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At least 217 records · Page 12Linked to original sources

Difference between splenic volume measured at necropsy and that measured in vivo by radionuclide tomography.

Reference values for splenic volume used in this study are based on necropsy measurements made in 1970. Because the volumes (measured by radionuclide tomography) seemed to be consistently greater than the necropsy values, the splenic volume in 35 healthy male volunteers ranging in age from 18-30 years (median age, 21 years) was studied. Their mean (SD) splenic volume was 281 (73) ml compared with 138 (34) ml in the reference group. The mean splenic volume in healthy volunteers seems to be significantly greater than in cadavers, and these results suggest that reference range for splenic volume in vivo should be revised.

Adult↗

Tc-99m stannous colloid-labeled leukocyte scintigraphy in the evaluation of the painful arthroplasty.

The aim of this study was to evaluate the utility of scintigraphy using leukocytes labeled with Tc-99m stannous colloid in the assessment of painful arthroplasties. The results of three-phase bone scintigraphy and imaging with Tc-99m-labeled leukocytes in 40 patients with painful joint prostheses, requiring the exclusion of infection are reported. Results were compared with microbiologic culture and/or long-term clinical review. Bone scintigraphy had a sensitivity of 100%, a specificity of 64%, and a diagnostic accuracy of 73% in detecting prosthetic infection. Tc-99m-labeled leukocytes yielded a sensitivity of 70%, a specificity of 100%, and a diagnostic accuracy of 93%. Leukocyte scintigraphy improves the specificity of bone scintigraphy in the assessment of the painful prosthetic joint. A positive study is highly suggestive of infection and warrants appropriate treatment.

Adult↗

An unusual white blood cell scan in a child with inflammatory bowel disease: a case report.

Technetium-99m-labeled leukocyte (WBC) imaging is a valuable screening method for inflammatory bowel disease, especially in children, because of its high rate of sensitivity, low cost, and ease of preparation. A 14-year-old girl is described who had juvenile arthritis and iritis complicated by inflammatory bowel disease. She was examined for recurrent abdominal pain. A Tc-99m stannous colloid WBC scan was performed, and tracer accumulation was seen in the small bowel in the region of the distal ileum on the initial 1-hour image. Delayed imaging at 3 hours also revealed tracer accumulation in the cecum and ascending colon, which was not seen on the early image. A biopsy of the colon during endoscopy showed no evidence of active inflammation in the colon. The small bowel was not seen. Computed tomography revealed changes suggestive of inflammatory bowel disease in the distal ileum. The appearance on the WBC study was most likely a result of inflammatory bowel disease involving the distal ileum, with transit of luminal activity into the large bowel.

Adolescent↗

99mTc colloid and 99mTc IDA imagings in diffuse hepatic disease.

Ninety-six patients with various diffuse hepatic diseases were observed using both 99mTc colloid and 99mTc iminodiacetic acid (IDA), focusing on the potential etiologies of the disease process as well as its chronicity and severity. The presence of acute hepatic disease was more sensitively depicted with 99mTc IDA than with 99mTc colloid. In chronic hepatic disease, on the other hand, 99mTc colloid and 99mTc IDA demonstrated a similar sensitivity. The potential etiology of the disease process (differential diagnosis) and the chronicity of the disease could be evaluated better with 99mTc colloid. Among the patients with different stages of liver cirrhosis, however, 99mTc IDA significantly discriminated the severity of the hepatic disease. These results suggest that 99mTc IDA may be used to determine the degree of functional disorder in acute hepatic disease and evaluate the severity of diffuse hepatic disease, whereas 99mTc colloid can effectively evaluate the potential etiology and chronicity of the disease.

Colloids↗

Liver scintiscanning as a screening test in the detection of alcoholic cirrhosis.

Ninety-nine patients with alcohol related problems underwent a liver scintiscan and biopsy. The scan changes were graded and compared with the histological changes found from percutaneous liver biopsy. The overall correlation between scan and biopsy changes was poor. However, scintiscanning was found to be highly sensitive (90%) in detecting cirrhosis and for this reason is useful as a screening test in selecting alcoholic patients for biopsy.

Biopsy↗

Reliability of the hepatic perfusion index for the detection of liver metastases.

The reliability of the technique for measuring the hepatic perfusion index (HPI) for the detection of liver metastases has been examined. Dynamic images from 173 patients with primary and recurrent colorectal cancer have been analysed by two operators using the peak values of both the right and left kidney time-activity curves. In 14.4% of analyses the right kidney HPI method failed, while only 5.7% of analyses failed using the left kidney method. The results showed (a) that disagreement between the operators HPI values was small but statistically significant (p less than 0.05) and (b) that disagreement between the two methods was highly significant (p less than 10(-7)), with the left kidney method resulting in a lower HPI value. An upper limit of normal for left kidney HPI of 0.37 was predicted from the data, assuming the corresponding right kidney value to be 0.40.

Evaluation Studies as Topic↗

A comparison of liver-spleen ratios and uptakes obtained using planar and tomographic techniques.

