RESUMO
We present the case of a 34-year-old woman diagnosed of an adenosquamous carcinoma of the uterine cervix, stage IIB of the FIGO classification (International Federation of Gynecology and Obstetrics), treated with quimiotherapy, radiotheraphy and brachytheraphy with posterior hysterectomy. A recurrence of the disease was suspected due to the progressive rise of CEA levels. A PET/CT revealed abnormal foci in both ovaries, that had been transposed to avoid lesions due to radiation, and in a left para-aortic adenopathy. The diagnosis of recurrence in these sites was confirmed by biopsy. PET with FDG (F18-fluorodeoxyglucose) is useful in the staging of primary tumour and in the detection of recurrence in uterine cervical carcinoma, with better sensitivity and specificity than CT and MRI. PET/CT improves anatomic resolution and helps to resolve the origin of unclear foci like in the case presented in which ovaries were not in their normal situation due to transposition.
Assuntos
Carcinoma Adenoescamoso/secundário , Metástase Linfática/diagnóstico , Neoplasias Ovarianas/secundário , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Adulto , Antineoplásicos Alquilantes/uso terapêutico , Braquiterapia , Carcinoma Adenoescamoso/diagnóstico por imagem , Carcinoma Adenoescamoso/terapia , Carcinoma de Células Escamosas/diagnóstico , Cisplatino/uso terapêutico , Terapia Combinada , Feminino , Humanos , Histerectomia , Metástase Linfática/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Radioterapia Adjuvante , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapiaRESUMO
OBJECTIVES: To evaluate the usefulness of 123I-labelled anti-vascular cell adhesion molecule-1 (VCAM-1) monoclonal antibody (MAb) scintigraphy in the assessment of colonic inflammatory damage. DESIGN: Colitis was induced by intracolonic administration of 30 mg trinitrobenzenesulphonic acid in 0.5 ml of 50% (v/v) ethanol. Rats injected with vehicle served as controls. Animals were studied at day 7 after induction of colitis. METHODS: Scintigraphy was performed in control and trinitrobenzenesulphonic acid-induced colitic rats 2, 4 and 24 h after intravenous administration of 123I-anti-VCAM-1 MAb. Scintigraphic uptake was quantified in selected areas on scintigraphs. Animals were killed, tissue 123I radioactivity accumulation was measured, and accumulation of anti-VCAM-1 MAb in each organ was calculated. 99mTc-hexamethyl propylene amine oxime-labelled leucocyte scintigraphy was performed in additional groups of animals for comparison. RESULTS: Colonic tracer uptake was visible in scans of colitic, but not control animals. Quantification of scintigraphic uptake in the colon was significantly higher in colitic rats than in control animals (P< 0.0001). The specificity of the increase was demonstrated by lack of 123I-labelled non-binding MAb uptake in the colon, and by displacement of 123I-anti-VCAM-1 MAb colonic uptake by pre-treatment with unlabelled MAb. Accumulation of anti-VCAM-1 MAb in the colon of colitic rats was eightfold higher than in control animals. Strong correlations were found between quantification of scintigraphic uptake, anti-VCAM-1 MAb accumulation, histological damage and myeloperoxidase activity in the colon. CONCLUSION: 123I-labelled anti-VCAM-1 MAb scintigraphy allows an accurate evaluation of colonic inflammatory damage in trinitrobenzenesulphonic acid-induced colitis, suggesting a potential role for this imaging technique in the assessment of human IBD.
