RESUMEN
PURPOSE: Ga-67 planar and SPECT images of 85 patients after treatment for mediastinal-hilar (M-H) lymphoma were reviewed retrospectively. Forty-seven patients had Hodgkin's disease and 38 patients had non-Hodgkin's lymphoma. The entire period was 7 years after diagnosis. The main goal was visual assessment of the significance of mild (grades 1 or 2) Ga-67 uptake in the M-H area as compared with Ga-67 uptake in bone marrow. METHODS: Residual Ga-67 mediastinal uptake after a complete course of chemotherapy or other treatments was defined as normal (no residual) M-H uptake, borderline (M-H residual uptake with intensity less than that or equal to the sternum, spine, or both), and abnormal (M-H residual uptake with intensity greater than that of the sternum or spine). RESULTS: Among the 38 patients (45%) with no residual M-H uptake, four (one Hodgkin's disease and three non-Hodgkin's lymphoma) experienced recurrence: two in the mediastinum and two in the abdomen. Among the 45 patients (53%) with borderline M-H uptake, five experienced recurrence: two in the mediastinum and three in other sites. The two patients (2%) with abnormal (M-H) uptake never responded to treatment. No significant statistical difference in tumor recurrence was found between no residual and borderline uptake (P = 0.21). CONCLUSIONS: Visual assessment of M-H Ga-67 uptake (without quantification) could be useful to differentiate active residual tumor from nonactive residual uptake.
Asunto(s)
Radioisótopos de Galio , Enfermedad de Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/diagnóstico por imagen , Neoplasias del Mediastino/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único , Femenino , Estudios de Seguimiento , Enfermedad de Hodgkin/terapia , Humanos , Linfoma no Hodgkin/terapia , Masculino , Neoplasias del Mediastino/terapia , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico por imagen , Pronóstico , Estudios Retrospectivos , Factores de TiempoRESUMEN
OBJECTIVE: We compared patient treatment with imaging strategy in patients with clinically suspected pulmonary embolism (PE) and intermediate-probability lung scans (IPLS). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 214 consecutive patients with clinically suspected PE with IPLS. RESULTS: Treatment (full anticoagulation, filter placement, or both) was given in 66 (31%) of 214 patients. Only 37% of patients were treated on the basis of definitive diagnostic imaging results. Most patients (134 [63%] of 214) were treated without an imaging diagnosis: 30 (14%) of 214 patients were treated for acute PE on clinical grounds, and the diagnosis of PE was not excluded in 104 (49%) of 214 patients. CONCLUSION: Most patients with IPLS are treated without a definitive imaging diagnosis. This lack of diagnosis may result in the overtreatment of patients who do not have acute PE or, more importantly, in the undertreatment of patients who do have acute PE. Further studies are necessary to evaluate the impact of the current management strategies on patient outcome.
Asunto(s)
Pulmón/diagnóstico por imagen , Embolia Pulmonar/diagnóstico por imagen , Anticoagulantes/uso terapéutico , Diagnóstico por Imagen/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/terapia , Radiografía , Cintigrafía , Estudios Retrospectivos , Ultrasonografía , Filtros de Vena CavaRESUMEN
Gastric accumulation of Ga-67 greater than that seen in the liver was observed in 16 of 162 (9.8%) patients with lymphoma. Endoscopic biopsies in six patients showed one instance each of histiocytic lymphoma, mixed cellularity Hodgkin's disease, adenocarcinoma, and hiatal hernia with mucosal deformity, as well as two instances of benign gastric ulcer. All six patients had chronic gastric symptoms, as well as persistent radiogallium accumulation on sequential examinations of 2 years duration. The remaining 10 patients exhibited transient radiotracer gastric uptake and only two has gastric symptoms. Persistent gastric Ga-67 accumulation is not common in lymphoma and warrants endoscopy when accompanied by prolonged symptoms.