Liver-spleen ratio, volume and uptake were measured in 20 patients undergoing routine 99Tcm-colloid examinations. Methods using planar views only were compared with results obtained using SPECT techniques and automated slice processing. The results suggest that a reasonable estimate of liver-spleen ratio may be obtained using anterior and posterior planar views only. Estimates of organ volume and absolute uptake were not reliably obtained using planar views only, and SPECT studies are required. The choice of attenuation correction technique for SPECT studies did not affect the results obtained for liver-spleen ratios and volumes, although systematic underestimation of absolute uptake occurred with simpler techniques.

Adult↗

Hepatic perfusion index in the diagnosis of overt metastatic colorectal cancer.

The hepatic perfusion index (HPI) was measured in 180 patients with colorectal cancer: 109 with primary colorectal cancer, 38 with suspected recurrent colorectal cancer and 33 following curative resection of colorectal cancer. In 21 patients with proven metastatic disease serial imaging studies were performed. HPI was determined using the peak of the left kidney time-activity curve to define the division of arterial and portal blood flow. HPI was elevated (greater than 0.37) in 54 of 115 patients (47%) with no evidence of hepatic metastases, 17 of 27 patients (63%) with hepatic metastases at initial presentation and 21 of 25 (84%) with metastatic disease detected during follow-up. Only 4 of 13 patients (31%) with local recurrence but no evidence of liver metastases had an elevated HPI. Serial imaging of patients with metastatic liver disease demonstrated a rising HPI with clinical disease progression in 18 of 21 patients (86%). This study confirms the association of an elevated HPI with hepatic metastases and suggests that a rising HPI in serial studies is associated with progression of disease but highlights the deficiency of one single HPI estimation in the identification of patients with overt hepatic metastases.

Colorectal Neoplasms↗

Index for predicting post-operative residual liver function by pre-operative dynamic liver SPET.

To predict residual liver function before hepatic resection, we devised a predictive index by combining clearance values with functional liver volume measured by liver dynamic single photon emission tomography (SPET). Forty-seven patients with liver disease underwent liver dynamic SPET with 99Tcm-Sn colloid before hepatic resection. There were no operation-related deaths. Three patients died from hepatic failure more than 1 month following the operation. Their predictive indices were 0.24, 0.33 and 0.34. When the predictive index was above 0.35, no patient had symptoms of hepatic failure or died. Our data suggest that when the predictive index is above 0.35, there is a low probability of hepatic failure after hepatectomy.

Adult↗

Demonstration of different patterns of musculoskeletal, soft tissue and visceral involvement in melioidosis using 99m Tc stannous colloid white cell scanning.

Melioidosis is an infectious disease that can present with multiple foci of disease involvement. Assessment of disease extent can be difficult, especially in musculoskeletal, visceral and soft tissue infection. This study examined the usefulness of white cell scans in this condition. 99mTc stannous colloid white cell scanning was performed in 21 patients with culture-proven melioidosis. Scan results were compared with clinical assessment and correlated with other forms of imaging. White cell scans demonstrated all but one of the clinically apparent sites of musculoskeletal, visceral and other soft tissue infection. Unsuspected disseminated soft tissue lesions were seen in two patients, including femoral node uptake in both, and these patients subsequently presented with relapsing musculoskeletal disease. Unsuspected musculoskeletal disease was found in one patient. Clinically suspected musculoskeletal disease was accurately excluded by white cell scan in another patient. The results of white cell scanning were also examined in disease of other viscera. Renal and prostatic disease were visualized. Unsuspected parotid involvement was found in two patients. Only one of two spinal lesions was visualized. Pulmonary disease was not necessarily associated with abnormal uptake. White cell scanning is a quick and effective way of assessing the extent of musculoskeletal, visceral and soft tissue disease in melioidosis.

Adult↗

Direct evidence of monocyte recruitment to inflammatory bowel disease mucosa.

Alterations in phenotype and function of intestinal macrophages occur in inflammatory bowel disease (IBD) but it is unclear whether these changes result from the recruitment of circulating monocytes to the intestine or from proliferation of resident intestinal macrophages. We sought to demonstrate the arrival of blood monocytes, the precursors of macrophages, in IBD mucosa. Peripheral blood mononuclear cells were isolated from 23 patients with clinically active intestinal inflammation (13 Crohn's disease, eight ulcerative colitis, two infective colitis), then radiolabelled with 99mtechnetium (Tc)-stannous colloid (n = 13) or 111indium (In)-oxine (n = 10) before re-injection and abdominal scanning. Four patients had demonstrable intestinal monocyte uptake using [99mTc]-stannous colloid, while six [111In]-oxine-labelled monocyte scans were positive. Uptake sites correlated with actively inflamed regions. Patients demonstrating monocyte uptake had been treated with corticosteroids for a significantly (P < 0.02) shorter duration (median 3 vs 20 days) than those with negative scans. There was no significant difference between positive and negative scans for disease category, clinical or histological disease, activity, or radioisotope used. Biopsies of inflamed mucosa from two patients suffering ulcerative colitis who had positive scans showed a high proportion of CD14-positive macrophages, 4-9% of which contained autoradiographic grains. These results demonstrate that blood monocytes are recruited to the mucosa of actively inflamed bowel, and suggest that this process may be inhibited by corticosteroids. Moreover, the phenotype of the recently-arrived monocytes indicates their susceptibility to stimulation by lipopolysaccharide, and suggests a mechanism for the continuing inflammation in the bacterial product-rich milieu of IBD.

Adolescent↗