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1.
Discordant hepatic uptake between Tc-99m HIDA and Tc-99m colloid occurred in a 63-year-old female with segmental biliary obstruction due to cholangioma. Radiographic CT and a percutaneous transhepatic cholangiogram revealed the obstructed right hepatic duct as well as the dilated intrahepatic duct in the right lobe. At surgery this was confirmed, and a 2 cm mass encasing the right hepatic duct was identified. It should be included in the gamut of discordant hepatic uptake of Tc-99m IDA and Tc-99m colloid.  相似文献   

2.
Tc-99m labeled HIDA imaging has been used to investigate suspected biliary leaks following orthotopic liver transplantation. In two patients the diagnosis of bile leakage was confirmed and appropriate surgical intervention undertaken. In a third patient, despite clinical suspicion, no leakage was apparent on HIDA imaging, and unnecessary surgery was avoided. HIDA imaging is a useful, noninvasive technique for confirming biliary leakage after liver transplantation.  相似文献   

3.
The authors report discordant hepatic uptake of Tc-99m NGA and Tc-99m PMT in a patient with hepatoma. Tc-99m PMT uptake was delayed and Tc-99m NGA concentrated in another area, thereby demonstrating that the uptake mechanisms for Tc-99m NGA and Tc-99m PMT are different. Tc-99m NGA imaging may be useful in characterizing the focal hepatic lesion of Tc-99m IDA or Tc-99m PMT concentration.  相似文献   

4.
PURPOSE: Various radionuclide methods have been studied for the evaluation of the disease activity and extent of ulcerative colitis and other protein-losing enteropathies. Recently, Tc-99m dextran and Tc-99m human immunoglobulin (HIG) have been used to detect inflammation and protein loss into the intestine, but only a few studies have been reported with these agents. MATERIALS AND METHODS: In this study, Tc-99m dextran and Tc-99m HIG were used to evaluate disease activity and extent in patients with ulcerative colitis. These agents were used in 12 patients with active disease and in five patients in remission, and five healthy control participants also were included. RESULTS: Large bowel activity was detected in 11 of the 12 patients with active ulcerative colitis using Tc-99m dextran and in 10 patients using Tc-99m HIG. Fifty-eight bowel segments were found to be active with endoscopy, 39 with Tc-99m dextran, and 31 with Tc-99m HIG. No intestinal activity was detected in the control participants. Grade 1 activity localization in the large bowel was detected in three patients with ulcerative colitis in remission using Tc-99m dextran and in one patient using Tc-99m HIG. CONCLUSION: Tc-99m dextran is more sensitive for detecting disease activity and extent than is Tc-99m HIG.  相似文献   

5.
Scintigraphic findings in a patient with biopsy-proven hypervitaminosis A included markedly impaired hepatic uptake of Tc-99m sulfur colloid but essentially normal uptake of Tc-99m DISIDA . This case presents a potential cause for image discordance with these two agents.  相似文献   

6.
A case of hepatic adenoma is reported, presenting as a defect on sulfur colloid liver image and visualized on a biliary scintigram. Although biliary imaging in the evaluation of sulfur colloid defects may be of value in selected patients, combination imaging in this case could not distinguish a benign from a malignant process.  相似文献   

7.
To assess the presence of primary biliary cirrhosis, 15 patients at various histopathologic stages were studied by Tc-99m IDA hepatobiliary and/or Tc-99m colloid hepatic imaging. In the earlier stages (I and II), seven of eight patients (88%) showed uniform hepatic retention of Tc-99m IDA. Of seven patients in the same stage, however, four (57%) showed no abnormality on Tc-99m colliod imaging. In three of these four negative patients (75%), uniform hepatic retention of Tc-99m IDA was noted. In the later stages (III and IV), all seven patients showed decreased clearance with or without delayed tracer appearance in the intestine and prominent hepatic retention on Tc-99m IDA imaging; with Tc-99m colloid imaging there was enlargement of the spleen and increased activity in the spleen and bone marrow. Thus, Tc-99m IDA imaging is considered to be more useful in revealing this functional disorder at the earlier stage of primary biliary cirrhosis and in evaluating progression from an earlier to a later stage of disease. Tc-99m colloid imaging also effectively evaluated progression.  相似文献   

