RESUMEN
BACKGROUND: Interpretation of abnormal foci with high tracer uptake may require morphological correlation. Fusion of functional images obtained by single photon emission computed tomography (SPECT) and anatomical images obtained by computed tomography (CT) or magnetic resonance (RM) allows an integrated comprehension of complementary information. AIM: To demonstrate that SPECT/CT fusion with external markers is useful in clinical practice to clarify the location and pathological meaning of questionable foci. MATERIAL AND METHODS: Thirty four pairs of images from separate equipments (31 SPECT/CT and 3 SPECT/RM) pertaining to 29 patients, were fused. Fifty one foci of abnormal tracer uptake of uncertain pathological meaning were analyzed. These were classified before and after the fusion as probably malignant or probably benign. RESULTS: Seventy percent of patients had a differentiated thyroid carcinoma. The fusion localized 100% of foci. Nine percent had a normal and 26% an abnormal anatomy. Before fusion 82% of foci were classified as potentially malignant. This figure changed to 59% after the fusion (p <0.01). Therefore the suspicion of malignancy was presumptively confirmed in 72% of foci and fusion results would have reached a 27% of incremental diagnostic value in 14 cases that changed of category (11 with differentiated thyroid carcinoma, one with colorectal cancer, one with a nasal Ewing sarcoma and one with a brain tumor). CONCLUSIONS: The fusion of SPECT and CT is useful in selected patients, specially those with differentiated thyroid carcinoma. The fusion of SPECT and RM is also feasible.
Asunto(s)
Carcinoma/diagnóstico , Imagen por Resonancia Magnética/métodos , Radiofármacos , Neoplasias de la Tiroides/diagnóstico , Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Carcinoma/diagnóstico por imagen , Niño , Preescolar , Femenino , Humanos , Aumento de la Imagen/métodos , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Técnica de Sustracción , Medronato de Tecnecio Tc 99m , Neoplasias de la Tiroides/diagnóstico por imagenRESUMEN
Background: Interpretation of abnormal foci with high tracer uptake may require morphological correlation. Fusion of functional images obtained by single photon emission computed tomography (SPECT) and anatomical images obtained by computed tomography (CT) or magnetic resonance (RM) allows an integrated comprehension of complementary information. Aim To demonstrate that SPECT/CT fusion with external markers is useful in clinical practice to clarify the location and pathological meaning of questionable foci. Material and methods: Thirty four pairs of images from separate equipments (31 SPECT/CT and 3 SPECT/RM) pertaining to 29 patients, were fused. Fifty one foci of abnormal tracer uptake of uncertain pathological meaning were analyzed. These were classified before and after the fusion as probably malignant or probably benign. Results: Seventy percent of patients had a differentiated thyroid carcinoma. The fusion localized 100 percent of foci. Nine percent had a normal and 26 percent an abnormal anatomy. Before fusion 82 percent of foci were classified as potentially malignant. This figure changed to 59 percent after the fusion (p <0.01). Therefore the suspicion of malignancy was presumptively confirmed in 72 percent of foci and fusion results would have reached a 27 percent of incremental diagnostic value in 14 cases that changed of category (11 with differentiated thyroid carcinoma, one with colorectal cancer, one with a nasalEwingsarcoma and one with a brain tumor). Conclusions: The fusion of SPECT and CT is useful in selected patients, specially those with differentiated thyroid carcinoma. The fusion of SPECT and RM is also feasible.
Asunto(s)
Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma/diagnóstico , Imagen por Resonancia Magnética/métodos , Radiofármacos , Neoplasias de la Tiroides/diagnóstico , Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía Computarizada por Rayos X/métodos , Carcinoma , Carcinoma , Aumento de la Imagen/métodos , Radioisótopos de Yodo , Estudios Retrospectivos , Sensibilidad y Especificidad , Técnica de Sustracción , Neoplasias de la Tiroides , Neoplasias de la TiroidesRESUMEN
El rol de la radiología en el diagnóstico de la pancreatitis aguda (PA) y de sus complicaciones ya ha sido establecido. Las distintas clasificaciones que se han creado para determinar la gravedad de esta enfermedad (dentro de ellas la más conocida es la de Balhtazar) no se correlacionan adecuadamente con el manejo ni con el pronóstico del paciente. Por otra parte, muchos de los términos clínico-radiológicos para caracterizar las PA, no son ampliamente aceptados y más aún, son definidos en forma distintas por los diversos autores. El año 1992 el simposio sobre PA en Atlanta estableció una nueva clasificación con el fin de unificar criterios. Esta clasificación es usada en forma sistemática desde el año 1998 en el Hospital Clínico de la Universidad de Chile, existiendo una buena correlación con la evolución clínica de los pacientes. Se presenta la clasificación de Atlanta 1992, para su difusión y discusión en el resto de los servicio de imágenes del país