Visualization of lumbar spine and sacral area by dynamic renal scan.
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Biomedical subjects
Publications and source records attributed to J Banzo.
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A case of intracranial meningioma is reported in a 5-month-old infant. To date, 25 cases have been reported in the world literature in children less than 1 year of age. Macrocephaly was the most prominent clinical finding. Skull radiological studies, head CT scans, and cerebral angiography were definitive tools in making the diagnosis. Pathological analysis was conclusive. Complete surgical extirpation was the treatment of choice; the tumor weighed 600 g. The child remains stable 24 months later.
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Using a gamma camera and image processing, 140 patients with known cerebral metastases had static images obtained after i.v. 99mTc-(Sn)-DTPA. Of these, 94.3% showed one or more lesions. A total of 120 of the patients had cerebral dynamic studies. Only 55.8% of these had abnormalities on the dynamic sequence. These values are not too dissimilar from prior studies using older equipment. The results suggest the need for additional radiopharmaceuticals for following cerebral dynamic and static events, since more recent equipment has not shown a major increase in detection.
A 39-year-old woman was admitted to hospital with headaches, vomiting, psychic impairment and diplopia. Three hydatid cysts of the lung had been previously removed. An avascular mass in the left hemisphere with left-to-right displacement of the anterior cerebral arteries was noted during a brain angioscintigraphy. A computed tomography (CT) brain scan showed two cystic lesions situated in the left-frontal and occipital regions. A CT abdominal scan showed multiple cysts in the liver, spleen and both kidneys. At operation, two brain cysts were totally extirpated without rupture. The definite pathological diagnosis was secondary hydatid cysts. The headaches, vomiting and diplopia were persistent in the post-operative period. Seven days after the operation, a CT brain scan showed an infratentorial cyst. The patient rejected any surgical intervention.
A 28-year-old man was admitted to the hospital with difficulty in speech and motor weakness of the right arm of sudden onset. Twelve years previously a grade I oligodendroglioma had been removed. The CT scan showed a low density area without enhancement in the left frontal region that appeared to communicate with the left lateral ventricle. An increased flow through the left middle cerebral-artery and a focal avascular area in the left hemisphere was noted during a dynamic study by angioscintigraphy. A radionuclide cerebral control study showed reduced flow through the left middle cerebral artery. The patient was discharged 25 days after admission with the diagnosis of (1) reversible ischemic neurological deficits associated a hyperperfusion and (2) porencephaly.
A new approach to the cerebral and extracerebral circulation phenomenon, during generalized seizure discharges (GSD) in the baboon is described. It is based upon the measurement of comparative variations of the regional blood volume (RBV) a new technique. First results demonstrate the existence of an extracerebral vascular structure of the face which is quite sensitive to the ictal phenomenon and which we have named the 'nasal region'. On the whole, when bursts of spike/waves occur the mean arterial blood pressure (MBP) and cerebral blood volume (CBV) increase moderately whereas the nasal blood volume (NBV) decreases. During the generalized seizure discharge, variations are much larger, increasing for MBP and CBV and decreasing for NBV. CBV variations do not passively follow those of MBP.
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The case of a 74-year-old woman with a carotid-cavernous fistula is reported. She was admitted to hospital with oliguria and generalized edema. After improvement of the edematous condition she suddenly presented intense, pulsatile, frontal cephalea. It was more intense on the right side and was accompanied by nausea and vomiting and swelling of the right eye with reddening, sharp pains, difficulty of movement, and loss of vision. Cerebral angiogammagraphy was practiced in anterior-posterior and right lateral view. A righ carotid-cavernous fistula was discovered with drainage through the superior ophthalmic vein and the deep venous system. The angiogammagraphic findings can be considered characteristic; it is important to obtain activity/time curves from various areas of interest in order to evaluate the degree of shunting and the pathway of drainage from the fistula. There was a good coorelation with the arteriographic findings. Eight cases of carotid-cavernous fistulas diagnosed with radionuclids have been published previously, though the activity/time curves were not determined by computer for any of them.
