The diagnosis of coronary artery disease in hypertensive patients with chest pain and complete left bundle branch block: utility of adenosine Tc-99m tetrofosmin SPECT.

Purpose: Hypertensive patients with complete left bundle branch block who experience chest pain present special problems in the radionuclide diagnosis of coronary artery disease (CAD). The aim of this study was to assess the utility of Tc-99m tetrofosmin SPECT for the diagnosis of CAD in 35 hypertensive patients with left bundle branch block hospitalized for chest pain.

Materials And Methods: Images were analyzed semiquantitatively for the presence of both fixed or reversible perfusion defects (method A) or only reversible defects (method B) in the distribution of the left anterior descending artery (LAD) territory.

Predicting cardiac events with Tl201 dipyridamole myocardial scintigraphy in renal transplant recipients.

Background: Renal transplant recipients should be screened for coronary artery disease. The purpose of this study was to evaluate the usefulness of thallium-201 dipyridamole myocardial perfusion single-photon emission computed tomography (SPECT) to predict major cardiac events in these patients.

Methods And Results: Eighty-two consecutive patients (61 males) in hemodialysis (HD) treatment, awaiting renal transplantation, underwent dipyridamole Tl-201 SPECT for pretransplant risk stratification.

Regional expiratory flow limitation studied with Technegas in asthma.

Regional expiratory flow limitation (EFL) may occur during tidal breathing without being detected by measurements of flow at the mouth. We tested this hypothesis by using Technegas to reveal sites of EFL. A first study (study 1) was undertaken to determine whether deposition of Technegas during tidal breathing reveals the occurrence of regional EFL in induced bronchoconstriction.

Prognostic value of the acute DMSA scan in children with first urinary tract infection.

We attempted to verify in a group of 101 children with first urinary tract infection whether it was possible to identify groups of patients with different risks of developing renal scarring by taking into account both the extent of kidney involvement documented in the acute phase of infection using a dimercaptosuccinic acid (DMSA) scan, and the presence or absence of vesicoureteral reflux (VUR). The frequency of persistent lesions in kidneys with mild-moderate lesions (less than 50% of kidney involvement) in the presence of VUR or in non-refluxing kidneys was similar (P=0.1447), while the frequency of persistent lesions in kidneys with severe lesions in the presence of VUR was significantly higher than the frequency of persistent lesions in non-refluxing kidneys (P=0.

Acute renal cortical scintigraphy in children with a first urinary tract infection.

This prospective study, performed in 101 children with a first symptomatic urinary tract infection (UTI), evaluates the diagnostic value of clinical, biological, and ultrasound parameters in detecting children with acute renal infection documented by dimercaptosuccinic acid (DMSA) scintigraphy. In children with a positive DMSA scan, mean C-reactive protein (CRP) was higher than in children with a normal DMSA scan (114+/-64 vs. 67+/-38 mg/dl, mean+/-SD, P=0.

Indium-111 labelled white blood cell scintigraphy in cranial and spinal septic lesions.

Cranial and spinal infections are severe events that require timely diagnosis and treatment. Physical and neurological examination, laboratory tests and radiological imaging may be insufficient for assessing cranial and spinal septic lesions. This study aimed to evaluate the accuracy of indium-111 white blood cell (WBC) scan in assessing the presence of leucocytes in intracranial and spinal lesions, and in the diagnosis, management and follow-up of primary, post-traumatic and post-surgical infections.

Sentinel node mapping for malignant melanoma.

Sixty-seven patients with malignant melanomas were seen in our institute since 1998. We looked for a sentinel node in 26 (38%) patients with lesions thicker than 1 mm, employing a double technique: staining with methylene blue and gamma probe mapping after injection of 99mTc. Forty-six nodes were retrieved, 25% of them containing tumor cells.

Estimation of glomerular filtration rate using chromium-51 ethylene diamine tetra-acetic acid and technetium-99m diethylene triamine penta-acetic acid.

Simultaneous measurements of the clearance rate of chromium-51 ethylene diamine tetra-acetic acid (51Cr-EDTA) and technetium-99m diethylene triamine penta-acetic acid (99mTc-DTPA) were performed in 54 patients with a range of function between 9 and 176 ml/min. Using multiple blood samples the two clearance values correlated well (r = 0.97, SEE 8.

Cutaneous, musculoskeletal and bone flow scintiscan by intravenous infusion of 99mTc-MDP (Diphosphonate) in the evaluation and control of patients treated with spinal cord stimulation for ischaemic pain.

In patients affected by unbearable pain secondary to peripheral vascular disorders beyond surgical repair such as thromboangitis obliterans, diabetic microangiopathy, arteriosclerosis obliterans, there is a need to establish the degree of micro-circulation functionality before proceeding with invasive pain therapy, such as Spinal Cord Stimulation (SCS). From our series some cases of refractory ischaemic pain subjected to nuclear medicine techniques assessment before and after SCS implant will be presented; these data suggest that the use of radionuclides for quantifying regional perfusion, in view of the information it offers us both in the dynamic angiographic phase and in the later static phase, constitutes a very valid aid in the diagnosis and treatment of chronic pain conditions of ischaemic origin. Cutaneous, musculoskeletal and bone flow scintiscan is a non-invasive procedure which allowed us to make an objective selection of patients who are candidates for prolonged conservative treatment thus limiting the incidence of ineffective permanent SCS implants.

Variations in regional cerebral blood flow investigated by single photon emission computed tomography with technetium-99m-d, l-hexamethylpropyleneamineoxime = l-h during temporary clipping in intracranial aneurysm surgery: preliminary results.

Single photon emission computed tomography with technetium-99m-d, l-hexamethylpropyleneamineoxime was used to assess variations in regional cerebral blood flow during temporary clipping in the course of intracranial aneurysm surgery and during the postoperative period in 20 patients, 14 of whom underwent temporary clipping. Of these 14 patients (Group A), 9 had aneurysms of the anterior communicating artery, 2 had aneurysms of the middle cerebral artery, and 3 had aneurysms of the carotid siphon. Temporary clips were applied, according to the site of the lesion, on A1, on the trunk of the middle cerebral artery, or on the trunk of the internal carotid artery.

[A study of the variations in myocardial perfusion induced by systemic thrombolysis in acute myocardial infarct using sequential scintigraphy with 201-thallium].

To assess scintigraphic changes induced by intravenous streptokinase therapy, serial rest redistribution thallium-201 perfusion imaging was performed in 62 patients with acute myocardial infarction lasting less than 6 hours. Twenty-seven patients randomized to treatment with intravenous streptokinase (group A) and 35 to conventional therapy (group B) underwent thallium-201 scintigraphy as soon as possible after admission to the coronary care unit (early study). Regional myocardial perfusion was assessed using thallium-201 scintigraphy 7-9 days later in each patient (late study).

[Heterotopic autotransplant of the spleen after splenectomy in traumatic rupture. Personal experience and scintigraphic follow-up].

Certain aspects of OPSI (Overwhelming Post-Splenectomy Infection) are examined, mainly its considerable gravity, its relatively high incidence, especially in children; its difficult prophylaxis with a report on personal experience of ectopic autotransplant of spleen tissue in two young patients after splenectomy for traumatic rupture. The technique was found to be simple and quickly performed. Scintigraphic follow-up for over 4 years after the operation showed satisfactory growth in the transplanted spleen tissue.

Single photon emission computed tomography with 99mTc HM-PAO in the study of focal epilepsy.

We used 99mTc HM-PAO SPECT to study 50 patients with partial epilepsy: 47 interictally and 3 during a seizure. All 3 patients studied during a seizure presented an area of increased tracer uptake. Of those in whom recordings were taken during seizure-free intervals 35 (74%) showed perfusion asymmetries: 27 (57%) with decreased and 8 (17%) with increased uptake.

Cerebral scintigraphy with 111indium oxine-labelled leukocytes in the differential diagnosis of intracerebral cystic lesions.

CT scanning and scintigraphy with 111Indium-oxide-labelled white blood cells were used to study 32 cases of intracerebral cystic lesions. The results and the criteria of positivity used to lower the false positive rate are discussed. A new criterion, designed to assess the time course of the scintiscan and so reduce still further the frequency of false positives is put forward.

Differential diagnosis of CT-hypodense cranial lesions with indium-111-oxine-labeled leukocytes.

Scintigraphy using indium-111-oxine-labeled white blood cells was used as a complementary diagnostic study in the differential diagnosis of 20 intracerebral cystic lesions for which computerized tomography scanning did not exclude abscess. To lower the rate of false-positive findings with scintiscanning, three criteria of positivity were tested in the 20 lesions. The most stringent criterion yielded 100% sensitivity, 94% specificity, and 96% diagnostic accuracy.

[Contribution of computerized radioisotope angiocardiography to the diagnosis of arrhythmogenic dysplasia of the right ventricle].

Radionuclide angiography phase analysis was performed in two patients presenting with recurrent right-sided ventricular tachycardia without angiographic evidence of valvular or ischemic heart disease. A dilated, poorly contracting (EF = 20%) right ventricle with localized dyskinetic areas was found in contrast with normal left ventricular function. The suggested diagnosis of Arrhythmogenic Right Ventricular Dysplasia was confirmed by right ventricular angiography performed in one patient.