The role of 99m-Tc HMPAO SPECT in the diagnosis of Creutzfeldt-Jacob disease.

A patient with acute dementia underwent imaging of the brain with technetium-99m hexamethylpropyleneamine oxime single-photon emission computed tomography. Regional perfusion abnormalities were identified in multiple locations, particularly in the left frontal lobe. This information was used to direct an open brain biopsy, which led to a diagnosis of Creutzfeldt-Jacob disease.

Intracavitary use of radioactive colloidal phosphorus 32 in the treatment of epithelial ovarian cancer.

The use of radioactive colloidal phosphorus 32 (32P) in the treatment of epithelial ovarian cancer continues to be controversial. One institution's experience with the use of 32P in 30 patients with epithelial ovarian cancer was reviewed retrospectively. One hundred percent of attempts at placement of 32P intra-abdominally were ultimately successful.

Bile leak following laparoscopic cholecystectomy.

The incidence and significance of bile leak after open cholecystectomy have been studied. The purpose of this study was to determine the incidence and significance of postoperative bile leak associated with both emergent and elective laparoscopic cholecystectomies. One thousand four hundred patients undergoing laparoscopic cholecystectomy from July 1990 to January 1995 were retrospectively reviewed.

Evaluation of the painful prosthetic joint. Relative value of bone scan, sedimentation rate, and joint aspiration.

Seventy-two joint arthroplasties undergoing total hip or total knee surgery were studied prospectively with plain radiographs, three-phase bone imaging (3PBI), erythrocyte sedimentation rate (ESR), aspiration of the joint for culture, and multiple intraoperative cultures at the time of revision. Intraoperative cultures and the operative appearance were used to form a diagnosis of definite infection (unequivocal microbiology and gross sepsis), possible infection (positive microbiology or gross sepsis), or no infection (neither positive microbiology nor gross sepsis). For the preoperative diagnosis of infection, as opposed to aseptic loosening, 3PBI alone had a sensitivity of 33% and a specificity of 86%.

Multiple coarctations of the pulmonary artery: scintigraphic appearance.

A case of angiography-proven multiple coarctations of the pulmonary arteries is presented. The patient had a history of long-standing exertional dyspnea and intranasal cocaine use. A chest radiograph suggested oligemia in the left lung and enlargement of the right pulmonary artery, prompting ventilation and perfusion radionuclide lung imaging.

Pulmonary embolism after hip or knee replacement: postoperative changes on pulmonary scintigrams in asymptomatic patients.

Serial pulmonary imaging has proved to be effective in the evaluation of patients undergoing total joint arthroplasty. A clinical dilemma arises in asymptomatic patients whose postoperative pulmonary images differ from the preoperative images. The authors prospectively evaluated 403 patients with serial imaging to determine the significance of changed postoperative images in asymptomatic patients undergoing total hip or knee arthroplasty.

Dual isotope parathyroid imaging.

Eleven patients who had clinical and biochemical evidence of primary hyperparathyroidism were studied using dual isotope technetium-thallium parathyroid subtraction imaging. The parathyroid scans correctly identified all surgically proven parathyroid adenomas. Three abnormal foci also were identified that were not parathyroid adenomas.