determined before and after surgery.. Nineteen patients completed the study. Of these, 6 (32%) presented POMI on CMRI and 4 (21%) on MS (p = NS). Of the 323 left ventricular segments assessed, 17 (5.3%) showed perioperative necrosis on CMRI and 7 (2.2%) on MS (p = 0.013). Moderate agreement was observed between the methods (kappa = 0.46). There was disagreement regarding the diagnosis of POMI in 4 (21%) cases, most of them with small areas of perioperative necrosis on CMRI which were not visualized on MS. In all cases with POMI on CMRI, significant CKMB and troponin I elevations were observed.. Moderate diagnostic agreement was observed between the methods for the detection of POMI, but CMRI enabled visualization of small areas of perioperative myocardial necrosis which were not identified on MS and were associated with elevation of biochemical markers of myocardial injury.

Topics: Biomarkers; Chronic Disease; Coronary Disease; Creatine Kinase, MB Form; Female; Humans; Intraoperative Complications; Magnetic Resonance Imaging; Male; Middle Aged; Myocardial Infarction; Myocardial Revascularization; Necrosis; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Pyrophosphate; Troponin I

Topics: Chest Pain; Chronic Disease; Echinococcosis; Heart Ventricles; Humans; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Pyrophosphate; Whole-Body Counting

A study of 45 patients with chronic obstructive bronchitis by the method of radionuclide ventriculography with 99mTc showed that even the early stages of the disease were characterized by an inhibition of the contractile function of the left cardiac ventricle. With progression of respiratory insufficiency, maintaining of the left cardiac ventricle stroke volume is achieved by increase of the final-diastolic and final-systolic volumes. Appearance of signs of cardiac decompensation is accompanied by a breakdown of this compensatory mechanism accompanied by a reduction of the strike volume and diminished rate of contraction of the circular fibers of the left ventricle myocardium.

Topics: Adult; Bronchitis; Chronic Disease; Gated Blood-Pool Imaging; Heart Failure; Humans; Middle Aged; Pulmonary Heart Disease; Respiratory Insufficiency; Technetium Tc 99m Pyrophosphate; Ventricular Function, Left

Topics: Cardiomyopathy, Dilated; Chronic Disease; Coronary Disease; Heart; Humans; Myocardial Infarction; Prognosis; Radionuclide Imaging; Technetium Tc 99m Pyrophosphate

Topics: Chronic Disease; Diphosphates; Exercise Test; Heart; Heart Failure; Hemodynamics; Humans; Pulmonary Circulation; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed

The time course of myocardial 99mTc-pyrophosphate accumulation 1 hour after a bicycle ergometric test versus the resting scintigraphic findings was correlated with the severity of chronic coronary heart disease (CHD) and long-term prognosis. A group of the patients who had higher radiotracer accumulation following the exercise showed the most severe disease and unfavorable prognosis (in this group 19.4% deaths were observed during a three-year follow-up). A single administration of 99mTc-pyrophosphate followed by scintigraphy 2 hours after bicycle ergometry and repeated scintigraphy 1 hour later allows one to assess the time course of myocardial radiotracer accumulation and to judge how the myocardium is supplied by blood.

Topics: Adult; Chronic Disease; Coronary Disease; Diphosphates; Exercise Test; Heart; Humans; Male; Middle Aged; Prognosis; Radionuclide Imaging; Severity of Illness Index; Technetium; Technetium Tc 99m Pyrophosphate

The possibility of myocardial necrosis occurrence in coronary failure proceeding as atypical myocardial infarction was examined in 176 patients with chronic types of coronary heart disease and in experiments with 16 dogs with reversible coronary failure simulated in chronic tests. 99mTe-labeled pyrophosphate myocardial scintigraphy was used in the clinical studies. Myocardial pyrophosphate accumulation was recorded in 37% of patients with angina pectoris without a history of myocardial infarction and 73% myocardial infarction survivals. Histological evidence for small myocardial necroses at various stages of their development was found in 12 dogs. Recurrent transient myocardial ischemias were shown to be able to lead to myocardial necroses that are not always followed by a typical course of acute myocardial infarction.

