technetium-tc-99m-sulfur-colloid and Necrosis

Drug induced hepatitis is a rare complication of thiourea antithyroid drugs. In some patients, the hepatotoxicity may be severe and lead to submassive hepatic necrosis (SHN). Submassive hepatic necrosis is a potentially fatal complication which is usually recognized on the liver biopsy and histological examination or autopsy. In the case presented here, SHN was identified on Tc-99m SC liver images. Sharply defined intrahepatic photopenic abnormalities without significant colloid shift were noted. SPECT images were most remarkable and exhibited extensive liver necrosis. Resolution of hepatic abnormalities correlated with clinical and biochemical resolution of SHN. In patients with propylthiouracil hepatotoxicity, serial liver SPECT images with Tc-99m SC appear helpful for the diagnosis and follow up of SHN and, in an appropriate clinical context, may obviate the need for liver biopsy.

Topics: Adult; Chemical and Drug Induced Liver Injury; Female; Graves Disease; Humans; Liver; Necrosis; Propylthiouracil; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon

A 74-year-old woman underwent two operations to correct an aortoduodenal fistula and to have an axillofemoral bypass graft inserted; these required temporary vascular occlusion. Her hepatic function test results began deteriorating. Initial and follow-up Tc-99m sulfur colloid studies revealed activity in the kidneys, consistent with disseminated intravascular coagulation. There was significant radiocolloid in the bone marrow and lungs, suggesting severe hepatic dysfunction. The spleen was not demonstrable on dynamic images or static views. In addition, there was a significant lateral hepatic defect, with a "lung overlap." The splenic lack of function and the hepatic lesion were due to necrosis (demonstrable on CT imaging), likely related to the prior vascular clamping.

Topics: Abdomen; Aged; Blood Vessels; Constriction; Female; Humans; Liver; Necrosis; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid

The effect of platelet activating factor (PAF) injections on the uptake of 99mTc-SC (99mTc-SC (99mTc-sulphur colloid) was determined in vivo. PAF (2 micrograms) injected intravenously into unanaesthetized, unrestrained rats was associated with the development of lesions in the small intestine and alteration of 99mTc-SC uptake in vivo. 99mTc-SC uptake into the lung was increased while spleen uptake was decreased. Pretreatment of the animals with a PAF antagonist, SRI-64-441, prevented the intestinal lesions and alterations of 99mTc-SC uptake. Macrophages, isolated from lung lavage of the PAF-treated rats, demonstrated a decreased generation of hydrogen peroxide in vitro. The present results suggest that, in addition to its other effects on the immune system, PAF can also alter the in vivo phagocytic activity of the reticuloendothelial system in the rat.

Topics: Animals; Burns; Cecum; Disease Models, Animal; Injections, Intravenous; Intestine, Small; Mononuclear Phagocyte System; Necrosis; Platelet Activating Factor; Rats; Stomach; Technetium Tc 99m Sulfur Colloid

A number of new radiopharmaceuticals have been developed to increase the diagnostic utility of nuclear medicine in cardiac diseases. The radiochemistry and dosimetry of and clinical experience with these new agents are summarized, and are compared with more widely used methods for assessing myocardial perfusion (thallium-201 scintigraphy) and ventricular function (technetium-99m radioangiography). Emerging techniques for the evaluation of myocardial necrosis and metabolism are also presented, with emphasis on the use of radiolabeled antimyosin antibody and fatty acid analogue imaging in ischemic heart disease.

Topics: Glucose; Gold Radioisotopes; Half-Life; Heart; Humans; Iridium; Krypton; Myocardium; Necrosis; Pentetic Acid; Radioisotopes; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed; Xenon Radioisotopes

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

2 patients with premortem marrow necrosis in acute leukemia are discussed. A review of the course of each patient plus those in the literature suggests that premortem marrow necrosis may not be a poor prognostic sign in acute lymphoblastic leukemia but generally precedes a prolonged and fatal pancytopenia in acute myelogenous leukemia. The technetium-99m rhenium sulfur colloid marrow scan was found to be of value in assessing the extent and degree of necrosis of the marrow as well as in documenting and predicting marrow recovery following chemotherapy.

Topics: Aged; Biopsy, Needle; Bone Marrow; Bone Marrow Examination; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Necrosis; Prognosis; Radionuclide Imaging; Rhenium; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adult; Anemia, Sickle Cell; Biopsy; Bone Marrow; Female; Fever; Humans; Mononuclear Phagocyte System; Necrosis; Pancytopenia; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid