Gallium-67 citrate localization in carriers of Duchenne muscular dystrophy.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J M Ash.
Explore the source record for details and available documents.
Many patterns of injury have been described in the child abuse syndrome. Until recently, all the bone manifestations of this syndrome have been diagnosed radiologically. Four cases of multiple costovertebral fracture diagnosed by bone scan are described and their etiology discussed. The use of bone scanning in identifying fractures which previously would have been missed is advocated.
A patient is described who demonstrated accumulation of Tc-99m-sulfur colloid in both the lung and kidney following treatment for disseminated intravascular coagulation. This phenomenon has been demonstrated experimentally in animals following the induction of disseminated intravascular coagulation, but to our knowledge has not been previously described in humans.
Forty patients, ages three days to 12 years, with neuroblastomas had bone scans with 99mtechnetium methylene diphosphonate (99mTc-MDP) as part of their pretreatment examination. Twenty-four (60%) had primary tumor uptake and 16 (40%) did not. No difference was seen between the two groups in the incidence of tumor calcification or necrosis. No relationship between the level of urinary vanillylmandelic acid (VMA) and the presence of primary tumor uptake of 99mTc-MDP was found. The possible causes for the localization of 99mTc-MDP are discussed.
Explore the source record for details and available documents.
Because a renal scan reflects the physiologic configuration and function of the kidney, it provides information that cannot be obtained with conventional intravenous pyelography. It is particularly useful in children with hydronephrosis, vesicoureteral reflux, chronic pyelonephritis, and congenital renal anomalies.
Twenty-one neonates suspected of having acute osteomyelitis were studied by technetium-99m phosphate radiopharmaceuticals. Of the ten infants subsequently proven to have osteomyelitis involving 20 sites in all, only sis sites (31.5%) were abnormal by bone imaging. Fifty-eight percent were normal and 10.5% equivocal. These poor results are contrary to the high accuracy rate achieved in slightly older infants; they negate the ability of the bone scan to diagnose neonatal osteomyelitis.
Hydronephrosis generally implies ureteropelvic junction obstruction, but may be mimicked by a variety of other disorders. The authors have attempted to determine the relative diagnostic value of diuretic renography and the pelvis perfusion test in children with hydronephrosis by correlating the results with operative findings, renal and ureteral histology, and postoperative results.
Explore the source record for details and available documents.
Of 63 99mTc-phosphate bone images in 49 patients with neuroblastoma, 41 were abnormal, 17 showed tracer uptake within the primary tumor, 29 showed evidence of skeletal metastatic disease, and 17 demonstrated renal/urinary tract involvement. The metastases were asymmetric in 24 patients and symmetrical in 9, in whom they involved the metaphyses and epiphyses of the long bones. Except for one patient with multiple "cold" areas, all metastases were seen as focal hyperactive regions. Eleven of 42 skeletal radiographic surveys were abnormal. The radionuclide study appears to be more accurate than skeletal radiography in estimating bone involvement in neuroblastoma. Primary tumor concentration of the tracer is almost pathognomonic of neural crest neoplasms in childhood.
Skull scintigraphy was performed in 68 children with suspected craniosynostosis after injection of technetium-99m methylene diphosphonate. The scans demonstrated four patterns of sutural activity: normal, absent, increased, and wide. When correlated with surgical findings, "absent" indicated fused sutures, "increased" indicated fusing hyperactive sutures or sutures reacting to fusion elsewhere, and "wide" indicated splite sutures. Upon correlation with the radiographs, it was found that when the radiograph was normal, the scan contributed little; when the radiograph was abnormal or equivocal, the scan was often of great assistance in confirming fused sutures and detecting other abnormal sutures.
Radionuclide bone scanning is an extremely sensitive, safe and widely applicable investigative aid. In most circumstances it cannot be employed to the exclusion of plain radiography as the two procedures--one dynamic and the other static--complement each other. In children, bone imaging demonstrates physiologic characteristics of bone growth and early suture closure, delineates obscure tumors and infection, recent or old trauma not always visible on orthodox radiography and may solve the diagnostic dilemma of a child with heretofore undiagnosed head, neck or back pain.
1972 TO April, 1977, 28 children with splenic rupture were managed nonoperatively. The diagnosis was confirmed by splenic scintigraphy with 99mTechnetium-sulfide colloid. Those patients whose condition was stable and satisfactory or maintained stable with intravenous fluids or blood transfusions were not operated upon. All patients sustained their ruptured spleens as a result of trauma, except for one spontaneous rupture in a patients with infectious mononucleosis. Emergency laparotomy for deterioration of clinical condition or late complications was never necessary. Splenic scans were repeated in 22 patients to assess resolution. Fourteen patients had minimal residual defects but there were no late complications detected.
Explore the source record for details and available documents.
Cerebrovascular disease was reviewed in 92 suspected or proved pediatric cases. In addition to the classical adult patterns of the disease, a separate group of patterns occurs in children and infants who suffer a severe transient episode of cerebral hypoxemia. The patterns in the newborn are periventricular increase, laminar cortical necrosis, watershed infarct, rapidly clearing infarct, and diffuse increase. Bilateral extensive patterns correlate well with an ensuing generalized neurological deficit, and localized patterns with a focal deficit. The mixed and diffuse patterns were found to be the most common.
A prospective study comparing the radionuclide skeletal survey with the radiographic survey was performed for 159 children with known primary neoplasm. Forty-four showed radionuclide evidence of metastases, while only 14 had radiographic evidence. Thus, 68% of metastases were discovered by bone imaging alone. No false negative images for metastases were obtained, though there was one false negative image for primary tumor. Radionuclide skeletal survey is recommended as the primary evaluation for bony metastases in all children with neoplasms. Suspect areas should then receive complete radiographic examination.
Explore the source record for details and available documents.
There is little information in the literature concerning the role of bone scanning in benign bone neoplasms except for sporadic reports. Since the advent of 99mTc-polyphosphate, bone imaging has proven feasible and useful in locating the cause of bone pain, such as in osteoid osteomas, which are not always radiologically apparent, and in evaluating whether or not a radiologic lesion is indeed benign and solitary. Blood-pool images are particularly important in neoplastic disease, since the absence of hyperemia in the immediate postinjection period favors the diagnosis of a benign neoplasm, as does low-grade uptake on the delayed study. The scan, including pinhole magnification images, is especially valuable in diagnosing lesions in the spine and pelvis, which are poorly seen radiologically. We have studied various types of benign bone tumors, including simple and aneurysmal bone cysts, fibrous cortical defects, and nonossifying fibromas, all of which had minimal or no increased uptake of the radiopharmaceutical, unless traumatized. Although osteochondromas and enchondromas showed varied accumulation of activity, the scan was useful in differentiating these from sarcomatous lesions. All osteoid osteomas demonstrated marked activity, and could be accurately located preoperatively, as could the extent of fibrous dysplasia. The bone scan in the reticuloses also showed abnormal accumulation of activity, and aided in arriving at the prognosis and treatment of histiocytic bone lesions.