Asunto(s)
Radioisótopos de Galio , Enfermedad de Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico por imagen , Estómago/diagnóstico por imagen , Adulto , Citratos , Ácido Cítrico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Gastropatías/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
We describe gastric localization of 67Ga in 13 patients with acquired immunodeficiency syndrome (AIDS) among 148 referred primarily to rule out Pneumocystis carinii pneumonia (PCP). Endoscopic biopsies in five of the patients indicated cytomegalovirus (CMV) infection in one, gastritis in two, and normal tissue in two. Other associated, but nongastric, infections in these 13 patients included esophageal candidiasis, PCP, Mycobacterium avium-intracellulare (MAI) complex, coccidioidomycosis, toxoplasmosis and Isospora belli. Only six of the patients exhibited gastric symptoms, and even fewer proved to have gastric pathology. Although gastric 67Ga uptake in a patient with AIDS may not require specific treatment, opportunistic infections as a possible cause of gastritis should be considered.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Citratos , Radioisótopos de Galio , Gastritis/diagnóstico por imagen , Infecciones Oportunistas/complicaciones , Estómago/diagnóstico por imagen , Adulto , Ácido Cítrico , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/diagnóstico por imagen , Femenino , Galio , Gastritis/microbiología , Humanos , Masculino , Persona de Mediana Edad , Infecciones Oportunistas/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
We reviewed the radiographs of thirty-one patients (thirty-two hips) who had had revision of the acetabular component of a total hip arthroplasty with a bipolar socket supplemented by allograft and were followed for twenty-four to forty-eight months. The grafts were categorized according to their consistency (solid or crushed bone), the location of the acetabular defect (peripheral [rim] or central), and the extent of the acetabular defect (contained--the medial part of the acetabular wall was intact, or non-contained--it was deficient). We recorded the time to incorporation of the graft, the amount of migration of the socket in the superior and medial axes, and the percentage of graft remaining at the time of the most recent follow-up. The time to healing was similar for all categories of grafts. The central, contained, solid grafts had less resorption than did the central, contained, crushed-bone grafts, as evidenced by less migration of the socket during follow-up. The non-contained grafts, in both peripheral and central locations, were associated with high rates of migration and of instability of the socket.
Asunto(s)
Acetábulo/diagnóstico por imagen , Trasplante Óseo , Prótesis de Cadera , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/cirugía , Femenino , Estudios de Seguimiento , Humanos , Inestabilidad de la Articulación/fisiopatología , Masculino , Persona de Mediana Edad , Osteoartritis de la Cadera/cirugía , Radiografía , Reoperación , Trasplante Homólogo , Cicatrización de HeridasRESUMEN
The radiographs of 268 patients with knee trauma were retrospectively reviewed. In 15 patients with intraarticular fracture, the images demonstrated fat-fluid levels. In 28 other patients with intraarticular fracture, only joint effusion without a fat-fluid level was depicted. The presence of a fat-fluid level in the knee indicated fracture in all patients in whom it was seen. The absence of such a level, however, did not exclude intraarticular fracture.
Asunto(s)
Fracturas Óseas/complicaciones , Hemartrosis/diagnóstico por imagen , Traumatismos de la Rodilla/complicaciones , Articulación de la Rodilla/diagnóstico por imagen , Exudados y Transudados/análisis , Hemartrosis/etiología , Humanos , Traumatismos de la Rodilla/diagnóstico por imagen , Lípidos , RadiografíaRESUMEN
We reviewed the radiographs and medical records of 76 patients with 98 nonconstrained total shoulder prostheses: 68 were inserted for rheumatoid arthritis, 25 for osteoarthritis, and five for avascular necrosis. The radiographic follow-up averaged 36 months. Radiographic evidence of postoperative complications was noted in 37 (38%) of 98 shoulders: dislocation of the humeral head (six), upward migration of the humerus (24), loosening of the glenoid compartment (15), loosening of the humeral component (five), subsidence of the humeral component (seven), and heterotopic bone formation (six). Patients with a dislocated prosthesis had limitation of motion, poor function, and residual pain. No increase in pain was associated with proximal subluxation of the humerus. No correlations were found between any of the radiographic findings (the presence of radiolucent lines about the glenoid or humeral components, humeral subsidence, or ectopic ossification) and any of the clinical findings (pain relief, range of motion, motor power, or functional improvement).
Asunto(s)
Prótesis Articulares , Articulación del Hombro/diagnóstico por imagen , Artritis Reumatoide/cirugía , Humanos , Prótesis Articulares/efectos adversos , Osteoartritis/cirugía , Osteonecrosis/cirugía , Complicaciones Posoperatorias , Falla de Prótesis , Radiografía , Articulación del Hombro/cirugíaRESUMEN
In 122 patients with fungal diseases studied over a six month period, sixty were seen with dermatophyte infections. Tinea pedis, cruris and ungruium occurred mainly in adult males attending the private hospital and tinea corporis and capitis children attending the University Hospital. The organisms found were Trichophyton rubrum, T. mentagrophytes, T. schonleinii, T. tonsurans, Epidermophyton floccosum and Microsporum canis. Infections with Candida albicans occurred both in the urban and rural population and included case of familial chronic muco-cutaneous candidiasis. Pityriasis versicolor was the commonest fungal disease seen.