Assuntos
Colite/diagnóstico por imagem , Molécula 1 de Adesão de Célula Vascular/imunologia , Animais , Anticorpos Monoclonais , Colo/metabolismo , Radioisótopos do Iodo , Fígado/diagnóstico por imagem , Cintilografia , Ratos , Ratos Sprague-Dawley , Baço/diagnóstico por imagemRESUMO
Monoclonal 111In antimyosin (AMS) uptake indicates the presence of ongoing myocyte damage. In idiopathic dilated cardiomyopathy (IDC), there is diffuse myocyte damage. We have attempted to find a correlation between AMS uptake and functional myocardial parameters. With this purpose in mind, we studied two groups of subjects: group 1 comprised 19 subjects with IDC and group 2 comprised 6 control subjects. In all subjects, an antimyosin scan was performed. Among the subjects with IDC, two-dimensional echocardiography was carried out to determine the left ventricular ejection fraction (LVEF) and left ventricular dimensions, and a gated blood pool study was undertaken to assess the LVEF at rest and end-diastolic and end-systolic volumes. Three months later, repeat antimyosin scintigraphy and equilibrium gated blood pool were performed on 13 of the patients. The mean heart to lung (H/L) ratio in the IDC subjects was 1.82 +/- 0.25 (range 1.42-2.25), a value significantly higher than that obtained in the controls: 1.41 +/- 0.12 (range 1.26-1.58) (P < 0.001). Linear regression analysis did not find a statistically significant correlation between H/L and gated blood pool or echocardiography measures. No marked changes in ejection fraction and antimyosin uptake were found between baseline and follow-up studies. Subjects with IDC have a high incidence of positive antimyosin scans, but antimyosin uptake is not related to any functional or morphological parameters.
Assuntos
Anticorpos Monoclonais , Cardiomiopatia Dilatada/diagnóstico por imagem , Coração/diagnóstico por imagem , Radioisótopos de Índio , Compostos Organometálicos , Cardiomiopatia Dilatada/fisiopatologia , Ecocardiografia , Feminino , Seguimentos , Imagem do Acúmulo Cardíaco de Comporta , Coração/fisiopatologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Miocárdio/metabolismo , Volume Sistólico/fisiologia , Fatores de Tempo , Função Ventricular Esquerda/fisiologiaRESUMO
The aim of this study was to establish whether tumour uptake of 99mTc-MIBI can predict response to chemotherapy in patients with breast carcinoma. Forty women suffering from breast carcinoma confirmed by tumour biopsy were studied prospectively. Fifteen patients subsequently underwent surgery and 25 were candidates for neoadjuvant chemotherapy. Breast scintigraphy was performed and planar and tomographic views (single photon emission computed tomography (SPECT)) were obtained after injection of 740 MBq of 99mTc-MIBI. The tumoural uptake was quantified by computer analysis. P-glycoprotein was evaluated by immunohistochemistry only in operable patients. The response to chemotherapy was evaluated at 3 months upon completion of treatment. The results of this study showed no relationship between 99mTc-MIBI uptake and the histological type or tumour size. There was an inverse correlation with the degree of tumour differentiation (P<0.05). 99mTc-MIBI uptake in negative P-glycoprotein lesions (2.36+/-1.72) was higher than in positive P-glycoprotein lesions (1.53+/-1.29), although the difference was not statistically significant. Lesions which responded to chemotherapy (16) showed higher 99mTc-MIBI uptake (7.70+/-5.20) than non-responding lesions (nine) (2.21+/-1.0) (P<0.001). In conclusion, there is a correlation between 99mTc-MIBI uptake in breast cancer and response to chemotherapy. Furthermore, 99mTc-MIBI uptake may be influenced by other factors such as the degree of tumour differentiation or tumour P-glycoprotein levels.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Antineoplásicos/uso terapêutico , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/metabolismo , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Ductal de Mama/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Cintilografia , Compostos Radiofarmacêuticos/farmacocinética , Tecnécio Tc 99m Sestamibi/farmacocinéticaRESUMO
67Ga scintigraphy has proven to be of value in the evaluation of patients with lymphoma, especially in their management after treatment. In this study, computed tomography (CT) and 67Ga scans were compared in 53 patients with lymphoma who had previously been treated. Twenty-eight were patients in continuous clinical remission in whom recurrence was suspected. The remaining 25 patients were studied between 1 and 3 months post-treatment to assess a residual mass. The sensitivity for the detection of lymphoma recurrence was 88% for 67Ga, with two false-negative results, and 59% for CT, with seven false-negative results. In the diagnosis of recurrence, the specificity of 67Ga was 100% and that of CT 72%, with three false-positive results. Therapeutic response was assessed in 25 patients and the ability to predict response to treatment resulted in a specificity of 86% for 67Ga and 81% for CT. Treatment failed in four patients, as detected by 67Ga scan, whereas CT did not detect any of these. In the remaining 21 patients who showed good response to treatment, there were three false-positive results for 67Ga and four for CT. 67Ga scintigraphy can detect relapse more accurately and much earlier than CT, as well as diagnose complete remission after treatment. Therefore, 67Ga scintigraphy should be used routinely in monitoring response to treatment in lymphoma.
