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Biomedical subjects

D Emrich

Publications and source records attributed to D Emrich.

At least 109 records · Page 6Linked to original sources
PubMed1980

[Myocardial scintigraphy with thallium-201 for evaluation of the patency of aorto-coronary bypasses in multiple vessel disease and multiple bypasses (author's transl)].

The reliability of myocardial scintigraphy with thallium-201 in evaluating the patency of aorto-coronary bypasses was examined. In addition to coronary angiography and ventriculography in 16 patients (42 stenosed vessels, 36 bypasses of which 22 were patent) quantitative myocardial scintigraphy was performed after maximum exercise and at rest, pre- and postoperatively. In general, 12 patients with postoperatively improved angina showed an improvement in their scintigram. The analysis of myocardial areas with a bypass showed a decrease of thallium uptake at rest in 39%, regardless of patency occlusion of the bypass. In 85% of these regions an increased thallium uptake was seen after exercise, again independent of the function of the bypass. The data show that myocardial scintigraphy with thallium-201 cannot be utilized in patients with multiple vessel disease and multiple bypasses to evaluate the patency of a particular bypass, but a general assessment is possible, whether myocardial perfusion has improved.

Adult↗
PubMed1980

[Results of quantitative myocardial scintigraphy with thallium-201 at rest and after maximum exercise--critical analysis of predictive value and clinical application (author's transl)].

In 20 normal individuals and 60 patients with CAD, myocardial scintigraphy with thallium-201 was performed after maximum exercise and two hours later at rest. The evaluation of digitized scintigrams was performed quantitatively by means of a 14-halfsegment model. Using ROC analysis, sensitivity and specificity were estimated. Furthermore the predictive value of a thallium scintigram was evaluated by means of the bayesian theorem, comparing the data with coronary angiography and partly also with exercise ventriculography. At a specificity of 90%, sensitivity of scintigraphy for CAD was 97% in 34 patients with previous myocardial infarction and 85% in 26 patients without infarction. Sensitivity for the extent of CAD was 93% for 44 vessels, perfusing infarcted myocardium and 67% for 96 vessels, perfusing non-infarcted myocardium. Sensitivity decreased with increasing extent of CAD and was higher for Cx than for LAD. The predictive value of a positive or negative scintigram was analyzed for different prevalences of CAD. At a low prevalence, e.g. 5%, the predictive value of a pathological scintigram is only 32%, consequently thallium scintigraphy is not applicable as a general screening procedure. At a high prevalence, e.g. 90%, the predictive value of a normal scintigram is only 40%. Therefore thallium scintigraphy seems not to be able to differentiate whether a coronary artery stenosis is hemodynamically significant or not. This was in agreement with the data from exercise cineventriculography. A high predictive value of thallium scintigraphy of about 85% is obtained only in the case of a medium prevalence of CAD, e.g. in asymptomatic patients with pathological Ecg or in patients with atypical angina pectoris. An improvement of the predictive value of myocardial scintigraphy would require other radionuclides than thallium-201, to use higher activities and to allow Ecg-gated myocardial scintigraphy.

Adult↗
PubMed1980

[Quantitative Tl-201 scintigraphy in diagnosis of severity and location of coronary artery disease. Comparison of a Tl-score to invasive and non-invasive parameters (author's transl)].

