RESUMO
Radionuclide oesophageal transit time was evaluated in 70 individuals, divided into three groups: normal individuals, patients with non-organic dysphagia and patients with primary oesophageal motility disorders treated with per-endoscopic forced pneumatic dilatation. In all of them the oesophageal transit time of a bolus of water with 18.5 MBq (500 microCi) of 99Tmc sulphur colloid was assessed, as was the percentage of residual activity of the bolus in the oesophagus. There was a significant difference in these parameters between the control group and the group with non-organic dysphagia, the diagnostic capacity of this test being 93% sensitivity, 100% specificity, 100% positive predictive value and 90% negative predictive value, which suggests its inclusion in diagnostic protocols of dysphagias. In patients with primary oesophageal motility disorders, a significant decrease in values of residual activity has been observed after treatment with per-endoscopic forced pneumatic dilatation.
Assuntos
Transtornos de Deglutição/diagnóstico por imagem , Esôfago/diagnóstico por imagem , Adulto , Idoso , Transtornos de Deglutição/fisiopatologia , Transtornos de Deglutição/terapia , Dilatação , Esôfago/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peristaltismo , Cintilografia , Fatores de TempoRESUMO
OBJECTIVES: To determine the accuracy of imaging techniques for localization of nodular lesions of parathyroid glands. MATERIAL AND METHODS: Seventy one patients were prospectively enrolled and underwent surgical examination for primary hyperparathyroidism. Ultrasonography (US), 201Tl/99mTc parathyroid subtraction scintigraphy and 99mTc MIBI scintigraphy were evaluated. RESULTS: The sensitivity and specificity for combined 201Tl/99mTc parathyroid subtraction scintigraphy and US for parathyroid adenomas were 72.27% and 89.22% respectively. The combination of 99mTc MIBI scintigraphy and US resulted in improved specificity (93.67%) and positive predictive value (80.39%). The accuracy of the localizing studies was lower for patients with hyperplasia. CONCLUSIONS: The combination of scintigraphy and US is the best approach for localization of nodules. In most cases, the two techniques are complementary.
Assuntos
Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Hiperparatireoidismo/diagnóstico por imagem , Hiperparatireoidismo/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Estudos Prospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios XRESUMO
Objetivo: Determinar la rentabilidad diagnóstica de las diferentes técnicas de localización de las glándulas paratiroides. Material y Métodos: Se realiza un estudio prospectivo sobre 71 pacientes diagnosticados de hiperparatiroidismo primario e intervenidos quirúrgicamente. Evaluamos la validez diagnóstica de la ecografía de alta resolución, gammagrafía de sustracción Talio/Tecnecio y gammagrafía sestamibi en doble fase. Resultados: La sensibilidad (S) y especificidad (E) de la utilización conjunta de la gammagrafía de sustracción Talio/Tecnecio y la ecografía en los adenomas fue de 72,27 por ciento y 89,22 por ciento, respectivamente. La combinación de la gammagrafía sestamibi seguida de la ecografía mejoró discretamente los parámetros evaluados, en particular la especificidad (93,67 por ciento) y el valor predictivo positivo (80,39 por ciento). En nuestra serie la rentabilidad diagnóstica ha sido inferior en las hiperplasias. Conclusión: La utilización conjunta de la gammagrafía seguida de la ecografía de alta resolución, realizadas por un operador experimentado, son la mejor estrategia diagnóstica a seguir para la localización preoperatoria de las glándulas paratiroides patológicas (AU)
OBJECTIVES: To determine the accuracy of imaging techniques for localization of nodular lesions of parathyroid glands. MATERIAL AND METHODS: Seventy one patients were prospectively enrolled and underwent surgical examination for primary hyperparathyroidism. Ultrasonography (US), 201Tl/99mTc parathyroid subtraction scintigraphy and 99mTc MIBI scintigraphy were evaluated. RESULTS: The sensitivity and specificity for combined 201Tl/99mTc parathyroid subtraction scintigraphy and US for parathyroid adenomas were 72.27% and 89.22% respectively. The combination of 99mTc MIBI scintigraphy and US resulted in improved specificity (93.67%) and positive predictive value (80.39%). The accuracy of the localizing studies was lower for patients with hyperplasia. CONCLUSIONS: The combination of scintigraphy and US is the best approach for localization of nodules. In most cases, the two techniques are complementary (AU)