[Pulmonary scintigraphy with MAA-Tc 99m perfusion in the diagnosis of pulmonary embolism]. / La scintigraphie pulmonaire de perfusion AU MAA-TC 99M dans le diagnostic de l'embolie pulmonaire.

Perfusion lung scintigraphy is vital to guide the diagnosis even without a ventilation scintigraphy. A customised strategy could be useful to optimise the use of perfusion scintigraphy when not coupled with a ventilation scintigraphy. We report about a retrospective study on 300 patients received in our department for suspected lung migrations. The patients underwent a perfusion scintigraphy only: a normal scintigraphy would discard the diagnosis when achieved between 6 and 72 hours after the accident. On the other hand, the evidence of one or two perfusion defects would allow to maintain the pulmonary embolism suspicion and establish an effective heparinic treatment. A second control comparative scintigraphy, a few weeks after the first one, very often confirms the diagnosis, allows the assessment of the heparinotherapy and if necessary, indicate to stop it.

[Bone scan and prostate cancer]. / Scintigraphie osseuse et cancer de la prostate.

Prostatic cancer has a great predilection for bone. The evaluation of its extension towards the skeleton is based on the bone scan, which has a better sensitivity than radiological examinations and clinical evaluation. Bone scan evaluation of the osseous extension, allowed a better comprehension of the mechanism of dissemination, the assumption of Batson appearing currently not very plausible. The importance of the osseous extension on the bone scan has a prognostic value; it constitutes one of the significant parameters of stratification in clinical trials. The indications of bone scan have been greatly modified since the introduction of prostate-specific antigen (PSA). At the initial assessment, the of bone scan should be indicated only if the rate of PSA exceeds 10-20 ng/mL, in the event of low grade tumor and pain. In the follow-up, the evolution of the PSA constitutes the major element of monitoring. After radical therapy, a rise in the PSA indicates bone scan, particularly if the level exceeds 10 ng/mL. In stage D2, routine bone scan is no longer indicated, except in phases II and III of the clinical trials.