Assuntos
Radioisótopos de Gálio , Linfoma/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Abdome/diagnóstico por imagem , Adolescente , Adulto , Idoso , Medula Óssea/diagnóstico por imagem , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/terapia , Humanos , Pulmão/diagnóstico por imagem , Linfoma/terapia , Linfoma não Hodgkin/diagnóstico por imagem , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Cintilografia , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios XRESUMO
Although prostatitis is a common problem the diagnosis is still controversial despite the availability of a wide variety of diagnostic tools. In fact, there is still no accurate method of localizing the infected tissue. The aims of the present study were to assess whether 111In labelled leukocytes (ILLs) accumulated in the infected tissue of acute prostatitis and if such uptake responded to treatment. We prospectively studied 10 adult male patients who had community acquired prostatitis and compared them with six male patients who had urinary tract infections but without prostatitis. An initial urinary culture and two blood cultures were carried out for each patient. All patients were followed up for 8 weeks after therapy was completed. Pre- and post-treatment scintigraphies were performed. Before treatment, all patients with prostatitis showed uptake of ILLs in the prostate area. After the patients had completed treatment with antibiotics, the scintigraphy results showed no uptake in the prostate area in 9/10 patients. The remaining patient showed a marked decrease in the uptake of ILLs. None of the six patients with urinary tract infection showed ILL uptake in the prostate region. It is suggested that ILLs could be useful for detecting acute prostatitis, especially in clinically ambiguous patients with urological infections. Furthermore, scintigraphy with 111In labelled leukocytes could help to determine the most appropriate course of therapy.
Assuntos
Radioisótopos de Índio , Leucócitos/diagnóstico por imagem , Prostatite/diagnóstico por imagem , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prostatite/diagnóstico , Cintilografia , Compostos RadiofarmacêuticosRESUMO
Radioimmunoscintigraphy (RIS) and radioimmunoguided surgery (RIGS) were assessed for their usefulness in patients with colorectal carcinoma. Twenty-nine patients (18 primary tumours, 10 with a suspicion of recurrence and one colonic diverticulitis) were studied. Radioimmunoscintigraphy was performed 48 and 72 h after the injection of an anti-TAG72 monoclonal antibody (CYT-103) labelled with 111In. Radioimmunoguided surgery was performed between 72 and 96 h post-injection. During surgery, a systematic screening was performed with a hand-held gamma detecting probe and a surgical index (tumour-to-normal tissue) was obtained. There were statistically significant differences between counts in normal tissue versus tumour (P < 0.001) and RIGS was considered positive for the detection of tumour if the ratio between the counts in the area suspicious of tumour and the counts in the normal tissue was greater than 1.5. The overall sensitivity for RIS and RIGS was 71.4% (55.6% in primary tumours and 100% in recurrences) and 82.1% (83.3% in primary tumours and 80% in recurrences), respectively. Radioimmunoguided surgery changed the surgical procedure in two cases with small tumour deposits. Occult regional lymph node involvement in primary tumours was not found; therefore, RIGS, as a complementary technique to RIS, is particularly useful in recurrences and can help the surgeon in the resection of small tumour deposits which are difficult to localize.
