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11.
J. Menzel O. Schober P. Reimer W. Domschke 《European journal of nuclear medicine and molecular imaging》1997,24(6):635-641
In patients with liver cirrhosis a transjugularly placed intrahepatic portocaval shunt (TIPS) is a non-surgical portosystemic device which aims to reduce portal venons pressure. In comparison with Doppler sonography, we evaluated in 28 patients the diagnostic impact of liver perfusion scintigraphy (with technetium-99m diethylene triamine penta-acetic acid) in the assessment of changes in the hepatic blood flow after TIPS shunting. The arterial and portal contributions to hepatic flow were calculated from the areas under the biphasic timeactivity curve. In the course of TIPS shunting, patency is threatened by reocclusion. Angiography is the gold standard for TIPS shunt reassessment. However, there is a need for a less invasive diagnostic procedure, such as scintigraphy or Doppler sonography, for the early detection of shunt insufficiency. Scintigraphy demonstrated that prior to TIPS shunting the portal venons contribution to hepatic perfusion was reduced to 29.2%, this reduction being due to portal hypertension. After TIPS placement a significant increase in portal venous perfusion was observed (38.2%;P<0.02). TIPS shunt occlusion was identified in patients by a significant reduction in the scintigraphically measured portal venons contribution to hepatic blood flow. Hepatic perfusion scintigraphy appears to be a valuable method to determine the immediate effect of TIPS on hepatic blood flow. Post-TIPS follow-up studies of hepatic haemodynamics by liver perfusion scintigraphy appear able to contribute to the detection of TIPS shunt occlusion before the clinical consequences of this complication have become apparent. 相似文献
12.
Markku Walamies Vesa Virtanen Matti Koskinen Arto Uusitalo 《European journal of nuclear medicine and molecular imaging》1994,21(9):968-972
The decrease in mortality among patients receiving thrombolytic therapy for myocardial infarction is greater than would be expected from the improvement in left ventricular contractile function alone; thus some additional advantage of recanalization of the infarctrelated coronary artery probably exists. Changes in the post-infarction myocardial metabolic state with respect to artery patency have not been studied with a gamma camera previously. A single-photon emission tomography scan using the fatty acid analogue para-123I-iodophenylpentadecanoic acid was performed at rest before hospital discharge on nine patients with first anterior myocardial infarction. All patients had received intravenous thrombolytic therapy at the beginning of the insult. The semiquantitative analysis of the left ventricle included a total of 44 segments in each patient. The test was repeated 3 months later, with the patients divided into two groups: six patients had an angiographically patent left anterior descending coronary artery (group A), and three an occluded artery (group B). In group A the number of myocardial segments with abnormal (<70% of maximum) fatty acid uptake was initially 20.2±4.7 (mean±SD) and was reduced to 11.3±6.1 during the follow-up (95% confidence interval of the decrease 16.0–1.7 segments). In group B the number of these aberrant segments was fairly constant (21.7±13.1, initial test, and 21.3±13.3, retest). Our preliminary results suggest that even when thrombolytic therapy fails to prevent myocardial infarction, myocardial fatty acid metabolism has a better change of recovering if the relevant coronary artery has regained its patency. This finding emphasizes the need for further study to establish whether a direct link exists between myocardial metabolic state and patient survival after infarction. 相似文献
13.
Hiroaki Hoshi Seishi Jinnouchi Kuniko Harada Katsushi Watanabe 《European journal of nuclear medicine and molecular imaging》1988,14(4):177-179
Gallium scintigraphy was evaluated in 25 patients with adult T-cell leukemia lymphoma (ATLL). Anterior and posterior images were obtained at 72 h after administration of 3 mCi 67Ga-citrate using a gamma camera (Maxi-Camera 400T, General Electric Co.) with a medium energy standard parallel hole collimator. Abnormally high accumulations were observed in 17 out of 25 cases (superficial lymph node, 8; hilar and mediastinal lymph node, 7; paraaortic lymph node, 2; lung, 9; liver, 1; bone, 1). There were 10 malignant lesions detected by 67Ga scintigraphy in 9 out of 17 cases (superficial lymph node, 1; hilar and mediastinal lymph node, 6; paraaortic lymph node, 1; liver, 1; bone, 1). White blood cell count and serum LDH levels were raised in patients with abnormally high accumulations of 67Ga. In conclusion, 67Ga scintigraphy seemed to be a useful examination to detect malignant lesions in patients with ATLL. 相似文献
14.
