Salivary gland scintigraphy--a suitable substitute for sialography?

By comparing 27 patients who had both scintigraphy and sialography in the assessment of salivary gland disease, scintigraphy has been shown to correlate well with abnormal sialograms. It is suggested that scintigraphy could become the initial screening procedure in the assessment of salivary gland disease. A normal scintiscan is unlikely to miss significant pathology (as demonstrated by sialography), but sialography must always be performed if there is a suspicion of duct obstruction on scintigraphy. Patients suspected of focal salivary gland pathology such as tumour have not been investigated. The series documents the findings in patients who presented with facial pain, swelling or xerostomia suggesting sialadenitis, duct occlusion or Sjögren's syndrome.

The urinary tract image obtained during 99mTc bone scanning.

During the course of a technetium (99mTc) bone scan, it is usual to obtain an image of both kidneys and the bladder. A review of 96 bone scans performed over a two-year period was undertaken in an attempt to assess the accuracy of this image. Ten examinations showed abnormalities of the urinary image suitable for inclusion in the paper, and were subsequently further investigated. Three cases showed that relatively small lesions may be detected within a kidney if localised caliectasis produced a 'hot-spot'. However, greater diffuse concentration of the imaging agent within one renal image does not necessarily represent an abnormality. Space-occupying lesions can be detected as areas of diminished activity within the renal image, if the tumour is extensive. 'Defects' in the bladder image reflect extrinsic impression rather than intrinsic lesions. A further six cases are included to demonstrate how unusual accumulation of the imaging agent within the abdomen may mimic renal tract pathology.

Tomography of the biliary tract during oral cholecystography: a review of 200 cases.

A review of 200 cases in which routine oral cholecystography was supplemented by tomography is presented. In 69 out of 82 non-visualised gallbladders (NVGB) definite confirmation of gallbladder apthology was obtained. In the poorly functioning gallbladder and the gallbladder obscured by bowel, further information was obtained in 32 out of 56 and 18 out of 26 cases respectively. Tomography proved helpful in localising small filling defects within the gallbladder. Tomography is unlikely to add any extra information to an oral cholecystogram in which a good after fatty meal (AFM) film has been obtained. It is concluded that tomography is a valuable addition to oral cholecystography and increases its accuracy.

Ultrasound in abdominal trauma: an alternative to peritoneal lavage.

Ultrasonography has been used as an investigation in patients with abdominal signs after blunt injury. Thirty-two patients were examined, of whom 11 had abnormal findings. Free intraperitoneal fluid was demonstrated in eight cases, seven of whom had this confirmed at subsequent laparotomy. The 21 patients with normal scans did not require abdominal intervention. It is suggested that ultrasonography is a reliable method of detecting haemoperitoneum and offers a valuable non-invasive method of investigating blunt abdominal injuries. The hepatorenal pouch is the site where free intraperitoneal fluid can be most easily demonstrated.