8.
A 22-year-old woman with severe acute hepatitis underwent a Tc-99m galactosyl human serum albumin (GSA) scan. Intense accumulation was observed in the cephalic region of the right hepatic lobe, whereas the accumulation was reduced in the left lobe and the caudal region of the right lobe. A computed tomographic (CT) scan showed that the left lobe and the caudal region of the right posterior segment had atrophied and become hypodense, which were thought to represent postnecrotic scarring after massive hepatic necrosis. The relatively hyperdense region in the right lobe was slightly swollen and was thought to represent regenerating liver tissue or a "potato liver." Compared with the CT, the regions of elevated Tc-99m GSA accumulation correlated well with the areas of regenerating liver tissue, and the regions with reduced accumulation corresponded closely with the areas of postnecrotic scarring. On a Tc-99m phytate scan, unlike the Tc-99m GSA scan, the radiocolloid accumulation was intense in the left lobe and caudal region of the right lobe and reduced in the cephalic region of the right lobe. Together, the Tc-99m GSA scan and the Tc-99m phytate scan formed a set of exact "nega-posi" images. Biopsy specimens obtained during laparoscopy showed a few hepatocyte columns in the postnecrotic scarred left lobe. Severe disruption of the hepatocytes, prominent inflammatory cell infiltration, and obvious Kupffer cell hypertrophy and clustering were also observed.  相似文献   

9.
Twelve patients with hepatocellular carcinoma and multiple metastatic pulmonary nodules were studied with Tc-99m HIDA imaging. Lung scanning was performed 1, 2, 3, 4, and 5 hours after administration of 6 mCi of Tc-99m HIDA with a preset count format of 400 K. In two patients, pulmonary uptake was clearly seen at 1 hour; in the other two patients, uptake could not be detected until 3 hours later. The overall detection rate of 33% suggests that Tc-99m HIDA has limited usefulness as a routine diagnostic tool in the detection of hepatoma metastases. The uptake may include both specific and nonspecific mechanisms.  相似文献   

10.
A case of pericholecystic hyperperfusion on Tc-99m sulfur colloid (SC) flow images with a pericholecystic rim of increased activity (PCHA) on delayed planar and single-photon emission computed tomography images of the liver was seen in a patient with a history of multiple renal transplants admitted with cramping right lower quadrant abdominal pain. Laparotomy performed 5 days after the scan revealed an acutely perforated gangrenous gallbladder and occluded cystic duct. The secondary findings of gallbladder hyperperfusion and PCHA or "rim sign" have been frequently reported with Tc-99m IDA hepatobiliary imaging. These secondary findings in conjunction with a nonvisualized gallbladder on an IDA scan suggest a complicated or advanced stage of acute cholecystitis and usually require urgent surgical intervention. The rim sign on Tc-99m SC scintigraphy also likely indicates the same grave diagnosis.  相似文献   

11.
Tc-99m HMPAO SPECT is more likely to detect a stroke in early stages than CT. However, a conventional HMPAO SPECT study takes at least 30 minutes to complete. This paper compares fast Tc-99m HMPAO SPECT scans and conventional Tc-99m HMPAO SPECT scans with respect to spatial resolution and diagnostic efficacy in vitro and in a small series of patients, respectively. The spatial resolution of fast Tc-99m HMPAO SPECT did not match that of images obtained from conventional SPECT, though the difference proved to be of no clinical significance. Since fast SPECT requires only one-fourth to one-fifth the time necessary for conventional SPECT, it may be more suitable for investigating cases of acute stroke in critical clinical situations.  相似文献   

