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Biomedical subjects

T G Rudd

Publications and source records attributed to T G Rudd.

At least 37 records · Page 2Linked to original sources
PubMed1984

Heterotopic bone formation (myositis ossificans) and lower-extremity swelling mimicking deep-venous disease.

A quadriplegic patient with a swollen leg was suspected of having deep-venous thrombosis, and was studied with radionuclide venography (RNV) and contrast venography. Focal narrowing of the femoral vein, seen on RNV, was due to extrinsic compression. Although soft-tissue radiographs were normal, Tc-99m diphosphonate imaging established the diagnosis of early heterotopic bone formation (myositis ossificans), which was responsible for the venous compression. Clinically this inflammatory process can mimic deep-venous thrombosis, and should be considered in evaluating patients at risk for both heterotopic bone formation and deep-venous thrombosis.

Adult↗
PubMed1983

Tc-99m hydroxymethylene diphosphonate and Tc-99m methylene diphosphonate: biological and clinical comparison: concise communication.

The biologic and imaging characteristics of Tc-99m HMDP and Tc-99m MDP were compared in ten patients. Tc-99m HMDP blood levels were marginally lower at 4 hr. There were no significant differences in 4-hr urinary clearance, normal bone-to-background ratio, or ratio of lesion to normal bone. Relative image quality comparison showed a slight preference for Tc-99m HMDP. Biologically Tc-99m HMDP compares favorably with Tc-99m MDP. Under the conditions of this study, Tc-99m HMDP image quality is at least comparable to that of Tc-99m MDP.

Aged↗
PubMed1982

PIPIDA scintigraphy for cholecystitis: false positives in alcoholism and total parenteral nutrition.

A review of gallbladder scintigraphy in patients with potentially compromised hepatobiliary function revealed two groups in whom cholecystitis might be mistakenly diagnosed. In 200 consecutive hospitalized patients studied with technetium-99m-PIPIDA for acute cholecystitis or cholestasis, there were 41 alcoholics and 17 patients on total parenteral nutrition. In 60% of the alcoholics and 92% of those on parenteral nutrition, absent or delayed visualization of the gallbladder occurred without physical or clinical evidence of cholecystitis. A cholecystagogue, sincalide, did not prevent the false-positive features which presumably are due to altered bile flow kinetics related to alcoholism and parenteral nutrition. Four patients on parenteral nutrition undergoing cholecystectomy for suspected cholecystitis had normal gallbladders filled with jellylike viscous thick bile. A positive (nonvisualized or delayed visualized) gallbladder PIPIDA scintigram in these two populations should not be interpreted as indicating a need for cholecystectomy.

Alcoholism↗
PubMed1982

Evaluation of acute right upper quadrant pain: sonography and 99mTc-PIPIDA cholescintigraphy.

A group of 75 patients with acute right upper quadrant pain was evaluated with both sonography and cholescintigraphy. Accuracy in screening for gallbladder disease was significantly greater with sonography (96%) than with cholescintigraphy (74%). For selecting patients with acute cholecystitis from this population that included acute and chronic cholecystitis as well as nonbiliary pathology, PIPIDA was less accurate (77%) than might be expected based on previous reports primarily due to false positive nonvisualization caused by chronic cholecystitis. Of patients with nonbiliary pathology, sonography was able to detect the cause of the right upper quadrant pain in 21%. Patients with acute right upper quadrant pain should first be screened with sonography. If cholescintigraphy is subsequently used for suspected acute cholecystitis, positive results should be interpreted with caution before surgery is planned.

Acute Disease↗
PubMed1981

Ureteropelvic junction obstruction in infants and children: functional evaluation of the obstructed kidney preoperatively and postoperatively.

We evaluated 14 children with primary ureteropelvic junction obstruction, using preoperative excretory urography and renal imaging with the renal cortical labeling agent 99mtechnetium dimercaptosuccinic acid. All children with a reduction in function of 10 per cent or more in the obstructed kidney had severe calicectasis; others with severe calicectasis had minimal functional loss. Renal scanning with dimercaptosuccinic acid discourages surgery in the questionably obstructed kidney and encourages repair in the severely obstructed kidney. In 10 children who had followup renal imaging after repair relative function was not significantly different.

Adolescent↗
PubMed1981

Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma.

Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. We have attempted to correlate the incidence of measureable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.

Adult↗
PubMed1980

Autosomal dominant polycystic kidney disease: early diagnosis and data for genetic counselling.

Because of the onset of symptoms in patients with autosomal dominant polycystic kidney disease is generally delayed until adulthood, genetic counseling is imprecise. In an attempt to identify patients early, 261 offspring of subjects with the gene for polycystic disease were tested. Agreement between the results of excretory urography with nephrotomography and radionuclide imaging was excellent. In the 15-19 year age group, polycystic kidney disease was diagnosed in only 30% of 33 subjects at risk, whereas the expected figure was 50%. The disease was diagnosed in 57% of 228 subjects at risk who were aged over 19. When the probands were excluded, this figure was 43% and did not differ significantly from the expected 50%. These data suggest that persons at risk aged over 19 years who have normal urograms and radionuclide images have less than a 5% chance of having inherited the gene for polycystic kidney disease.

