[Diagnosis and localization of hyperparathyroidism by nuclear medicine procedures]. / Contribución de las técnicas de medicina nuclear al diagnóstico y localización del hiperparatiroidismo.

Primary hyperparathryoidism is a PTH hypersecretion caused by the parathyroid glands. In most cases (85%), the origin is to be due to the existence of a parathyroid adenoma, despite the intrinsic difficulty in being localized under certain circumstances. From some time now, we can count with the invaluable help of a nuclear medicine technique, namely the parathyroid scintigraphy with Technetium 99m-sestamibi (Tc99m-MIBI), a technique which is easy to perform, cheap and with excellent results, and which additionally can provide us with the above mentioned necessary information regarding location. We present here the case of a patient suffering from primary hyperparatyiroidism, in whom both the disease and the precise location of the hyperfunctioning tissue were identified by means of the parathyroid scintigraphy. Another nuclear medicine procedure, the one known as bone scintigraphy, also contributed meaningfully to the correct diagnosis in the same patient.

Repair of coarctation of the aorta in children: postoperative morphology.

To determine the morphologic sequelae after surgical repair of coarctation of the aorta, the authors retrospectively reviewed angiograms and hemodynamic and clinical data on 215 patients who underwent cardiac catheterization after surgical repair of coarctation of the aorta during a 13-year period. Ninety-seven patients (45%) underwent coarctation resection with end-to-end anastomosis; 92 (43%), subclavian-flap angioplasties; and 26 (12%), synthetic-patch repairs. Sixty-four patients (30%) had an "aneurysm," defined as a measurement ratio of repair site to diaphragmatic aorta greater than 1.5. Transverse-arch or isthmic hypoplasia or recoarctation was detected in 86 patients (40%) and was most commonly associated with septal defects or obstruction of the left ventricular outflow tract. Pullback systolic pressure gradients at catheterization were significantly higher (P = .0001) in the patients with transverse-arch hypoplasia and recoarctation than in those with ratios of transverse arch to diaphragmatic aorta greater than 0.9. Significant postoperative arch obstructions can be predicted with measurement ratios on the basis of the diameter of the abdominal aorta.