Assuntos
Anticorpos Monoclonais , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/cirurgia , Radioisótopos de Índio , Oligopeptídeos , Ácido Pentético/análogos & derivados , Radioimunodetecção , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Neoplasias/imunologia , Colo/diagnóstico por imagem , Colo/cirurgia , Feminino , Glicoproteínas/imunologia , Humanos , Linfonodos/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Compostos Radiofarmacêuticos , Reto/diagnóstico por imagem , Reto/cirurgia , Sensibilidade e EspecificidadeRESUMO
Hypertension is a common complication observed after renal transplantation. If the hypertension is of renovascular origin, transluminal angioplasty or surgery of the renal artery stenosis can lead help cure the hypertension. The blood pressure of a 31-year-old man who underwent renal transplantation 2 years earlier gradually increased. Arteriography showed stenosis (>80%) in the two branches of the renal artery. To help confirm the presence of renovascular hypertension, captopril renography was performed but showed no significant changes compared with baseline renography. Renography was performed again after losartan administration and showed impaired renal function. In this case, losartan renography was more useful than captopril in suggesting renovascular hypertension.
Assuntos
Anti-Hipertensivos , Captopril , Hipertensão Renovascular/diagnóstico por imagem , Transplante de Rim , Losartan , Complicações Pós-Operatórias/diagnóstico por imagem , Renografia por Radioisótopo/métodos , Obstrução da Artéria Renal/diagnóstico por imagem , Adulto , Humanos , Hipertensão Renovascular/etiologia , Masculino , Compostos Radiofarmacêuticos , Obstrução da Artéria Renal/etiologia , Pentetato de Tecnécio Tc 99m , Fatores de TempoRESUMO
INTRODUCTION AND OBJECTIVES: The natural history of diabetic cardiomyopathy remains unclear, mainly due to concurrent coronary disease or hypertension. Since the presence of confounding factors is less likely in youngsters, they constitute a suitable study model to analyze early stages of diabetic cardiomyopathy. PATIENTS AND METHODS: We screened 33 young normotensive asymptomatic patients with type I diabetes mellitus. Mean age was 28 +/- 8 y (range 18 to 46 y) and there were 14 men. RESULTS: 2-D Echo showed normal left ventricular size and wall motion in all patients but one. Radionuclide basal ejection fraction was 56.5 +/- 6.6% and increased to 63 +/- 7.4% (p < 0.02) on exercise. According to Rozansky criteria, 16 patients had an abnormal response. Abnormal stress sestamibi was detected in 18 patients and only 3 had reversible defects. Coronary angiography was performed in 11 patients with at least one abnormal non-invasive study response. Coronary angiography revealed normal vessels in all patients and left anterior descending blood flow velocity (Doppler) increased 4 fold after papaverine infusion. Left ventricular biopsies showed hypertrophy (either nuclear or cellular) in 11, myocytolysis in 6, interstitial fibrosis in 9 and lipid deposits in 4. Morphometric analysis of cardiac samples comparing the diabetic group and a control group showed that the volume fraction of fibrosis (0.19 +/- 0.06 vs 0.10 +/- 0.06; p < 0.01), fiber area -mu2- (1,062 +/- 547 vs 600 +/- 167; p < 0.02) and fiber diameter -mu- (24.2 +/- 3.3 vs 15.1 +/- 3.4; p < 0.001) were higher in the former; and volume fraction of the myocytes was higher in the latter (0.71 +/- 0.006 vs 0.89 +/- 0.07; p < 0.001). CONCLUSIONS: Left ventricular dysfunction, not related to coronary atherosclerosis or small vessel disease, is frequent in asymptomatic young diabetic patients. Abnormal pathologic findings are common in the type of cell hypertrophy, interstitial fibrosis, myocytolysis and lipid deposits.
Assuntos
Cardiomiopatias/patologia , Diabetes Mellitus Tipo 1/patologia , Disfunção Ventricular Esquerda/patologia , Adolescente , Adulto , Biópsia , Cardiomiopatias/diagnóstico , Angiografia Coronária , Interpretação Estatística de Dados , Diabetes Mellitus Tipo 1/diagnóstico , Endocárdio/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Disfunção Ventricular Esquerda/diagnósticoRESUMO
We present two cases of uremic patients with poor medical control of their secondary hyperparathyroidism. They had to undergo surgery to control symptoms. A total parathyroidectomy with autotransplant in the forearm muscles was performed. After a symptom-free period, both showed a recurrence of their hyperparathyroidism. A double phase 99mTc-MIBI scintigraphy was essential in order to correctly locate hypertrophic parathyroid gland. In one case there was a cervical recurrence and in the second patient hyperplasia in a forearm gland autotransplant was found. Both patients remained asymptomatic with medication during their follow up.