12.
Tc-99m mercaptoacetyltriglycine (MAG3) is a new Tc-99m renal agent that compares favorably to I-131 Hippuran in animal models, normal volunteers, and patients. Based on the fact that Tc-99m MAG3 has a much more rapid clearance than Tc-99m DTPA and a smaller volume of distribution, it was postulated that the image quality of Tc-99m MAG3 studies should be superior to scans obtained using Tc-99m DTPA, particularly in patients with impaired renal function. To test this hypothesis, Tc-99m DTPA and MAG3 images were obtained in three transplant patients during periods of stable but impaired renal function. In one study, the Tc-99m DTPA study was potentially misleading, whereas the Tc-99m MAG3 examination assessed the clinical situation correctly. In all three cases, the Tc-99m MAG3 images were superior.  相似文献   

13.
Tc-99m DTPA renography in patients with collagen disease   总被引:2,自引:0,他引:2  
PURPOSE: This study evaluated the use of Tc-99m DTPA renography in patients with collagen disease. MATERIALS AND METHODS: Tc-99m DTPA renal scintigraphy was performed in 28 patients with clinically diagnosed collagen disease. Twenty-two other patients who underwent renal scintigraphy and were subsequently shown to have no kidney abnormalities served as the control group. RESULTS: One quarter of the patients with collagen disease had abnormal findings of renography, despite the absence of abnormal laboratory data. Renograms were 100% sensitive for the detection of renal disease in patients with collagen disease, and their specificity was 53% when serum blood urea nitrogen, serum creatinine concentration, and proteinuria were the only measures of renal impairment considered. The glomerular filtration rate was not significantly different between the groups, but the bilateral time to peak was significantly greater in the patients with collagen disease. Hydronephrosis was present in 7% of patients with collagen disease. CONCLUSION: Renography is useful for detecting early changes of renal involvement when the clinical state of collagen disease is evaluated.  相似文献   

14.
Ninety patients, 85 of them jaundiced, were examined after the injection of Tc-99m pyridoxylidene glutamate, a substance rapidly concentrated by normal hepatocytes and excreted into the biliary tract. It appears in the gallbladder after 10-15 min, and in the gastrointestinal tract at 30 min. On the basis of the time of appearance in the intestine, four groups of patients were recognized: 1. Seventeen patients with a normal pattern, with visualization of the gut at 30 min. 2. Nineteen patients with a slight delay in passage, with appearance in the gut between 30-180 min. 3. Twenty-nine patients showing very slow excretion visualized only at 24 hr; 21 of these had parenchymatous disease of the liver, three choledocholithiasis and five had malignant disease causing partial obstruction. 4. Twenty-five patients with no visualization of the intestine; eight of them proved to be cases of medical jaundice, and 17 were surgical cases. Groups 3 and 4 comprise 54 patients where the question of medical or surgical jaundice was critical. If lack of intestinal activity is considered an indicating surgical jaundice, the accuracy of this study was only 72.4%.  相似文献   

15.
Tc-99m HIDA cholescintigraphy is the diagnostic procedure of choice for acute cholecystitis. Acute cholecystitis is associated in vast majority of the cases with cystic duct obstruction. The demonstration of presence (cystic duct patency) or absence (cystic duct obstruction) of visualization of the gallbladder on cholescintigraphy is critical to the diagnosis of acute cholecystitis. The visualization of the gallbladder rules out acute cholecystitis in most of the cases. Although, in most cases, determination of visualization or nonvisualization of gallbladder is straight forward, occasionally it can be challenging. We describe a patient with suspected acute cholecystitis, in whom an unusual appearance of the gallbladder on hepatobiliary scintigraphy was clarified with SPECT/CT, an approach that is rarely used in Tc-99m HIDA cholescintigraphy.  相似文献   

