RESUMO
A rare case of Gorham's disease affecting the radius in a 46-year-old woman is presented. It was studied by plain radiography, MRI, and scintigraphy, including three-phase radionuclide bone scan and thallium scan. Three-phase bone scan demonstrated slightly decreased activity in the affected portion of the forearm in the early phase, but showed increased activity on the blood pool and delayed imaging. A thallium scan revealed no abnormalities. Histopathologic examination revealed osteoclastic activity and scar tissue with minimal remaining vasculature.
Assuntos
Imageamento por Ressonância Magnética , Osteólise Essencial/diagnóstico , Rádio (Anatomia)/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Osteólise Essencial/diagnóstico por imagem , Osteólise Essencial/patologia , Radiografia , Cintilografia , Rádio (Anatomia)/diagnóstico por imagem , Medronato de Tecnécio Tc 99m , Radioisótopos de TálioRESUMO
An 82-year-old man had his third episode of melanotic stool. Two previous workups had failed to localize the source of bleeding. A Tc-99m labeled RBC scan visualized the gallbladder early in the study. Administration of sincalide visually decreased the activity, confirming gallbladder activity. Three months later, at his second surgery, hepatic metastases were finally identified as the source of bleeding. In retrospect, the hepatic activity is inhomogeneous with at least two cold defects that could have represented hepatic metastases.
Assuntos
Vesícula Biliar/diagnóstico por imagem , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemobilia/diagnóstico por imagem , Sincalida , Pertecnetato Tc 99m de Sódio , Adenocarcinoma/complicações , Adenocarcinoma/secundário , Idoso , Divertículo/complicações , Eritrócitos , Hemorragia Gastrointestinal/etiologia , Hemobilia/etiologia , Humanos , Doenças do Jejuno/complicações , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/secundário , Masculino , Neoplasias Primárias Desconhecidas , CintilografiaRESUMO
Portable cerebral perfusion studies provide a quick and accurate alternative to traditional confirmatory examinations (such as four-vessel angiography and electroencephalography) to determine brain death. The authors retrospectively analyzed 26 cerebral perfusion studies using both Tc-99m DTPA and Tc-99m HMPAO. The flow agents gave identical results. Additionally, the delayed-phase Tc-99m HMPAO images gave the same results for brain death (14 positive and 12 negative) as the flow images from either agent. Because the Tc-99m HMPAO delayed images can be used for diagnosis, many technical problems become less crucial. Unlike Tc-99m DTPA, Tc-99m HMPAO normally visualizes the gray matter of the cerebellum, midbrain, and medulla. These areas must be evaluated to ensure that they meet the strict criteria for brain death. These differences and the present study suggest that Tc-99m HMPAO is a superior agent for cerebral perfusion studies to determine brain death.
Assuntos
Morte Encefálica/diagnóstico por imagem , Compostos de Organotecnécio , Oximas , Pentetato de Tecnécio Tc 99m , Adulto , Encéfalo/diagnóstico por imagem , Circulação Cerebrovascular/fisiologia , Feminino , Humanos , Masculino , Cintilografia , Estudos Retrospectivos , Tecnécio Tc 99m Exametazima , Fatores de TempoRESUMO
Andersen Air Force Base in Guam boasts the tallest control tower in the Air Force. In 1986, an air traffic controller was struck by lightning as the bolt proceeded through the tower. Although he received only a backache, the lightning left a hole with surrounding scorch marks on his fatigue shirt and his undershirt. The lightning strike also ignited a portion of the field lighting panel, which caused the runway lights to go out immediately. Lack of a lightning rod is the most likely reason the controller was struck. Proper precautions against lightning strikes can prevent such occupational safety hazards.
Assuntos
Aviação , Lesões Provocadas por Raio , Militares , Guam , Humanos , Lesões Provocadas por Raio/terapia , Masculino , Sobrevida , Estados UnidosRESUMO
Scintigraphy was instrumental in two histologically proven cases of forme fruste melorheostosis. Radionuclide bone scans demonstrated a moderately increased uptake of radiopharmaceutical localized to the "flowing" cortical hyperostosis of melorheostosis observed radiographically. The medullary portion of the affected bones showed no increase in tracer activity. In one case, imaging with Tl-201 chloride demonstrated increased focal activity of the lesion. These scintigraphic findings can help distinguish the mildest manifestation (forme fruste) of melorheostosis from the well-ossified lesions of myositis ossificans and parosteal or periosteal osteosarcoma. The findings of MRI are also described in one patient.
Assuntos
Fêmur/diagnóstico por imagem , Melorreostose/diagnóstico por imagem , Tíbia/diagnóstico por imagem , Adulto , Biópsia , Feminino , Fêmur/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Melorreostose/diagnóstico , Cintilografia , Tíbia/patologiaRESUMO
A 76-year-old woman presented after 1 day of melena and anemia. A Meckel's scan revealed an upper mid abdominal focus of activity that paralleled stomach activity. Later, the surgeon removed the corresponding lesion in the mid ilium. Pathology confirmed that the lesion was a carcinoid tumor, not ectopic gastric mucosa. The false-positive Meckel's scan had revealed the true source of gastrointestinal bleeding and an unsuspected solitary carcinoid tumor. This is the third published case of a carcinoid tumor discovered by a false-positive Meckel's scan.
Assuntos
Tumor Carcinoide/diagnóstico por imagem , Hemorragia Gastrointestinal/diagnóstico por imagem , Neoplasias do Íleo/diagnóstico por imagem , Divertículo Ileal/diagnóstico por imagem , Idoso , Tumor Carcinoide/complicações , Tumor Carcinoide/cirurgia , Reações Falso-Positivas , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Neoplasias do Íleo/complicações , Neoplasias do Íleo/cirurgia , Cintilografia , Pertecnetato Tc 99m de SódioRESUMO
Classically, the "rim sign" has been described throughout the hepatobiliary scan. The authors present a case of a late rim sign visualized at 25 minutes postinjection that proved to be acute upon chronic acalculous cholecystitis without gangrene.
Assuntos
Colecistite/diagnóstico por imagem , Vesícula Biliar/diagnóstico por imagem , Fígado/diagnóstico por imagem , Doença Aguda , Colecistite/patologia , Doença Crônica , Feminino , Vesícula Biliar/patologia , Humanos , Iminoácidos , Pessoa de Meia-Idade , Compostos de Organotecnécio , Cintilografia , Sensibilidade e Especificidade , Disofenina Tecnécio Tc 99m , Fatores de TempoRESUMO
Osteosarcoma commonly presents with osseous and pulmonary metastases. We present an unusual case of extraosseous metastatic abdominal chondroblastic osteosarcoma presenting as intestinal obstruction.