Thallium-201 scintigraphy was performed in 20 normals and 60 patients (pts) with angiographically proven coronary artery disease (CAD) at rest after maximal exercise for evaluation of severity and location of CAD. The Tl-scintigrams were quantified by a Tl-score. The results of the Tl-score were compared with invasive and non-invasive parameters. Sensitivity asnd specificity of the Tl-score in evaluation of CAD was 90%. In normals, there were no significant differences from rest to exercise (Tl-score less than or equal to 1.2). Twenty-six of the pts with CAD, who had no evidence of myocardial infarction, showed a significant increase of Tl-score from 5.0 +/- 1.7 to 8.7 +/- 2.6 after exercise (p < 0.001). In 34 pts with CAD and a history of MI, Tl-score increased from 24.9 +/- 3.1 to 33.3 +/- 3.8 (p < 0.001). Exercised-induced ischemia was assessed by exercise electrocardiography in 48%, by Tl-score in 62% and by angina pectoris in 77%. In 37 pts, the Tl-score was compared with the coronary score, ejection fraction (EF) and local wall motion derived from biplane cineventriculograms. There was a significant correlation between the Tl-score and the EF: y = 79.13 - 1.11 x, n = 74, r = 0.688 (p < 0.001). No correlation was found between the coronary score and the Tl-score. Hypokinetic wall motion disturbances were assessed by Tl-score in 34% only, whereas akinesia and dyskinesia were detected in 86% (p < 0.001). The data suggest that Tl-scintigraphy even with a quantitative Tl-score is not sufficient for exact assessment of extent and severity of CAD.

Adult↗
PubMed1980

[Qualitative and semi-quantitative analysis of local wall motion abnormalities by gated-blood-pool in comparison to biplane cineventriculography (author's transl)].

Left ventricular wall motion at rest was assessed by the following three methods in 37 patients of whom 12 patients had coronary artery lesions of > 75% and Ecg-signs of transmural MI: A) qualitative analysis of GBP, B) semi-quantitative analysis of GBP, C) qualitative analysis of a biplane cineventriculogram. Sensitivity and specificity of each method were evaluated based on the cineventriculographic findings. Specificity of method A was 83%, of method B 100%. Sensitivity of method A was 88%, of method B 84%. Concordance of methods B and C was 92.8% (167/180 left ventricular segments). Discordance between the two methods was found only in 1 segment judged to be akinetic and in 12 segments judged to be hypokinetic by one of the two methods.

Adult↗
PubMed1979

[Changes in thyroid function after application of iodinated contrast media to normal subjects (author's transl)].

In 39 patients without thyroid disorder the influence of radiographic contrast media (Conray 60, Biligram) on the thyroid function was studied. 6 weeks after the application of the iodine compounds a significant increase of T3 in blood serum could be established being accompanied by decreased TSH level and reduced response of TSH rpoduction to TRH injection. These findings showed to be even more marked 6 months later. It is assumed that the observed hormonal changes may possibly be due to a persistent Wolff-Chaikoff block induced by diffusion of free iodide and subsequent shifting of the intrathyroidal MIT/DIT ratio, which is finally followed by an increase of T3-levels in serum.

Adolescent↗
PubMed1979

[Cytological diagnosis of thyroiditis (author's transl)].

In 2347 patients fine needle aspiration of the thyroid gland was performed. In 49 cases (2.1%), a final diagnosis of thyroiditis was established. Non-specific granulomatous thyroiditis occurred most frequently (n = 24), followed by lymphocytic hypertrophic thyroiditis Hashimoto (n = 18), focal lymphocytic (n = 5), atrophic lymphocytic (n = 1) and chronic fibrosing thyroiditis (n = 1). Fine needle aspiration biopsy is most suited to diagnose granulomatous thyroiditis. In Hashimoto's thyroiditis cytological investigations are superior to estimation of thyroglobulin antibodies. The cytological method is of little value for the diagnosis of atrophic lymphocytic and chronic fibrosing thyroiditis.

Biopsy, Needle↗
PubMed1979

[Non bacterial thyreoiditis, diagnosis and differential diagnosis (author's transl)].

Retrospective analysis of signs, symptoms, and laboratory data (BSR, thyroid scan, thyroxine, triiodothyronine, TRH-test and antibodies against thyroglobulin) was performed on 68 individuals. Diagnosis of subacute and of chronic thyreoiditis was proven in 26 patients and 21 patients respectively by cytological examination. It was excluded by the same procedure in 21 patients, in whom there were some indications of these two kinds of thyroiditis. The following mosaic of clinical and laboratory parameters showed a sensitivity of 0.73 at specificity of 0.95 for diagnosis and exclusion of the two diseases: spontaneous pain, pain by palpation, fever, elevated BSR, thyroid scan, free thyroxine index, and TRH-test.