16.
17.
18.
Tc-99m polyclonal immunoglobulin-G has been shown to be a successful agent in the depiction of active inflammation in rheumatoid arthritis (RA). The objective of this study was to compare the uptake behaviors of Tc-99m HIG and Tc-99m MDP in RA and variants of rheumatoid arthritis (VRA). Seventeen patients with RA and 8 patients with VRA presenting with active inflammation were included in this study. Ten subjects with well-diagnosed degenerative joint disease constituted the control group. All joints in patients were also imaged with Tc-99m HSA to evaluate the vascularization status of the joints. Tc-99m HIG and HSA scans were obtained at 2, 4 and 24 hours after the injection of 555 MBq Tc-99m HIG and 296 MBq Tc-99m HSA. Conventional bone scans were performed 4 hours after the injection of 740 MBq Tc-99m MDP. Target-to-background (T/B) ratios were obtained exclusively over the joint regions. Tc-99m HIG T/B ratios of the active joints in RA were significantly higher than those of the non-active joints and the control group (p < 0.05). Tc-99m HIG T/B ratios in active joints showed a progressive increase between 2 and 24 hour images (p < 0.05). In contrast, Tc-99m HSA T/B ratios decreased in all active joints significantly (p < 0.05) except the ankle joint region (p > 0.05). The T/B ratios in Tc-99m MDP bone scans were higher in all active joints than in non-active RA joints and joints of controls but significantly differences were only detected in wrist and elbow joints. All clinically active joints in VRA patients accumulated Tc-99m HIG and HSA, and showed increased Tc-99m MDP uptake. These joints had a very similar Tc-99m HIG retention pattern to the RA joints. The detection rate of active joint inflammation with Tc-99m HIG was much higher than that with Tc-99m MDP. The increasing Tc-99m HIG uptake ratio between 2 and 24 hours in contrast to Tc-99m HSA indicates the presence of other binding mechanisms besides increased vascularity in RA.  相似文献   

19.

Objective

The study aimed to investigate the incidence of bone uptake of tracer on Tc-99m MIBI imaging and explore its influencing factors and significance for diagnosis of metabolic bone disease (MBD) in patients with hyperparathyroidism (HPT).

Methods

Seventy-nine consecutive patients with histopathologically confirmed HPT (63 primary and 16 secondary) who had preoperative Tc-99m MIBI imaging were retrospectively evaluated. Serum calcium (Ca), phosphorus (P), and intact parathyroid hormone (iPTH) were measured for all patients, and serum alkaline phosphatase (ALP) was measured for 62 patients. Of the 79 patients, 50 underwent bone mineral density (BMD) examination and 30 underwent bone scintigraphy. The incidence and characteristics of abnormal bone uptake of MIBI were recorded. Mann–Whitney test was performed to determine if serum iPTH, Ca, P, ALP, and BMD were different between the patients with and without MIBI bone uptake. Logistic regression analysis was used to analyze the factors that influence the bone uptake of MIBI. The concordance rate between Tc-99m MIBI imaging and bone scintigraphy in delineating MBD was calculated.

Results

Tc-99m MIBI imaging disclosed the abnormal bone uptake of tracer in 22 (27.8 %) patients. Of them, 19 showed diffusely increased activity in skeleton, 2 showed focal uptake in brown tumors, and one showed both above patterns. Patients with bone uptake MIBI had higher level of serum iPTH (Z = ?4.34, P < 0.001) and ALP (Z = ?3.50, P < 0.001) than those without bone uptake. Logistic regression analysis also showed that bone uptake of MIBI was correlated with serum iPTH (OR = 4.42, P < 0.001) and ALP (OR = 3.21, P = 0.002). Among the 30 patients that underwent bone scintigraphy, 76.7 % patients showed signs of MBD, and the concordance rate between Tc-99m MIBI imaging and bone scintigraphy was 60 % for detecting MBD.

Conclusions

Bone uptake of MIBI in patients with HPT is commonly related to a high level of iPTH and ALP; it probably reflects an active stage of MBD, and it should be monitored during the conventional Tc-99m MIBI scintigraphy.  相似文献   

20.
Imaging prostatitis with Tc-99m ciprofloxacin   总被引:2,自引:0,他引:2  
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