Adolescent↗
PubMed1980

Liver cysts in patients with autosomal dominant polycystic kidney disease.

Liver cysts were found in 46 (29 per cent) of 158 patients over 10 years of age with documented autosomal dominant-type polycystic kidney disease (PKD) from 62 unrelated families. Hepatic cysts were not found in any patient at risk for PKD in whom renal cysts were not detected. The prevalence of liver cysts increased with advancing age and with declining rate of glomerular filtration. Results of clinical and laboratory studies indicate that polycystic liver disease in patients with autosomal dominant-type PKD is a benign condition, rarely, if ever, causing impaired liver function or portal hypertension.

Adolescent↗
PubMed1980

Gastroesophageal reflux in children: radionuclide gastroesophagography.

Sixty-five symptomatic infants and children underwent radionuclide gastroesophagography, acid reflux testing, and barium esophagography with water-siphon testing to evaluate the clinical efficacy of the scintigraphic technique in detecting gastroesophageal reflux. After ingesting 99mTc sulfur colloid in fruit juice, patients rested beneath the gamma camera for 30-60 min while esophageal activity was monitored continuously. By using the acid reflux test as a standard of comparison, the sensitivity of radionuclide gastroesophagography was 75%. Because of its physiologic nature, low radiation exposure, and convenience, radionuclide gastroesophagography warrants further evaluation as a screening test for gastroesophageal reflux.

Barium Sulfate↗
PubMed1980

Combined pressure-radionuclide evaluation of suspected cerebrospinal fluid shunt malfunction: a seven-year clinical experience.

A simple, safe radionuclide technique for evaluating the functional status of a cerebrospinal fluid shunt has been used in the clinical management of hydrocephalus in 306 patients over a seven-year period. Results of 526 studies showed greater than 99% sensitivity and accuracy in diagnosing distal shunt obstruction and 96% correct correlation with clinical outcome overall. Intrareservoir pressure measurements are especially valuable to diagnose proximal catheter shunt malfunction and to assess shunt dependency.

Adolescent↗
PubMed1979

Rose bengal sodium I 131 studies in infants with suspected biliary atresia.

Twenty-eight infants suspected of having biliary atresia were studied with radionuclide imaging and quantitation of liver activity clearance using rose bengal sodium I 131. Scanning the abdomen for the presence or absence of gut radioactivity was a sensitive indicator of complete biliary obstruction. Absence of gut radioactivity correctly predicted biliary atresia in all 11 infants proved to have that diagnosis. Biliary atresia was excluded by the presence of gut radioactivity in 13 of 17 infants with other forms of neonatal juandice. When present, gut activity was identifiable within 24 hours after injection. Serial tests improved specificity. Plotting the rate of clearance of liver activity did not aid diagnosis.

Bile Ducts↗
PubMed1979

Demonstration of gastroesophageal reflux in children by radionuclide gastroesophagography.

Twenty-five infants and children with proved gastroesophageal reflux were studied by radionuclide gastroesophagography to determine its sensitivity in detecting reflux. Patients swallowed an inert radiotracer (Tc-99m sulfur colloid) and gamma camera images of the stomach and esophagus were made with and without abdominal pressure. The test was easy to perform and was well tolerated. Reflux was demonstrated in 20 patients (80%); this compared favorably with barium gastroesophagography.

Barium Sulfate↗
PubMed1979

What becomes of pulmonary infarcts?

In 32 patients, 58 angiographically proven pulmonary infarcts were followed for 3 months or longer by serial chest radiography. Complete clearing was seen in 29 (50%) of the infarcts on chest radiography. In the other 29 infarcts that left residual findings, linear scars were identified in 14, pleural diaphragmatic adhesions in nine, and localized pleural thickening in six; in all cases the features were diminutive when compared with the original abnormality. Follow-up perfusion lung images at similar time intervals to the chest films were available for 44 infarcts. Seven of these showed complete resolution and the other 37 showed a residual but much smaller perfusion defect. None of the patients had known preexisting pulmonary disease. The frequency of permanent radiographic scarring seemed to be the same at all ages.

Adolescent↗
PubMed1979

Technetium-99m-labeled methylene diphosphonate and hydroxyethylidine diphosphonate--biologic and clinical comparison: concise communication.

The biologic and imaging characteristics of Tc-99m MDP and Tc-99m HEDP were compared in ten patients: Tc-99m MDP exhibited lower blood activity, lower 4-hr urinary excretion, and higher normal bone-to-background ratio. Assessment of overall image quality also favored Tc-99m MDP, indicating that the normal skeleton is better visualized with this agent. The total number of lesions seen (18) was not large enough to allow critical comparison of relative lesion-detecting efficacy. However, discrepancies between the two agents were observed, suggesting additional evaluation of the relative lesion-detecting efficacy of these two bone agents.

Adult↗