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

Two cases of Erdheim-Chester disease are presented: a 26-year-old white male patient with lipoidgranulomatosis of numerous long and flat bones and infiltration of pericardium, pleura, liver, spleen, thyroid, skin, conjunctiva, gingiva, and false vocal cord; and a 54-year-old white male with involvement of bones, orbits, brain, pericardium, and retroperitoneum. The scintigraphic findings in this disease are described, and a comprehensive review of the 27 previously reported cases is given including an assessment of the value of scintigraphy for diagnosis and follow up of this rare disease.

Topics: Adult; Bone Diseases; Cholesterol; Follow-Up Studies; Granuloma; Humans; Lipidoses; Male; Middle Aged; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Topics: Abnormalities, Multiple; Female; Humans; Infant, Newborn; Intellectual Disability; Lymphedema; Lymphoscintigraphy; Male; Obstetric Labor, Premature; Pregnancy; Preoperative Care; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Sulfur Colloid

Children with cyclic vomiting syndrome have a characteristic periodicity, and this could be due to abnormal gastric myoelectrical activity detectable by cutaneous electrogastrography (EGG). Fifteen children, aged 4-15 years, with CVS (eight symptomatic and seven asymptomatic at the time of study) underwent EGG and were compared to five normal and four disease control children. The relative tachygastria activity (RTA) or power ratio was calculated in each group. Five of the eight symptomatic CVS children showed marked episodes of tachygastria preprandially and all showed tachygastria postprandially. The asymptomatic CVS children showed tachygastria only postprandially after the test meal. RTA index and or power ratio of symptomatic children was significantly different from the asymptomatic CVS children (P = 0.001), normal (P = 0.007) and disease control children (P = 0.006). In a subsequent study, 2-hr gastric emptying 99mTc scintiscans were performed in 28 CVS children and compared to eight healthy control children. Twelve of 16 CVS children (75%) showed abnormal gastric emptying, and 7 of 28 (25%) showed abnormal EGG with significant tachygastria. The CVS children had significantly higher RTA both preprandially (P < 0.05) and postprandially (P < 0.05). Our results demonstrate that accelerated gastric rhythm was seen during the acute episodes of half of the CVS patients studied. Abnormal EGGs and higher RTA or power ratios were associated with delayed gastric emptying in the CVS children. Abnormal gastric myoelectrical activity may play a role in the pathogenesis of CVS syndrome.

Topics: Adolescent; Adult; Child, Preschool; Electrodiagnosis; Female; Gastric Emptying; Humans; Male; Myoelectric Complex, Migrating; Periodicity; Postprandial Period; Signal Processing, Computer-Assisted; Stomach; Syndrome; Technetium Tc 99m Sulfur Colloid; Vomiting

Topics: Aged; Bone Marrow; Bone Neoplasms; Gallium Radioisotopes; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Lymphoma, Large-Cell, Immunoblastic; Male; Radionuclide Imaging; Syndrome; Technetium Tc 99m Sulfur Colloid

For the evaluation of a variety of hepatosplenic disorders, SPECT complements planar 99mTc-sulfur colloid liver/spleen imaging. By isolating small, ectopic or poorly functioning spleen(s) from overlying or adjacent liver, SPECT imaging should facilitate identification of splenic tissue in infants with suspected heterotaxy syndrome.. During a 10-yr period, 10 planar-only and 9 planar-plus-SPECT liver/spleen scans were obtained from 15 infants, 13 of whom were less than 1 mo of age at first examination. Four of the planar-only group had follow-up planar-plus-SPECT imaging. Scintigraphic diagnosis regarding presence of splenic tissue was correlated with clinical diagnosis.. Thirteen infants had splenic tissue; two were asplenic. Planar-only imaging provided correct diagnoses in six [four with, two without spleen(s)] but was negative or equivocal in four infants. Planar-plus-SPECT imaging was positive in all in whom it was performed; moreover, in 4/13 infants (31%), splenic tissue was documented only by SPECT imaging.. Particularly when planar views are inconclusive, SPECT imaging is invaluable for identification and localization of functioning splenic tissue in infants with suspected heterotaxy syndrome.

Topics: Abnormalities, Multiple; Female; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Liver; Male; Retrospective Studies; Sensitivity and Specificity; Situs Inversus; Spleen; Syndrome; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon

Byler's syndrome is a rare form of autosomal recessive intrahepatic cholestasis that is fatal in children. A 10-year-old girl diagnosed with Byler's syndrome underwent reduced-size liver transplantation using lateral segments of her living mother's liver. The donor's and the recipient's liver functions after transplantation were evaluated using Tc-99m disofenin and Tc-99m SC to investigate morphology, liver perfusion, and hepatobiliary function.

Topics: Child; Cholestasis, Intrahepatic; Female; Genes, Recessive; Hepatectomy; Humans; Imino Acids; Liver Transplantation; Organotechnetium Compounds; Radionuclide Imaging; Syndrome; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid; Tissue Donors

Three cases of postpartum hepatic hemorrhage in the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELP) were diagnosed by Tc-99m sulfur colloid liver-spleen scanning. Two patients had follow-up scans. One showed rapid resolution of the hematoma on the repeat scan performed six days later, while the other showed delayed resolution on the repeat scan four weeks later. All patients received non-surgical supportive therapy with or without blood transfusion after delivery, and recovered well. Usefulness of radionuclide liver-spleen scanning in the diagnosis of peripartum hepatic hemorrhage and monitoring course of the disease is emphasized.

