technetium-tc-99m-sulfur-colloid and Infant--Newborn--Diseases

Scintigraphic studies of swallowed 99m Tc-sulphur colloid mixed with a few millilitres of liquid, performed on 400 paediatric patients of all ages, allowed visualisation of foregut function and measurement of oesophageal transit time and gastric emptying proportions. This non-invasive and physiological procedure requires a standard gamma camera with computing facilities and was performed as an outpatient routine. It proved very effective for the detection of gastro-oesophageal reflux and aspiration of refluxed liquid in patients of all ages but especially in neonates. The relevance of these scintigraphic results to oesophagitis, repeated respiratory problems, cyanotic and apnoeic spells and alternative methods of investigation is described.

Topics: Apnea; Esophagitis, Peptic; Female; Gastric Emptying; Gastrointestinal Motility; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Pneumonia, Aspiration; Radionuclide Imaging; Respiration Disorders; Sudden Infant Death; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

After the intravenous administration of Tc-99m sulfur colloid, there was found homogeneous lung, renal, and splenic uptake with absence of uptake by the liver and bone marrow of a nine-day-old female infant. More than 20 other doses were dispensed from the same Tc-99m sulfur colloid preparation with the expected biodistribution. A necropsy done two days later showed diffuse hepatic hemorrhagic necrosis without evidence of intravascular fibrin deposition in the lungs or kidneys. The underlying cause of the infant's disease was a Coxsackie B2 viral infection, based upon positive postmortem viral cultures of kidney and liver tissues and characteristic histopathologic lesions of the central nervous system and viscera. The altered biodistribution presumably reflected marked impairment of Kupffer cell function and an apparent increase in pulmonary macrophages.

Topics: Coxsackievirus Infections; Enterovirus B, Human; Female; Hemorrhage; Hepatitis, Viral, Human; Humans; Infant, Newborn; Infant, Newborn, Diseases; Liver; Liver Diseases; Necrosis; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

The use of multiple imaging modalities to diagnose hepatic hemangioendothelioma in a neonate is demonstrated. This approach avoided operative intervention to establish the diagnosis. Tc-99m sulfur colloid and Tc-99m PIPIDA scintigraphy was used to define the nature of sonographic hypoechoic structures in the liver, and angiography was employed to confirm the suspected diagnosis.

Topics: Hemangioendothelioma; Humans; Imino Acids; Infant, Newborn; Infant, Newborn, Diseases; Liver; Liver Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

99mTc colloid scintigraphy is a sensitive technique for the detection of gastro-oesophageal reflux, compared to X-ray studies. A quantification index of reflux is used and can be of value when there is concern about the significance of a positive result. Continuous monitoring during one hour increases by 25% the detection of reflux in comparison with a 30 min test. In our series, no case of lung aspiration was recognized using this technique. The scintiscanning index cannot predict the existence of an associated oesophagitis.

Topics: Barium; Computers; Esophagoscopy; Gastroesophageal Reflux; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Radiography; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

A patient is described who demonstrated accumulation of Tc-99m-sulfur colloid in both the lung and kidney following treatment for disseminated intravascular coagulation. This phenomenon has been demonstrated experimentally in animals following the induction of disseminated intravascular coagulation, but to our knowledge has not been previously described in humans.

Topics: Colloids; Disseminated Intravascular Coagulation; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Kidney; Liver Neoplasms; Lung; Neuroblastoma; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid