Functional Imaging of Testicular Torsion.

This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients presenting with an acute hemiscrotum for an early and reliable diagnosis of testicular torsion. The technique of testicular perfusion scintigraphy is described, and the characteristic findings are detailed with examples. The imaging characteristics of the various phases of testicular torsion and its differentiation from epididymitis and/or epididymo-orchitis and the other related conditions presenting as an acute hemiscrotum are detailed.

The Clinical Value of Serial Radionuclide Gastric-Emptying Scintigraphy for Objective Evaluation of Gastroparesis in a Patient with Superior Mesenteric Artery Syndrome Post Corrective Surgery.

Superior mesenteric artery syndrome is a rare cause of intestinal obstruction. The condition results from compression of the duodenum between the aorta and the superior mesenteric artery, which causes an impairment of gastric emptying and associated chronic symptoms. There is a need to objectively assess the severity of gastric-emptying disorder in these patients post-treatment to assess the efficacy of the conservative or surgical management.

Dual-tracer radionuclide imaging in hyperparathyroidism: thallium-201 parathyroid scintigraphy revisited.

Objectives: Tc-sestamibi is the current radiopharmaceutical of choice for the localization of hyperactive lesions of the parathyroid glands in patients with hyperparathyroidism. However, there are multiple factors that adversely affect the accumulation and retention Tc-sestamibi in the hyperfunctioning parathyroid tissue, resulting in a false-negative scan. The objective of this study was to investigate the possibility of an incremental diagnostic role of thallium-201 parathyroid scintigraphy in patients with presumably false-negative Tc-sestamibi scan results.

A case of dupable duple duplicity and duplexity.

Duplication anomalies are quite common with ureteral duplication anomalies being the most frequent. Despite the relatively frequent incidence of a horseshoe kidney and duplication anomalies in any individual patient, the combination of horseshoe kidney and bilateral ureteric duplication is a very rare entity and very few cases have been reported to date. We present a case of a patient with a novel combination of a horseshoe kidney and multiple rare congenital renal anomalies and their sequelae.

Radiological and radionuclide investigation of malignant otitis externa.

This study looks at case series of malignant otitis externa, outlines detailed structural (radiological) and functional (radionuclide) investigations, and discusses their utility in the initial diagnosis, patient management and follow up of this condition. Patients were investigated by computerized tomography (CT), magnetic resonance imaging (MRI), two-phase planar and single-photon emission tomography (SPECT), technetium-99m methylenediphosphonate bone scans, gallium-67 planar and SPECT scans, and indium-111 or technetium-99m labelled WBC planar and SPECT scintigraphy. We discuss example case reports with the various radiological and scintigraphic findings and outline a protocol for rational investigation.

Clinical evaluation of technetium-99m infecton for the localisation of bacterial infection.

The aim of the study was to distinguish infection from inflammation in patients with suspected infection using technetium-99m Infecton. Ninety-nine patients (102 studies) referred for infection evaluation underwent imaging with 400 MBq 99mTc-Infecton at 1 and 4 h. Most patients had appropriate microbiological tests and about half (56) had radiolabelled white cell scans as well.

Detection of early asymptomatic esophageal dysfunction in systemic sclerosis using a new scintigraphic grading method.

Objective: To screen patients with systemic sclerosis (SSc) for esophageal disease and to demonstrate a new system of grading dysmotility; to determine the relationship between the symptom of dysphagia and the degree of hypomotility shown by scintigraphy.

Methods: 301 patients with SSc were studied by esophageal scintigraphy using a semisolid orally ingested bolus to detect esophageal dysfunction and gastroesophageal reflux. A new system of grading was used to quantitate the degree of dysfunction, ranging from grade 0 (normal) to grade 4 (severe abnormality).

Comparison of 99mTc infecton imaging with radiolabelled white-cell imaging in the evaluation of bacterial infection.

Background: Bacterial infection can pose a substantial diagnostic dilemma. Techniques involving radiolabelled leucocytes can pinpoint the site of inflammation. However, previous radiolabelling techniques have failed to distinguish between bacterial-mediated infection and non-bacterial inflammation.

Tumour imaging.

This review looks at the nuclear medicine scanning techniques that are available for tumour imaging. It aims to promote an understanding of the specific value of this imaging modality, and thereby help to conserve resources, save time, and assist clinicians in providing optimal care.

Predictive value of captopril transit renography in essential hypertension and diabetic nephropathy.

Captopril renography was utilized to assess the presence of angiotensin II dependent renovascular dysfunction in (1) 28 patients with mild to moderate essential hypertension (EH) with unimpaired renal function, and (2) 25 hypertensive patients with diabetic nephropathy (HDN). These studies were classified according to the diagnostic criteria outlined by the Working Party on Diagnostic Criteria of Renovascular Hypertension with Captopril Renography and the mean parenchymal transit time (MPTT) was used as an index for detecting the presence of angiotensin II dependent renal haemodynamic change. Patients with EH showed non-significant or non-specific alterations in the MPTT.

Diagnostic value of radionuclide phallography with intravenous vasodilator stress in the evaluation of arteriogenic impotence.

Arteriogenic impotence is a major cause of organic erectile dysfunction. We evaluated the diagnostic value of quantitative radionuclide phallography with intravenous pharmacological stress in screening impotent patients for penile arterial inadequacy. Using technetium-99m labelled autologous erythrocytes, dynamic scintigraphy of the penile blood pool was performed.

Captopril renal scintigraphy in patients with hypertension and chronic renal failure.

Unlabelled: The aim of this prospective study was to determine the ability of the captopril renogram to reveal the presence of angiotensin II-dependent renovascular disorder in hypertensive patients with chronic renal failure and to assess the possibility of predicting beneficial effect of angiotensin-converting enzyme (ACE) inhibitors on renal function.

Methods: Forty-one patients were evaluated. Baseline renal scintigraphy was performed with 80 MBq of 99mTc-mercaptoacetyltriglycine (MAG3) injected intravenously.

A pilot study of flaccid penile blood flow patterns in normal subjects and patients with erectile dysfunction.

Dynamic penile scintigraphy was performed using 99Tcm-labelled autologous erythrocytes in five normally potent volunteers and 22 patients with erectile dysfunction including 11 patients with psychogenic and 11 patients with vasculogenic impotence (four arteriogenic, three venogenic, three arteriogenic and venogenic, one arteriogenic and neurogenic). Penile radioactivity changes in the flaccid state were monitored by a gamma camera for 60 min after injection of the radionuclide. The penile time-activity curves of the normal controls characteristically showed secondary pulses of increased activity of variable amplitude, duration and frequency, consistent with phasic increase in penile blood pool.

Volume-dependent intracavernous hemodilution during pharmacologically induced penile erections.

The change in the cavernous hematocrit following induction of pharmacological erection by an intracavernous injection of papaverine hydrochloride was documented in normal controls and patients with impotence. Blood samples taken from the penile cavernosa showed a significantly lower hematocrit compared to the systemic venous blood in all normal subjects. The decrease in the cavernous hematocrit was attributable to dilution of the cavernous blood pool by the injected volume of the drug, since this was not observed in erections produced by visual sexual stimulation.

The effect of intracavernosal haemodilution on the radionuclide quantification of penile vascular changes during pharmacologically induced penile erections.

Radionuclide phallography was performed using 99Tcm-labelled red blood cells in conjunction with pharmacologically induced penile erections. The radioactivity content of aliquots of systemic venous blood taken from the antecubital vein was compared with aliquots of blood withdrawn from the penile cavernosa 20 min after an intracavernosal injection of 10 micrograms prostaglandin E1. The cavernosal samples showed significantly lower counts per unit of blood compared to the systemic venous blood indicating a comparatively lower concentration of tagged red blood cells.