Cystic parathyroid adenoma: Primary hyperparathyroidism without 99mTc-MIBI uptake. / Adenoma quístico paratiroideo: hiperparatiroidismo primario sin captación de 99mTc-MIBI.

Cystic parathyroid adenoma is a rare disease (<0.01% of all cervical masses) that associates primary hyperparathyroidism in 9% of cases. Parathyroid scintigraphy is essential for its diagnosis with uncommon false negative results. Hybrid SPECT/CT equipments allow a more accurate diagnosis. Functional cystic parathyroid adenomas are surgically treated. A case of a 64-year-old woman with diagnoses of hyperparathyroidism and a cystic parathyroid adenoma without uptake in scintigraphy is described.

[Sarcoidosis of bone. Findings in the Gallium citrate examination]. / Sarcoidosis ósea. Hallazgos en la exploración con citrato de Galio.

Sarcoidosis of bone lesions are rare, with an overall incidence of 3-9% of the cases. When they do occur, they are more frequent in the small bones of hands and feet than in long bones, spine or skull. We report a case of a male patient with sarcoidosis with multiple enlarged lymph nodes, skin and bone lesions, and the scintigraphic findings.

[The clinical relevance of FDG-PET imaging in severe traumatic brain injuries]. / Relevancia clínica de la FDG-PET en los traumatismos craneoencefálicos graves.

AIM: To evaluate the usefulness of positron emission tomography (PET) as a predictor of long-term disability after a severe traumatic brain injury (TBI). PATIENTS AND METHODS: Fifty-six patients who had sustained a severe TBI were assessed with a broad battery of cognitive and functional scales at baseline and 6-months after inclusion in a multidisciplinary rehabilitation program. All patients underwent a FDG-PET at baseline. A physician blind to clinical data performed a semiquantitative analysis (normal vs altered) of functional neuroimaging (PET), including four cortical and three subcortical areas. The total number of lesions (cortical, subcortical and total) was correlated to the intensity of the TBI and to clinical data at admission and at follow-up. RESULTS: All patients showed changes in cerebral metabolism, being the thalamus the area most frequently affected. The degree of cerebral hypometabolism showed a significant correlation with TBI severity, functional disability, global outcome and cognitive impairment not only at baseline but also at follow-up. CONCLUSIONS: According to our results, FDG-PET may be a useful tool when studying brain dysfunction after severe TBI. FDG-PET findings correlate with the TBI severity, and with the level of patients' disability, as well as with the degree of memory and intelligence impairment. However, clinical variables related to the severity of the TBI, still are the best predictors of functional outcome after TBI.

[Scintigraphy with labelled leukocytes in acute pancreatitis. Preliminary results]. / Gammagrafía con leucocitos marcados en la pancreatitis aguda. Resultados preliminares.

This study aims to evaluate the contribution of the 99mTc-HMPAO labelled leukocyte in the prognostic assessment of patients with acute pancreatitis. We have compared the usual methods of prognostic evaluation (computed tomography CT and the Ranson clinical score scale) with the scintigraphic findings in 23 consecutive patients with a clinical diagnosis of mild or severe acute pancreatitis. All 6 patients with severe pancreatitis showed an uptake which was mostly mild. 9/17 patients with mild pancreatitis showed uptake, which also frequently had a low intensity. When the severity index of CT was compared with the leukocyte results, the only patient with a high severity index showed a grade 3 uptake. However, in over 50% of the patients with a low severity index, uptake, generally having a low intensity, was found. When the uptake degree was compared with the Ranson score level, we observed a predominance of mild uptake in both patients with mild and severe pancreatitis. Considering these results, we believe that the lack of uptake in the leukocyte study in a patient with acute pancreatitis can be interpreted as a good prognosis sign. The significance of the finding of uptake in the pancreatic area is uncertain and studies should be performed in larger sized samples.