Ga-67 uptake unsuppressed by leukopenia and intense antibiotic therapy.

The authors describe a patient with myelofibrosis who showed intense Ga-67 uptake in spite of being severely leukopenic and receiving large amounts of antibiotics. They conclude that false-negative results associated with leukopenia or intensive antibiotic treatment may not always be correct.     

Hybridbildgebung bei abdominellen Erkrankungen

Die Radiologie - Eine adäquate Bildgebung ist für die Detektion mitunter kleinster Läsionen, die non-invasive Charakterisierung von fokalen und diffusen Veränderungen, sowie die...     

Radionuclide assessment of penile corporal venous leak using technetium-99m-labeled red blood cells.

In an attempt to evaluate penile corporal venous outflow, a method that utilizes intracorporal injection of Tc-RBC was developed and used in 20 patients with erectile dysfunction. Seven patients showed venous leak and 13 had normal venous outflow. Technetium-labeled RBC corporal clearance in the flaccid state and after intracorporal injection of papaverine (30 mg) and regitine (1 mg) were assessed in sequence by two separate injections of 18.5 MBq of Tc-RBC each. The time for 50% corporal clearance (T50%) was determined from the time activity curves obtained in flaccid state and after intracorporal injection of the vasoactive agent. There were no statistically significant differences in T50% measured in the flaccid state between normal venous outflow (202 +/- 139 sec) and venous leak (92 +/- 35 sec, p = 0.1). However, after intracorporal injection of papaverine and regitine a significant increase in the T50% was noted in normal venous outflow (2892 +/- 1899 sec) as compared to venous leak (213 +/- 123 sec, p less than 0.001). The results suggest that measurement of corporal clearance of Tc-RBC after intracorporal injection of papaverine may be a useful method in detecting venous leak, and could be used as a screening test in patients with erectile dysfunction.     

Bone and gallium scintigraphy of an oleothorax

Olcothorax was largely used for the treatment of pulmonary tuberculosis, before the advent of specific chemotherapy. Although the method was dis-continued more than 30 years ago, late complications do occur. We report here a case of a painful oleothorax that took up ^99mTc-MDP and ⁶⁷Ga-citrate.     

Effect of extracorporeal piezoelectric lithotripsy shock waves on renal function measured by Tc-99m-DMSA using spect

Extracorporeal shock-wave lithotripsy has altered the therapeutic approach to urinary stone disease. Recently, a method was developed in which shock-wave generation is obtained piezoelectrically. To evaluate the effect of extracorporeal piezoelectric lithotripsy (EPL) on renal function, 20 patients were studied prior to and after EPL of renal calculi. Renal cortical function was evaluated by using a previously described and validated quantitative single photon emission computerized tomography (SPECT) method to measure individual absolute uptake of technetium-99m dimercaptosuccinic acid (Tc-99m-DMSA). Twenty kidneys were treated, and the 19 contralateral kidneys were without stone disease (1 patient had a single kidney). The absolute kidney uptake of Tc-DMSA in the normal kidneys was 21.4% +/- 6.2% before and 22.2% +/- 6.4% after EPL. For the treated kidneys the absolute update was 16.8% +/- 5.3% and 16.8% +/- 4.7% before and after, respectively. There was no statistical significant difference between pre- and post-treatment values. The absolute kidney uptake was significantly lower (p less than 0.01) in the treated than in the normal kidneys. This study indicates that the EPL procedure did not cause any damage to cortical function detectable by the DMSA uptake.     

Elevated CK-MB isoenzyme after exercise stress test and atrial pacing in patients with ischemic heart disease

Using a highly sensitive monoclonal antibody kit for CK-MB, significant release of small amounts of CK-MB isoenzyme after exercise stress test was detected 4 to 6 h after induction of ischemia. This occurred in ten out of 15 patients with ischemic heart disease (66 percent) and in only one of the 18 healthy subjects (5.6 percent) serving as a control group. In five patients with coronary artery disease in whom atrial pacing was performed with simultaneous blood sampling from coronary sinus, a drastic elevation in CK-MB isoenzyme (from 2.04 +/- 2.06 ng/L to 10.88 +/- 6.9 ng/L; p less than 0.001) was detected within 10 to 30 min after induction of acute ischemia. A small but significant increase in total CK also was detected (from 21 +/- 12 IU/L to 52 +/- 14IU/L; p less than 0.01). These preliminary observations have to be further investigated in a larger group of patients before a definitive conclusion can be reached about the clinical significance of CK-MB release during exercise.     

Stress fractures and bone pain: are they closely associated?

The relationship between bone pain and stress fractures diagnosed by bone scintigraphy was investigated in military recruits during active training. In three patients pain appeared in the site of abnormal uptake 7-14 days after the bone scan in a previously asymptomatic site. One hundred and twenty-four sites of stress fractures were found in 64 patients; 32 (26 per cent) were asymptomatic. In 38 patients (59 per cent) there were multiple stress fractures; 32 (33 per cent) had asymptomatic stress fractures. Fifty-three per cent of the regions with abnormal uptake in the femur were painless, compared with 17 per cent in the tibia. The necessity for imaging all bones susceptible to stress fractures, even when asymptomatic, is stressed. It is suggested that diagnosis of stress fracture should be made when typical abnormal uptake appears on scintigraphy. Bone pain in such cases may be delayed.     

Quantitative SPET 99Tcm-DMSA uptake by the kidneys: age-related decline in healthy males

To evaluate if 99Tcm-dimercaptosuccinic acid (99Tcm-DMSA) uptake by the kidneys is related to age and creatinine clearance in males with normal renal function, quantitative single photon emission tomography (SPET) of DMSA uptake by the kidneys was performed in 18 volunteers aged 20-79 years. The quantitative uptake of DMSA in the right kidney was 13.9 +/- 2.9% and in the left kidney 14.2 +/- 3.0%. There was no statistically significant difference between left and right kidney uptake (t = 1.2, N.S.). Global kidney uptake (right + left) was 28.1 +/- 5.9%. There was a statistically significant age-related decline in global DMSA uptake. The estimated DMSA uptake (%) was given by -0.27 x age + 42 (r = -0.87, P < 0.001). A good correlation was found between creatinine clearance and global DMSA uptake (r = 0.87, y = 2.8x + 28.3, P < 0.001). The results suggest that normal values of DMSA uptake by the kidneys are age-dependent.