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UNLABELLED: Somatostatin receptor scintigraphy has become an essential tool in the treatment planning of patients with carcinoid tumor (CaT) and pancreatic neuroendocrine tumors (PNET). However, the contribution of SPECT images in the diagnosis and staging of these tumors has not been well established. OBJECTIVE: 1) To find out if SPECT improves the sensitivity of planar imaging and adds any value to tumor diagnosis, and 2) To determine under which circumstances SPECT images must be obtained. MATERIAL AND METHODS: We have evaluated 49 patients, 26 females and 23 males, using both planar and SPECT 111In-DTPAOC images. The patients were classified into three groups according to their clinical indication: Group A: Indolent symptoms of CaT or PNET (n = 9); Group B: Known or functioning CaT or PNET tumors (n = 22); Group C: Post-surgical follow-up (n = 18). The total number of SPECT studies were 51 (37 abdomen, 13 thorax and 1 brain). In all cases SPECT was performed 24 hours after 111In-DTPAOC injection. Scintigraphic images were compared with surgical findings in 17 patients and with a synthesis of biochemical, clinical and CT findings in the other patients. RESULTS: 16 primary lesions were detected with planar images whereas SPECT detected 18. The two tumors detected only by SPECT were a bronchial CaT and an insulinoma located in the pancreatic tail. Planar and SPECT image sensitivities were 66.6% and 75% respectively. Twenty one patients developed metastatic disease. Sensitivities of planar and SPECT images for metastases were 76.1% and 90.4% respectively. Furthermore, SPECT helps planar images in the evaluation of six patients with uncertain images (lesions with low receptor density or with an uncertain scintigraphic localization). Therefore, in 15.6% of patients with primary or metastatic tumors, planar images were normal whereas SPECT was abnormal and SPECT provided an added value in 21.8% of the studies with abnormal planar images. CONCLUSIONS: We recommend the use of SPECT images in: 1) Patients with specific functional clinical syndrome or with a known CaT or PNET and normal planar images. 2) When planar images are abnormal only in primary tumor. 3) In order to confirm the absence of other metastases in patients with known liver metastases. 4) In order to enhance the detection of lesions with low receptor density and uncertain planar images and 5) In order to determine exactly the anatomic location of some lesions
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A 68 year old Ecuadorian man was investigated for polyuria, polydipsia and weight loss of 3 kg during the previous two months. Insulin dependent diabetes mellitus was diagnosed 10 year before admission and treated with appropriate diet and insulin (35 U/d). 18 months before was diagnosed in El Ecuador of "multiple liver nodes non-suggestive of malignancy". Physical examination showed a large multinodular petrous hepatomegaly. There was no evidence of skin lesions. Results of laboratory studies included a basal plasma glucose level that ranged between 275-367 mg/dl (N=60-100), glycosylated haemoglobin of 8.9% (N<5) and a serum albumin of 2.8 gr./dl (N=3.4-4.8). At admission non-other laboratory alterations were detected. Computed tomography showed a mass on the head of the pancreas with loco-regional lymph nodes and liver metastases. Tumor markers were normal. Fine-needle aspiration cytology of the liver masses revealed the presence of liver metastases of a non-differentiated malignant tumor. A 111In-DTPAOC scintigraphy revealed the presence of somatostatin receptors in the liver metastases, also detecting the presence of multiple bone metastases in the axial and appendicular skeleton. Plasma glucagon level was 678 pg/ml (N<250). A diagnosis of metastatic glucagonoma was established and therapy with streptozocin, 5-FU, insulin and synthetic somatostatin analogs was initiated. Three months after the therapy initiation the patient was symptom free. Some weeks after the patient suffered from left hip pain, and a control 111In-DTPA scintigraphy showed progression of his bone metastases. In conclusion, glucagonoma must be suspected in all diabetic patients with metastatic liver, even in absence of necrotic migratory erythema. In these circumstances, plasmatic glucagon level and somatostatin receptors scintigraphy will be a useful tool for establishing the final diagnosis.
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