RESUMO
Iodine-123 thyroid scintigraphy allows the diagnosis of a functioning retrosternal goiter in a patient with a mediastinal mass. The case report of a 60-yr-old lady demonstrates this. The correlative values of nuclear magnetic resonance imaging and thyroid scintigraphy in the initial evaluation and continued management of patients with thyroid mediastinal mass are presented. In addition, this observation demonstrates the ability of nuclear magnetic resonance to identify retrosternal thyroid tissue. This may obviate the need for TCT evaluation, which involves both ionizing radiation and iodinated contrast enhancement.
Assuntos
Bócio Subesternal/diagnóstico , Radioisótopos do Iodo , Espectroscopia de Ressonância Magnética , Feminino , Bócio Subesternal/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , CintilografiaRESUMO
A patient had severe congestive cardiomyopathy secondary to myocardial sarcoidosis. The clinical diagnosis was confirmed by radionuclide ventriculography, thallium 201 (201Tl), gallium-67 (67Ga), and technetium-99m (99mTc) pyrophosphate (TcPYP) scintigraphy. Myocardial TcPYP uptake has not been reported previously in sarcoidosis. In this patient, TcPYP was as useful as gallium scanning and thallium imaging in documenting the myocardial process.
Assuntos
Cardiomiopatias/diagnóstico por imagem , Difosfatos , Radioisótopos de Gálio , Coração/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Tecnécio , Adulto , Feminino , Humanos , Radioisótopos , Cintilografia , Pirofosfato de Tecnécio Tc 99m , TálioRESUMO
The thickness of the endometrium was compared in 15 patients who conceived and 15 who did not with an in vitro fertilization and embryo transfer (IVF-ET) protocol after ovulation induction with human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG). There was no statistically significant difference (P = 1.0) in the endometrial thickness in the conception versus the nonconception group. Average estradiol (E2) values and number of mature follicles were also not statistically different in the two groups (P = 0.78, P = 0.81). There was a slightly significant difference in the number of embryos transferred in the conception versus nonconception groups (2.5 versus 1.9, P = 0.005). However, the most significant difference between the conception and nonconception groups was the total number of oocytes retrieved (4.4 versus 2.8, P = 0.005). These findings indicate that there are no sonographically detectable differences in the endometrial thickness in patients who achieve pregnancy versus those that do not when given a similar ovulation induction regimen of hMG/hCG for IVF-ET.
Assuntos
Endométrio/patologia , Fertilização in vitro , Gravidez , Ultrassonografia , Gonadotropina Coriônica/administração & dosagem , Estradiol/sangue , Feminino , Humanos , Infertilidade Feminina/patologia , Infertilidade Feminina/terapia , Menotropinas/administração & dosagem , Folículo Ovariano/patologia , Indução da Ovulação , Estudos ProspectivosRESUMO
Allograft renal vein thrombosis has been reported in 1 to 4% of the renal transplants. Salvage of the graft is possible only if there is prompt recognition and operative intervention. We present the case of a living-related renal transplant that was salvaged because of early diagnosis of allograft renal vein thrombosis by correlation of the radioisotopic angiogram, renogram and duplex doppler sonography.
Assuntos
Transplante de Rim , Complicações Pós-Operatórias/diagnóstico , Veias Renais , Trombose/diagnóstico , Adolescente , Humanos , Masculino , Cintilografia , Trombose/diagnóstico por imagem , Trombose/patologia , UltrassonografiaRESUMO
An unusual case is described in which in spite of clinical, scintigraphic and histologic findings strongly supportive of a diagnosis of "hyperacute rejection," recovery of renal function occurred. These findings are in contrast to the current literature in which it is generally accepted that a renal allograft showing neither pertechnetate transit nor hippurate concentration warrants allograft nephrectomy irrespective of the etiology. Scintigraphic evaluation included both dynamic studies after a bolus administration of Tc-99m pertechnetate and serial renogram collections after the intravenous administration of I-131 Hippuran.
Assuntos
Rejeição de Enxerto , Ácido Iodoipúrico , Transplante de Rim , Tecnécio , Adulto , Humanos , Rim/diagnóstico por imagem , Masculino , Cintilografia , Pertecnetato Tc 99m de Sódio , Fatores de TempoRESUMO
Microlymphaticovenous anastomoses provide a potential for reducing lymphedema of the upper extremity complicating radical mastectomy or irradiation. Lymphoscintigraphy is a valuable investigative modality in the perioperative evaluation of patients undergoing this surgical procedure. The radionuclide studies provide information regarding structural change and physiologic derangement with a low radiation dose to the patient. It is a simple, painless procedure requiring minimal skill and no surgical intervention. In addition, a reproducible method for preparing a radiocolloid suitable for lymphatic imaging using an approved drug as a precursor has been developed.
Assuntos
Linfonodos/diagnóstico por imagem , Linfedema/cirurgia , Braço/irrigação sanguínea , Humanos , Período Intraoperatório , Metástase Linfática , Sistema Linfático/cirurgia , Linfedema/diagnóstico por imagem , Microcirurgia , Cintilografia , Enxofre , Tecnécio , Coloide de Enxofre Marcado com Tecnécio Tc 99mRESUMO
Sonography has a major role in the identification, evaluation, and treatment of the hydropic fetus. Although the prognosis of the NIH fetus is generally poor, the IIH fetus can frequently be treated effectively by transfusions performed by percutaneous needling of the umbilical vein. In addition, sonographic guidance of percutaneous umbilical vein sampling affords an accurate assessment of the etiology of NIH by facilitating karyotyping of the fetal blood.
Assuntos
Doenças Fetais/diagnóstico , Hidropisia Fetal/diagnóstico , Diagnóstico Pré-Natal/instrumentação , Feminino , Humanos , Hidropisia Fetal/terapia , Gravidez , Prognóstico , Ultrassonografia/métodosRESUMO
Subtle sonographic findings and other nonspecific clinical presentations often lead to missed diagnoses that can have significant legal implications. This communication discusses current diagnostic and laboratory methods used to evaluate patients with a suspected ectopic pregnancy in light of the concepts of "missed lesions" as they relate to negligence and malpractice theory.
Assuntos
Gravidez Ectópica/diagnóstico , Feminino , Humanos , Legislação Médica , Gravidez , UltrassonografiaRESUMO
This report documents the outcome of 25 pregnancies with elevated serum alpha-fetoprotein levels on two separate samplings despite normal anatomic appearance of the fetus on a detailed "consultative" sonographic examination. Six of these also had elevated amniotic fluid alpha-fetoprotein. All fetuses in this series were anatomically normal at time of delivery; one aborted fetus was triploid. Of the 25 pregnancies, 16 had sonographically demonstrable placental hemorrhage, eight retroplacental and eight subchorionic. One had hydropic changes in the placenta associated with triploidy. Of the subgroup of six pregnancies in which both serum and amniotic fluid values were elevated, one had a retroplacental hemorrhage, one had a subchorionic hemorrhage, and one had diffuse hydropic changes in the placenta. A control group of 112 patients with normal alpha-fetoprotein levels yielded four with small (less than 2 cm3) subchorionic hemorrhage. The occurrence rate of placental hemorrhage in women with elevated alpha-fetoprotein and normal fetus was 64%, whereas the control group of patients with normal alpha-fetoprotein had a 3.6% occurrence rate of placental hemorrhage. Sonographically detectable placental abnormalities may be associated with elevated alpha-fetoprotein in serum and/or amniotic fluid samples. Such abnormalities may occur because of fetomaternal admixture associated with placental hemorrhage and/or intraamniotic bleeding resulting from subchorionic hemorrhage.