Adolescent↗
PubMed1979

[Typical presentation of sequential scintigraphy images in the diagnosis of cyanotic heart disease in the newborn, using a computer-assisted imaging technique (author's transl)].

The technique of sequential scintigraphy in investigating newborn infants in order to exclude or detect cyanotic congenital heart disease has been improved. The primary scintigraphic data are recorded digitally (list mode, 1 ms, 128 by 128 pixels) and evaluated automatically as a sequence of 1/2 s frames in 1/8 s increments. A 35 mm film is exposed to a scanning pulsed light spot on a CRT-screen with quantitative correspondence between local count density and the local number of light pulses. A series of highly resolved images of the rapidly changing scintigraphic pattern is achieved in 30 min. The results of 3 investigations are discussed. They prove the importance of adequate spatial resolution and definition in time in nuclear angiocardiography in infancy. Three case results are discussed in detail. In one case cardiac catheterisation and angiocardiography had been omitted, since the radioisotopic findings excluded cyanotic congenital heart disease. Two further investigations are discussed with reference to the findings at cardiac catheterisation.

Angiocardiography↗
PubMed1979

[The determination of the left ventrical volume curve without background correction and its validation by direct intercomparison with the ejection fractions as determined by biplane laevocardiography (author's transl)].

Background corrections applied on the left ventricular volume curve determined by the "gated blood pool"--method are based on an estimated rather than on a directly measured background. This imposes an uncertainty on the values determined from the volume curve, especially on the ejection fraction. A method which does not require background correction may be applied if all available measurement and evaluation facilities are utilized fully. High temporal and spatial resolution is of fundamental importance, permitting the exact determination of the time-dependent scintigraphic contour variations of the left ventricle during the mechanical action of the heart. A good criterion of the validity of the volume curves with respect to interfering background radiation is the ejection fraction calculated from these curves. The direct intercomparison of 10 ejection fractions obtained by an expanded "gated blood pool"-method, employing cardiac catheterization, immediately before a biplane laevocardiography demonstrated very good agreement. A small systematic underestimation of the ejection fraction by the nuclear method was observed. This understimulation shows that the influence of the true background is small if other interfering count rate contributions or methodical uncertainties are excluded systematically.

Angiography↗
PubMed1979

[Radioisotopic methods of diagnosis in pulmonary embolism (author's transl)].

Pulmonary profusion scintigraphy is a simple, noninvasive and low-cost method for identifying acute pulmonary embolism. Although the method is highly sensitive, it is relatively non-specific, so that final assessment must include history, clinical findings and plain roentgenography of the thorax. Pulmonary scintigraphy is indicated whenever acute pulmonary embolism is suspected, on account of the therapeutic consequences resulting therefrom, in all cases where clinical findings and basic diagnosis cannot definitely establish the disease. It must not, however, be considered as an alternative to angiography of the pulmonary artery; as a matter of fact, it should be employed early and frequently in view of the high percentage of undiagnosed embolism of the lungs during the patients' lifetime.

Acute Disease↗
PubMed1979

[Quantitative exercise scintigraphy of the myocardium with 201Tl--methods and normal values (author's transl)].

Quantitative myocardial scintigraphy was performed in 20 normal individuals after maximum exercise and after two hours of rest. A mobile Anger camera with converging collimator and a Data-General computer with a 128 x 128 matrix were used. Quantitative analysis of data was performed on the basis of a 14-halfsegment model. Quantitative normal values after exercise and after redistribution of activity during rest are presented.

Adult↗
PubMed1978

[The use of nuclear medicine in the examination to liver and spleen (author's transl)].

The employment of scintigraphy in the examination of liver and spleen represents a simple and rapid diagnostic method which hardly burdens the patient since it is non-invasive. The accuracy ratings in respect of focal lesions show that it should not be over-estimated. When used in a meaningful and relevant manner within the spectrum of all available diagnostic measures, however, liver-spleen scintigraphy will often supply significant information.

Humans↗