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Biomedical subjects

L M Freeman

Publications and source records attributed to L M Freeman.

At least 19 recordsLinked to original sources
PubMed1979

Thallium-201 myocardial scintigraphy in patients with triple-vessel disease and ischemic exercise stress tests.

Thirty patients with triple-vessel coronary artery disease proven by angiography, symptomatic angina and a positive ECG stress test were evaluated with thallium-201 (201TI) scintigraphy. Twenty patients also had aortocoronary saphenous vein bypass surgery; 15 of them had repeat noninvasive evaluation. Seventy percent of these patients showed ischemia by 201TI scintigraphy, of which one-half returned to normal after surgery. Postoperative reversion of the ECG stress test together with 201TI stress/reperfusion imaging correlated well with the completeness of surgical revascularization. We could not explain the prevalence (80%) of infarcts detected by 201TI in this group, of which 76% could be anatomically correlated to epicardial scars. The positivity of infarcts by 201TI exceeded that predicted by previous history of infarction, Q waves on resting ECG or ventriculographic akinesis. These observations suggest that 201TI scintigraphy is a useful noninvasive tool in the follow-up and understanding of patients with coronary heart disease. These conclusions also support the concept that 201TI stress imaging need not have the identical connotation as the ECG stress test.

Adult↗
PubMed1979

Rapid and accurate diagnosis of acute cholecystitis with 99mTc-HIDA cholescintigraphy.

Technetium-99m dimethyl acetanilide iminodiacetic acid (HIDA) cholescintigraphy was performed on 90 patients with suspected acute cholecystitis. Visualization of the gallbladder established patency of the cystic duct and excluded the diagnosis of acute cholecystitis in 50 of 52 patients. Nonvisualization of the gallbladder with visualization of the common bile duct was diagnostic of acute cholecystitis in 38 patients, all subsequently proven at surgery. The observed accuracy of this procedure is 98% and specificity is 100%. The false negative rate is 5% and false positive rate is zero. Technetium-99m-HIDA has many advantages which make it the procedure of choice in evaluating a patient for suspected acute cholecystitis. It is a rapid, simple, safe examination which provides functional as well as anatomic information about the hepatobiliary system in individuals with a serum bilirubin level up to 8 mg/100 ml.

Acetates↗
PubMed1979

Demonstration of traumatic bile leakage with cholescintigraphy and ultrasonography.

Technetium-99m HIDA cholescintigraphy and ultrasonography are noninvasive, safe, simple procedures that can document the presence, location, and extent of a bile leak. Early detection of posttraumatic or postoperative biliary tract disruption can significantly reduce morbidity and mortality. The possibility of biliary tract disruption should be considered in any patient who has had blunt or penetrating abdominal trauma. In two cases reported, the new hepatobiliary radiotracer 99mTc dimethyliminodiacetic acid (HIDA) was quite useful in detecting such leaks. Sonography was particularly useful in detecting small intra- or perihepatic bile collections which no longer communicate with the biliary tree. An active bile leak at a surgical anastomosis may also be documented by 99mTc-HIDA cholescintigraphy and can yield information of potential prognostic importance. Serial cholescintigraphy is also useful in evaluating the response to medical or surgical treatment.

Aged↗
PubMed1979

Computer-assisted static/dynamic renal imaging: a screening test for renovascular hypertension?

Computer-assisted static/dynamic renal imaging with [197Hg] chlormerodrin and [99mTc]pertechnetate was evaluated prospectively as a screening test for renovascular hypertension. Results are reported for 51 patients: 33 with benign essential hypertension and 18 with renovascular hypertension, and for 21 normal controls. All patients underwent renal arteriography. Patients with significant obesity, renal insufficiency, or renoparenchymal disease were excluded from this study. Independent visual analyses of renal gamma images and time-activity transit curves identified 17 of the 18 patients with renovascular hypertension; one study was equivocal. There were five equivocal and three false-positive results in the essential hypertension and normal controls groups. The sensitivity of the method was 94% and the specificity 85%. Since the prevalence of the renovascular subset of hypertension is approximately 5%, the predictive value is only 25%. Inclusion of computer-generated data did not improve this result. Accordingly, this method is not recommended as a primary screening test for renovascular hypertension.

Adult↗
PubMed1978

Is the anterior bone scan necessary in the diagnosis of osseous metastases?

Bone imaging studies of 1650 patients with known or strongly suspected extraosseous malignancies were reviewed to determine whether a completely negative posterior view was sufficient to exclude metastatic disease. Of 708 negative posterior images, 27 (3.4%) were positive for metastasis on anterior views. All of the anterior lesions were in the sternium, sternoclavicular joints and first four ribs. When the posterior view is positive, further views may be unnecessary. Negative or equivocal posterior images necessitate anterior views of the thoracic cage.

Bone Neoplasms↗
PubMed1977

A simple approach to the diagnosis of bronchopleural fistula.

The authors describe a simple, yet reliable technique for confirmation of a bronchopleural fistula. It is based on detection of radioactivity in the pleural space after the washout phase of the 133Xe ventilation study. This method demonstrated the pathological communication while bronchoscopy, bronchography, and methylene blue testing did not.

Bronchial Fistula↗