Giant hepatic hemangioma studied with intravenous total body arteriography technique. A case report.

Hepatic hemangiomas are the most common benign tumors of the liver. They are usually single, small, and asymptomatic. However, giant hepatic hemangiomas have been reported in the past, usually detected as incidental findings. Radionuclide blood pool imaging studies are used to confirm the presence of a hemangioma. This report describes a case of a giant hepatic hemangioma detected using intravenous total-body arteriography, done as a part of radionuclide blood pool hemangioma study. This simple addition to the regular RBC blood pool hemangioma study helps to determine the size of the liver in the early arterial phase and shows obvious increased blood pool activity in the delayed phase. It is also useful in detecting lesions in other parts of the body when present.

Evaluation of Klippel-Trenaunay syndrome with radionuclide total body angiography. A case report.

A 21-year-old Italian woman with extensive Klippel-Trenaunay syndrome (KTS) developed recurrent pulmonary embolism in spite of the insertion of a Greenfield filter in the inferior vena cava. Clinical and radiologic diagnostic tests failed to demonstrate the pathway of the emboli. Radionuclide venography and intravenous radionuclide total body arteriography were performed. These radionuclide procedures helped to evaluate the extent of KTS and to detect the route of the emboli. This is the first case of KTS studied with intravenous total body arteriography reported in the literature.

Obstruction of the iliac veins due to markedly distended urinary bladder demonstrated by radionuclide venography. A case report.

An unusual case of obstruction of the iliac veins by a markedly distended urinary bladder (UB) is presented. Initial radionuclide venography (RNV) was positive, revealing obstruction of the iliac veins associated with marked dilatation of the UB. After the UB was emptied, RNV was negative.

Use of i.v. radionuclide total body arteriography to evaluate arterial bypass shunts--a new method--a review of several cases.

Currently, Doppler ultrasound and contrast angiography are the main imaging procedures being used to evaluate arterial bypass shunts. IV radionuclide total body arteriography (TBA) is another useful imaging procedure for evaluation of bypass shunts. The authors reviewed 33 patients, 19 women and 14 men, ranging in age from forty-three to eighty-five, who had TBA done after arterial bypass surgery. Ten patients had multiple shunts and 5 had multiple follow-up studies. In total there were 80 shunts, including 43 femoropopliteal, 16 axillofemoral, 1 axillopopliteal, 13 crossover femorofemoral, and 7 aortofemoral shunts. Sixty-two of the 80 shunts were patent, 14 were occluded, and 4 had partial occlusion. The results were confirmed by Doppler studies, contrast angiograms, and/or surgical exploration without false positives or false negatives. Since the radiotracer used was 99mTc-labeled red blood cells, a MUGA study can also be performed immediately following TBA in the same injection. Twenty-eight patients had gated cardiac blood pool studies (MUGA) done; 16 had abnormal wall motion and diminished ventricular function. TBA requires only a single IV injection of radiotracer (less than 1 cc) in the upper limb. The imaging times for total body arterial and perfusion images are seventy seconds and five minutes respectively. Both total body arterial and perfusion images clearly demonstrated the entire course of shunts (single or multiple); underlying and coexisting arterial abnormalities, e g, occlusive disease (27 patients), or aneurysm (3 patients); and related perfusion changes in the extremities. TBA has unique features. It permits a complete, excellent visualization of the bypass graft without the hazard of contrast media injection. It is a simple and a virtually noninvasive procedure, particularly useful for preoperative workups and postoperative follow-ups.

Cutaneous fistula communicating with the hip in a patient with a painful total hip prosthesis. Demonstration by radionuclide arthrography.

Radionuclide arthrography is becoming increasingly useful in the evaluation of femoral component loosening in patients with a painful total hip prosthesis. Additional potential advantages of radionuclide arthrography include detection of abnormal communications with the hip, such as bursae, abscess cavities, and fistulas. A case of cutaneous fistula communicating with the hip in a patient with loosening and infection of the femoral component of the total hip prosthesis that is clearly demonstrated by radionuclide arthrography is presented.

Intravenous radionuclide total body arteriography: a new technique.

We have developed a technique using a blood pool agent Tc-99m labeled red blood cells and a detector head set moving at a high speed to obtain total body arterial and blood pool images with only a single intravenous injection. Previously with an intravenous radiotracer injection, only regional arterial images could be obtained. Now, with this simple, non-invasive technique, we can evaluate the major arterial system, organs, and soft tissues in the whole body, as well as cardiac function. On reviewing 500 cases, more than 90% of the first-pass arterial phase images clearly demonstrated the aorta, ilio-femoral arteries, and, to a lesser extent, the more distal arteries in the lower extremities. The second-pass blood pool images revealed the anatomical and morphological status of the solid organs, as well as perfusion changes in various organs and soft tissues.

IV radionuclide total-body arteriography: a new noninvasive whole-body screening procedure--a case report.

Recently the authors introduced a new technique of intravenous (IV) radionuclide total-body arteriography. The major arterial system, multiple organs of the whole body, and cardiac function can be evaluated with one small IV injection in the arm. After analyzing more than 1000 cases, they have found that many pathologies can be detected and/or confirmed in this procedure. This new technique may be used as a general whole-body screening test for those patients at high risk for disease.

Successful removal of a severed transvenous pacemaker electrode.

The ease and simplicity of the transvenous approach to permanent pacing continue to be among its greatest advantages. However in a small proportion of transvenously paced patients complications can occur. A rare complication is an incompletely removed pacing catheter with subsequent embolization to more central parts of the cardiovascular system. This communication reports the migration of a severed transvenous pacemaker electrode and its removal from the left iliac vein with a femoral-ventricular pigtail catheter.