Topics: Adult; Female; Hemolysis; Hemorrhage; Humans; Liver; Liver Diseases; Pre-Eclampsia; Pregnancy; Puerperal Disorders; Radionuclide Imaging; Syndrome; Technetium Tc 99m Sulfur Colloid; Thrombocytopenia

The thesis of primariness of the disease and of its osseous tissue manifestations is discussed on the grounds of the results from a complex study on 3 patients. The periosteal ossifying hyperplasia and disturbances in the osseous tissue structure develop with no other organ symptomatics and in the absence of any changes in the available laboratory and immunological indices. The macromorphological X-ray characteristic corresponds to the radionuclide tests of the study with 99MTc-pertechnetate, 99MTc-pyrophosphate and 99MTc-sulfocolloid, informing about abnormal vascularization index, growth of bone-marrow tissue and intensified joint-tissue anabolism.

Topics: Adult; Arthrography; Diphosphates; Humans; Joints; Middle Aged; Osteoarthropathy, Primary Hypertrophic; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Syndrome; Technetium; Technetium Tc 99m Pyrophosphate; Technetium Tc 99m Sulfur Colloid

Radionuclide arthrography of the knee is described using Tc-99m sulfur colloid, which is injected into the synovial cavity following partial distension of the joint space with saline. The preliminary findings in Baker's cyst are described. There appear to be four patterns: 1) a herniation or cyst that can be posterior, inferior, medial or lateral to the knee synovial space; 2) a limited leak inferiorly toward the calf or superiorly toward the thigh; 3) extensive leak: giant cyst found in patients with rheumatoid arthritis; 4) multiple "cysts" or communications with the knee synovial space. The series is small, and more work is needed before these preliminary findings can be used as firm categories. Radionuclide arthrography should be considered in patients with unexplained calf pain or pain behind the knee, especially with a history of previous internal knee derangement, or rheumatoid arthritis in whom ruptured cysts can closely mimic acute thrombophlebitis. Radionuclide arthrography has certain advantages over contrast arthrography and also arthroscopy in the diagnosis of Baker's cyst.

Topics: Humans; Knee Joint; Radionuclide Imaging; Syndrome; Synovial Cyst; Technetium Tc 99m Sulfur Colloid

Topics: Colloids; Female; Heart Defects, Congenital; Humans; Infant, Newborn; Radionuclide Imaging; Spleen; Splenic Diseases; Sulfur; Syndrome; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adolescent; Bile Duct Diseases; Bile Ducts, Intrahepatic; Child; Child, Preschool; Humans; Imino Acids; Infant; Organotechnetium Compounds; Radionuclide Imaging; Sulfur; Syndrome; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Asplenia was suspected in one patient with combined immunodeficiency syndrome and 5 with congenital cardiac anomalies who had Howell-Jolly bodies on peripheral blood smears. 99mTc-sulfur colloid scans were equivocal for absence of the spleen. When they were compared with the 99mTc-PIPIDA hepatobiliary images, a discrepancy in organ morphology between the two scans indicated that the spleen was present, whereas similarity of the two images suggested asplenia. This procedure was useful in establishing asplenia in 4 patients and confirming the presence of a rudimentary or ectopic spleen in 2 others. Unequivocal demonstration of the spleen on the sulfur colloid scans makes the hepatobiliary study unnecessary, while unequivocal demonstration of a normal-appearing liver without splenic activity may warrant a tagged red-cell study for a more complete evaluation.

Topics: Erythrocyte Inclusions; Female; Heart Defects, Congenital; Humans; Imino Acids; Immunologic Deficiency Syndromes; Infant; Infant, Newborn; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Spleen; Sulfur; Syndrome; Technetium; Technetium Tc 99m Sulfur Colloid

Ten children underwent splenic imaging with heat-denatured red blood cells labeled with technetium-99m (Tc-99m DRBC). The presenting problems included the heterotaxia syndrome, recurrent idiopathic thrombocytopenic purpura following splenectomy, mass in the left posterior hemithorax, and blunt abdominal trauma. In nine patients, the presence or absence of splenic tissue was established. A splenic hematoma was identified in the tenth patient. All patients were initially scanned with Tc-99m sulfur colloid (Tc-99m SC), and were selected for Tc-99m DRBC scintigraphy only after the results of the SC scans failed to establish the clinical problem beyond doubt. The availability of kits containing stannous ions, essential for efficient and stable labeling of red blood cells with Tc-99m and requiring only a small volume of blood, make splenic scintigraphy in children a relatively simple and definitive diagnostic procedure, when identification of splenic tissue is of clinical importance.

Topics: Abdominal Injuries; Adolescent; Child, Preschool; Erythrocytes; Female; Humans; Infant; Infant, Newborn; Isotope Labeling; Male; Purpura, Thrombocytopenic; Radionuclide Imaging; Reagent Kits, Diagnostic; Spleen; Sulfur; Syndrome; Technetium; Technetium Tc 99m Sulfur Colloid