William G. Kohn Jonathan A. Ship Jane C. Atkinson Lauren L. Patton Philip C. Fox 《Journal of oral pathology & medicine》1992,21(2):70-74
Sequential salivary gland scintigraphy with 99mTc-technetium pertechnetate (Tc-99) is a safe, minimally invasive test for study of major salivary glands. However, its relationship to salivary function has not been investigated in detail. We have investigated the relationship between major salivary gland flow rates and Tc-99 scans and developed a new rating scale using scans of a control group with normal salivary function. Salivary flow rates and Tc-99 scans were obtained from healthy, non-medicated subjects (n = 33) and from xerostomic patients (n = 22). There were significant differences between the groups for salivary flow rates and Tc-99 ratings. Significant correlations were found between salivary flow rates and Tc-99 ratings in the control and xerostomic groups. The Tc-99 rating scale proved reliable in assessing salivary dysfunction, and showed a high inter-examiner correlation. These results demonstrate the usefulness of salivary gland scintigraphy in assessing major salivary gland flow rates and the utility of a new rating scale. 相似文献
15.
Hisayoshi Oka Masayuki Yoshioka Kenji Onouchi Masayo Morita Soichiro Mochio Masahiko Suzuki Toshiaki Hirai Mitsuyoshi Urashima Kiyoharu Inoue 《Movement disorders》2007,22(10):1510-1514
We assessed the relations of visual hallucinations (VH) to cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD). The subjects were 37 patients without VH (VH(-)) and 31 with VH (VH(+)). Autonomic function was evaluated on the basis of cardiac 123-radioiodinated metaiodobenzylguanidine (123I-MIBG) uptake and hemodynamic testing with Valsalva maneuver. Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured by tilt-table testing. 123I-MIBG uptake was lower in VH(+) than VH(-). Hemodynamic studies showed that VH(-) had only cardiac sympathetic and parasympathetic dysfunction, while VH(+) additionally had reduced vasomotor sympathetic functions. The fall in SBP during tilt-table testing was greater in VH(+) than VH(-). NE and its difference in the supine and upright positions were decreased in VH(+). We conclude that cardiac and vasomotor sympathetic dysfunction is more severe in VH(+) than in VH(-). Severe dysfunction in PD with VH is probably attributed to Lewy-body lesions or neuronal loss in sympathetic ganglia, the central autonomic system, or both. 相似文献
16.
123I-MIBG myocardial scintigraphy as a noninvasive screen for the diagnosis of coronary artery spasm
Jong-Won Ha Jong-Doo Lee Yangsoo Jang Namsik Chung June Kwan Se-Joong Rim Young-Joon Lee Won-Heum Shim Seung-Yun Cho Sung-Soon Kim 《Journal of nuclear cardiology》1998,5(6):591-597
Background It has been suggested that the sympathetic nervous system might play an important role in the development of coronary artery
spasm. However, no cardiac imaging modality has been able to demonstrate abnormal sympathetic innervation in patients with
coronary artery spasm. The purpose of this study was to assess the presence and location of abnormal sympathetic innervation
using iodine 123-metaiodobenzylguanidine (123I-MIBG) single photon emission computed tomography (SPECT) and to evaluate the clinical efficacy of 123I-MIBG SPECT as a noninvasive screening test in patients with coronary artery spasm.
Methods and Results Coronary arteriography and a provocative test with intravenous administration of ergonovine maleate were performed in 26 patients
(20 men, 6 women, mean age 48.2±12.0 years, range 20 to 67 years) who were suspected of having a coronary artery spasm. The
subjects were divided into 2 groups: group 1 (n=18) comprised subjects with negative provocative provocative test result,
and group 2 (n=8) comprised subjects with negative provocative test results. Ten healthy subjects served as controls. No abnormal
MIBG uptake was observed in the control subjects. Abnormal sympathetic nervous innervation using 123I-MIBG SPECT was observed either as a reduced uptake or a defective pattern in the perfused areas in 13 of the 18 regions
supplied by vessels of ergonovine-induced vasospasm. Normal sympathetic innervation, as evidenced by normal 123I-MIBG uptake, was noted in all of the 60 segments of normal vessel territories. Reduced uptake of 123I-MIBG was not detected in the perfused areas of 5 vasospasm-induced vessels (perfusion territory of left anterior descending
coronary artery [LAD] and the right coronary artery [RCA] in 2 and 3 patients, respectively). The sensitivity and specificity
of 123I-MIBG for detection of coronary artery spasm were 72.2% (95% confidence interval, [CI] 55% to 89%) and 100%, respectively.
The positive predictive and negative predictive values were 100% and 92.3% (95% CI 91% to 93%), respectively.
Conclusion
123I-MIBG SPECT is a feasible method to evaluate noninvasively and localize the territories of coronary arteries with spasm.
Invasive diagnostic coronary arteriography with ergonovine provocation test may be unnecessary for diagnosis of coronary artery
spasm in patients with typical resting pain, negative exercise test or normal thallium perfusion scan results, but showing
abnormalities in 123I-MIBG SPECT.
Presented in part at the European Association of Nuclear Medicine Congress, September 1996, Copenhagen, Denmark. 相似文献
17.
Roelf Valkema MD Berthe L. F. van Eck-Smit MD Ernst E. van der Wall MD 《Journal of nuclear cardiology》1994,1(6):546-560
Noninvasive techniques for the assessment of cardiac metabolism are important for the detection of potentially salvageable
tissue in jeopardized areas of the myocardium. The correct identification of hibernating and stunned myocardium in patients
with severely depressed cardiac function can have vital therapeutic consequences for the patient. Changes in myocardial fatty
acid and glucose metabolism during acute and prolonged ischemia can be traced by positron-emitting or gamma-emitting radiopharmaceuticals.
Alternatively,31P-labeled magnetic resonance spectroscopy can be used for the assessment of high-energy phosphate metabolism. It is not yet
clear which modality will emerge as the most useful in the clinical setting. Positron emission tomography (PET) that uses
combinations of flow tracers and metabolic tracers offers unique opportunities for quantification and high-resolution static
and rapid dynamic studies. Currently, assessment of glucose metabolism with18F-fluorodeoxyglucose is regarded as the gold standard for myocardial viability and prediction of improvement of impaired contractile
function after revascularization. However, preserved oxidative metabolism may be required for potential functional improvement,
and therefore assessment of residual oxidative metabolism by11C-labeled acetate PET may prove to be more accurate than18F-fluorodeoxyglucose PET, which reflects both anaerobic and oxidative metabolism. Moreover, because fatty acids are metabolized
only aerobically, they are excellent candidates for the clinical assessment of myocardial viability and prediction of functional
improvement after revascularization. Especially derivatives of fatty acids that are not metabolized but accumulate in the
myocyte are attractive for myocardial imaging. Examples are123I-beta-methyl-p-iodophenyl pentadecanoic acid and 15-(o-123I-phenyl)-pentadecanoic acid. These tracers can be detected by planar scintigraphy and single-photon emission computed tomography,
which are more economical and widely available than PET. In addition, 511 keV collimators have been developed recently, making
the detection of positron emitters by planar scintigraphy and single-photon emission computed tomography feasible. The experience
with31P-labeled magnetic resonance spectroscopy in humans is still limited. With current magnetic resonance spectroscopic techniques,
insufficient spatial resolution is achieved for clinical purposes, but the possibility of serial measurements to monitor rapid
changes of phosphate-containing molecules in time makes magnetic resonance spectroscopy very valuable for the research of
myocardial metabolism. 相似文献
18.
DANCHIN N.; HAOUZI A.; AMOR M.; KARCHER G.; BRUNOTTE F.; JUILLIERE Y.; CUILLIERE M.; VILLEMOT J.P.; PERNOT C.; GILGENKRANTZ J.M.; BERTRAND A.; CHERRIER F. 《European heart journal》1988,9(4):454-457
Of 46 consecutive patients who underwent percutaneous transluminalcoronary angioplasty (PTCA) from April 1980 to August 1982 andwho had a satisfactory angiographic result six months later,one died of cancer and 41 had a detailed evaluation with exercisesingle-photon emission computed tomography (SPECT, 40 patients)or repeat coronary angiography (one patient), 4878 monthsafter the procedure. During follow-up, two patients had recurrentangina due to progression of coronary artery disease requiringa second PTCA procedure of another coronary artery; one of themlater had a limited myocardial infarction in an area suppliedby the vessel initially dilated. At follow-up, only one patienthad definite angina. All but one patient had a negative exercisetest. Myocardial perfusion during exercise in the PTCA-relatedarea, assessed by SPECT, was normal in 90% of the patients andshowed a limited defect due to reversible ischaemia in the remainingfour (10%). It is concluded that patients with a less than 50%stenosis six months after PTCA show sustained improvement intheir functional status and myocardial perfusion, four to sixyears after the procedure suggesting continued patency of thecoronary artery. 相似文献
19.
H. Kobayashi Y. Kotoura M. Hosono T. Tsuboyama C. Shigeno J. Konishi 《European radiology》1995,5(6):651-653
Melorheostosis is a benign sclerosing dysplasia with a very unusual and characteristic roentgenographic appearance. We reported a patient with melorheostosis in the left lower extremity followed up for 14 years. Although the extraosseous lesions only slightly enlarged, the bone scintigraphy showed the activity of the metabolism to be still high. 相似文献
20.
G. Hör 《European journal of nuclear medicine and molecular imaging》1988,13(12):619-636
The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative — quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and asymptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis, cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The normal values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with 111In-antimyosin and 99mTc-Isonitriles are presented including correlative results between global ejection fraction determination according to gated 99mTc-isonitrile and conventional 99mTc-erythrocyte ventriculogram (r=0,75; n=10).Dedicated to Prof. Heinz Hundeshagen on the occasion of his 60th birthday 相似文献