Topics: Angina Pectoris; Animals; Chronic Disease; Coronary Disease; Diphosphates; Dogs; Heart; Myocardium; Necrosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

The authors presented the results of clinical, x-ray and osteoscintigraphic investigations of 133 psoriatic arthritis patients and 72 patients with common psoriasis. Osteoscintigraphy was performed using a routine method with 99mTc-pyrophos (USSR) and 99mTc-phosphone (Hungary) on gamma-camera LFOV (Nuclear-Chicago, USA). X-ray signs of the involvement of the osteoarticular system were noted in 69 (51%) patients with psoriatic arthritis and in 16 (22%) patients with common psoriasis. The method permitted the detection of the foci of RP hyperfixation in 129 (97%) patients with psoriatic arthritis and in 51 (70.8%) patients with common psoriasis. They were observed mostly in large and small limb joints, less frequently--in the vertebral column, cranial bones, thorax, and ribs. Thus, osteoscintigraphy is a highly sensitive method for the detection of active inflammatory foci of the osteoarticular system in psoriasis at all stages of arthritis development. It makes it possible to detect the spreading of arthritis and its preclinical forms.

Topics: Arthritis; Bone and Bones; Chronic Disease; Diphosphates; Evaluation Studies as Topic; Humans; Psoriasis; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Application of a complex of clinical, thermography and radionuclide methods in 79 patients with rheumatoid arthritis has demonstrated high sensitivity of scintigraphy with the use of osteotropic radiopharmaceuticals (99mTc-pyrophosphate, 99mTc-phosphone) as well as a possibility of diagnosing preclinical injuries to the joints. The thermography and scintigraphic parameters depended on the degree of inflammation, permitting an objective evaluation of the treatment effect.

Topics: Adult; Arthritis, Rheumatoid; Chronic Disease; Combined Modality Therapy; Diphosphates; Female; Follow-Up Studies; Humans; Joints; Male; Middle Aged; Prognosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thermography

Topics: Adolescent; Adult; Aged; Chronic Disease; Diagnosis, Differential; Diphosphates; Female; Humans; Male; Middle Aged; Osteomyelitis; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray Computed

Topics: Adult; Angina Pectoris; Chronic Disease; Coronary Disease; Diphosphates; Evaluation Studies as Topic; Heart; Humans; Male; Middle Aged; Physical Exertion; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed

The general and regional contractility of the left ventricle was studied in 69 patients with chronic coronary heart disease (CHD) and in 10 practically healthy persons using the method of radionuclide ventriculography (RNVG). The contractility indicators in dynamic and static RNVG were correlated. A high degree of correlation was obtained between them as well as with the findings of radiopaque ventriculography. It was established that data processing with the help of a cardiosynchronizer is of high informative value, significant and can be used in RNVG variants thus making it possible to use the same program of processing. The frequency of the methods and mean dispersion of the results were assessed. Numerical values of the general and regional contractility in healthy persons and in patients with varying severity of chronic CHD were determined.

Topics: Adult; Chronic Disease; Coronary Disease; Diphosphates; Heart; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Contraction; Pentetic Acid; Sodium Pertechnetate Tc 99m; Stroke Volume; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed

The paper reports the results of a retrospective study of the frequency of complications of chronic coronary disease in 51 patients with stable angina subjected to myocardial 99mTc-Sn-pyrophosphate scintigraphy at rest at first screening. In the group with positive scintigraphic results, myocardial infarction and death from cardiac causes was five times as frequent within the next five years as it was in the group where myocardial incorporation of the drug was not observed. The frequency of complications was higher in cases where positive scintigraphic results were combined with cardiomegaly and electrocardiographic signs of transitory ischemia. Positive scintigraphic test with 99mTc-Sn-pyrophosphate can indicate future aggravation of the disease in patients with stable angina pectoris.

Topics: Adult; Aged; Angina Pectoris; Chronic Disease; Electrocardiography; Heart; Humans; Male; Middle Aged; Myocardium; Polyphosphates; Prognosis; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Pyrophosphate; Tin Polyphosphates

Topics: Adult; Chronic Disease; Diphosphates; Humans; Middle Aged; Osteomyelitis; Pentetic Acid; Radionuclide Imaging; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Pyrophosphate; Tibia

In 66 patients suffering on chronic stable angina pectoris myocardial scintigrams with 99mTc-pyrophosphate were evaluated. Patients who had former infarcts or infarct signs in ECG were excluded. 16 normal subjects were used as controls. In all normal subjects and in 35 patients with chronic A.P. a normal myocardial scintigram could be obtained. In the remaining 31 patients a localized myocardial tracer accumulation could be seen. There was a correlation between the tracer accumulation and the limitted left ventricular function. No correlation was found between the severity and the number of involved coronary arteries and a positive scintiphoto. The mechanism of the tracer accumulation is discussed. The results of this investigation show that a positive myocardial scintigram does not prove a myocardial infarction. It is a sign for a insufficiency of the contractility of the left ventricle, probably due to under perfusion.

Topics: Angina Pectoris; Chronic Disease; Diphosphates; Electrocardiography; Humans; Myocardial Infarction; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate