Assuntos
3-Iodobenzilguanidina , Radioisótopos do Iodo , Neuroblastoma/diagnóstico por imagem , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/secundário , Neoplasias Abdominais/terapia , Adolescente , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Medula Óssea , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Criança , Pré-Escolar , Terapia Combinada , Erros de Diagnóstico , Feminino , Seguimentos , Genes myc , Humanos , Lactente , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/secundário , Estadiamento de Neoplasias , Neuroblastoma/genética , Neuroblastoma/patologia , Neuroblastoma/secundário , Neuroblastoma/terapia , Cintilografia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Sensibilidade e Especificidade , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/secundário , Sinovite/diagnóstico , Neoplasias Torácicas/diagnóstico por imagem , Neoplasias Torácicas/secundário , Neoplasias Torácicas/terapia , Transplante AutólogoRESUMO
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Assuntos
Adolescente , Pré-Escolar , Humanos , 3-Iodobenzilguanidina/uso terapêutico , Radioisótopos do Iodo , Neuroblastoma , Protocolos de Quimioterapia Combinada Antineoplásica , Genes myc , Neuroblastoma/secundário , Transplante Autólogo , Transplante Ósseo , Neoplasias Abdominais , Neoplasias Abdominais/terapia , Neoplasias Ósseas , Neoplasias Ósseas/secundário , Neoplasias Hepáticas , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares , Neoplasias Pulmonares/secundário , Neoplasias do Mediastino , Neoplasias Torácicas , Neoplasias Torácicas/secundário , Neoplasias Torácicas/terapiaRESUMO
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.
Assuntos
Anticorpos Monoclonais , Miocardite/diagnóstico por imagem , Compostos Organometálicos , Criança , Pré-Escolar , Feminino , Humanos , Radioisótopos de Índio , Lactente , Masculino , Cintilografia , Estudos Retrospectivos , Fatores de TempoRESUMO
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.
Assuntos
Glândulas Suprarrenais/patologia , Síndrome de Cushing/diagnóstico por imagem , Glândulas Suprarrenais/metabolismo , Hormônio Adrenocorticotrópico/sangue , Adulto , Colesterol , Síndrome de Cushing/etiologia , Síndrome de Cushing/fisiopatologia , Feminino , Humanos , Hidrocortisona/metabolismo , Hiperplasia , Masculino , Pessoa de Meia-Idade , Cintilografia , Tomografia Computadorizada por Raios XRESUMO
A retrospective study is presented of 19 patients who suffered Hypercortisolism who were examined by adrenal gammagraphy, echography, and CT scan in order to evaluate the usefulness of gammagraphy in the diagnostic approximation of this pathology. The gammagraphy findings had an excellent correlation with anatomopathologic findings, probably due to the combined morphologic and functional evaluation obtained with this technique which facilitates a complementary vision to the other diagnostic image exams (CT scan and echography) which, although they are the first choice given their availability and good resolution, they can easily lead to diagnostic errors which can be avoided if we can perform an adrenal gammagraphy; it is of special interest in the study of macro-micro-nodular hyperplasia and its differentiation from single adenomas.