[Study of active myocardial damage in children with suspected myocarditis using antimyosin monoclonal antibodies (AMMoAb-111In)]. / Estudio evolutivo del daño miocárdica activo en niños con sospecha de miocarditis mediante anticuerpos monoclonales antimiosina (AbMoAM-111In).

BACKGROUND: The study with monoclonal antimyosin antibody-111In has proved to be useful in the detection of the myocardial damage present in different processes. There is active myocardial damage and specific antimyosin uptake in myocarditis, as both experimental and clinical trials have shown. In experimental models the evolution of myocardial damage has been studied, where a parallelism between the histological changes of the myocardial damage and the evolution on the antimyosin uptake has been found. In clinical myocarditis it is difficult to do an histological follow up of the inflammatory process, and therefore the evolution of myocardial damage present in myocarditis is unknown. The antimyosin antibody images allow a non-invasive study of this evolution. OBJECTIVES: a) to study with monoclonal antimyosin antibody-111In, the myocardial damage present regarding the disease evolution in children with suspected clinical diagnosis of myocarditis; b) to evaluate the evolution of the active myocardial damage reflected on the changes on the monoclonal antimyosin antibody-111In uptake. METHODS: A study with monoclonal antimyosin antibody-111In was carried out on 43 children, 16 males and 27 females with a median age of 39 months (SD 48 m; range: 2-167) with suspected diagnosis of acute myocarditis defined as the presence of congestive cardiac failure or severe ventricular arrhythmia with less than 12 months of evolution. The image evaluation was done visually and through the heart to lung ratio. Twenty of these patients were also followed up with antimyosin antibody scan for a period of 19 +/- 9 months, and 3.8 +/- 1.7 studies were performed on them in this time. RESULTS: The prevalence of positive myocardial uptake was 83.72%. There is a negative correlation (r = -0.352; p < 0.02) between the evolution time of the process and the heart to lung ratio: patients studied before two months, have a higher heart to lung ratio and greater prevalence of positive studies than those studied later (heart to lung ratio 2.09 vs 1.74; p = 0.013; 90% vs 69.2%). Of the patients followed up with antimyosin antibody scans, 6 showed a clinical relapse which increased their heart to lung ratio. The other 14 showed an progressive decrease of the heart to lung ratio reaching normality in 14 +/- 6 months. CONCLUSIONS: a) the uptake intensity of monoclonal antimyosin antibody-111In, as a reflection of the myocardial damage, depends on the disease evolution time, as in the first two months is when the major damage happens; b) the uptake intensity slowly decreases, tending to normality around the 14th month, although this evolution may be altered by the appearance of relapses.

[Gammagraphic study of nodular adrenal hyperplasia]. / Estudio gammagráfico de la hiperplasia suprarrenal nodular.

A common cause of the Cushing's Syndrome (CS) is nodular suprarenal hyperplasia (NSH), which is characterized by the presence of nodes in both suprarenal glands. Its pathophysiology is not well known and its diagnosis is quite difficult due to the heterogenicity of the biochemical and radiological data. We analyzed the suprarenal gammagraphies (SRG) of 7 patients with anatomopathological diagnosis of NSH. Bilateral uptake was observed in all cases and in five patients, such bilateral uptake presented a clear asymmetry. We believe that these observations demonstrate a bilateral suprarenal affectation and are of great use in order to orientate the diagnosis of NSH and, especially, in order to differentiate it from other suprarenal diseases causing CS, like adenomas, in which uptake is unilateral.

[Brain scanning in children (author's transl)]. / Valoración de la gammagrafía en los tumores cerebrales de la infancia

This report is concerned with evaluation of brain scintigraphy in the detection of brain tumors in children. Brain scans have been reviewed in 309 cases and were evaluated in 182 patients; brain tumor suspicious was present in 41 childrens. True positive results were obtained in 73% of brains tumors and true negative results in 5% with other diseases. There were either false positive or false negative results in 21% of scans. Results are compared to other series reported, showing similar findings. Finally the importance of this type of investigation is stressed.