Assuntos
Hiperparatireoidismo Secundário/diagnóstico por imagem , Glândulas Paratireoides/transplante , Paratireoidectomia , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Transplante Autólogo , Transplante Heterotópico , Uremia/complicações , Adulto , Idoso , Calcitriol/uso terapêutico , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/cirurgia , Evolução Fatal , Feminino , Antebraço , Rejeição de Enxerto/cirurgia , Humanos , Hiperparatireoidismo Secundário/tratamento farmacológico , Hiperplasia , Neoplasias Renais/complicações , Neoplasias Renais/cirurgia , Transplante de Rim , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/fisiopatologia , Glândulas Paratireoides/cirurgia , Cintilografia , Recidiva , Diálise Renal , Reoperação , Uremia/cirurgia , Uremia/terapiaRESUMO
UNLABELLED: A retrospective study was made to evaluate the usefulness of bone SPECT of the dorsolumbar spine in identifying benign and malignant lesions. A study was made of oncological patients who presented active images in the spinal column visible on planar radionuclide scans who also underwent SPECT. The average follow-up period was 25+/-13 months. MATERIAL AND METHOD: In 43 neoplastic patients 55 visible lesions on SPECT were evaluated, of which 29 were benign and 26 metastatic. The criteria for benign lesions were the absence of change or involution without treatment in the follow-up period. The criteria for classifying metastases were: 1. Positive biopsy. 2. Neurological complications derived from the lesion. 3. Increased extension and tracer uptake by the lesion, and the appearance of other bone metastases. RESULTS: Twelve of 15 lesions located in the vertebral body or pedicle and 11/16 located in the body with extension toward the pedicles were metastases. Twenty-one of 24 lesions located on the anterior face of the vertebral body, articular processes, lamina, or intervertebral disk were benign. CONCLUSION: Bone SPECT was useful for locating the vertebral lesion, which in many cases allows differentiation of benign and metastatic lesions.
Assuntos
Vértebras Lombares/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Osteoartrite/complicações , Osteoartrite/diagnóstico por imagem , Estudos Retrospectivos , Doenças da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/secundário , Medronato de Tecnécio Tc 99mAssuntos
Morte Encefálica , Parada Cardíaca , Transplante de Rim/patologia , Necrose Tubular Aguda/diagnóstico por imagem , Tecnécio Tc 99m Mertiatida , Doadores de Tecidos , Adulto , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Transplante de Rim/métodos , Transplante de Rim/fisiologia , Necrose Tubular Aguda/classificação , Necrose Tubular Aguda/epidemiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Cintilografia , Fatores de TempoRESUMO
Recently, it has been suggested that lateral (LAT) spine bone mass measurements by absorptiometry may be more sensitive for detecting bone loss than the standard anteroposterior (AP) projection. The aim of this study was to evaluate the precision of LAT spine dual-energy X-ray absorptiometry (DEXA) and its diagnostic sensitivity. A group of 1554 subjects with no risk factors that might affect bone metabolism and 185 osteoporotic patients with vertebral fractures were studied. Bone mineral density (BMD) was measured in the lumbar spine (standard AP and LAT projections) and proximal femur with a DEXA absorptiometer. The precision of the measurements was assessed in 15 volunteers. Diagnostic sensitivity was evaluated by the Z-score method. Comparing young people and the elderly, spine bone loss in the latter was similar for AP and LAT projections, when it was evaluated in absolute values (glcm2). However, when it was evaluated in percentage terms, bone loss was about twice as high in the LAT projection. LAT spine BMD correlated significantly with all the other areas assessed. The best correlation was found with the standard AP projection (r = 0.67, P < 0.0001). The precision in the LAT projection was found to be within an acceptable range (1.6% in normal subjects, 2% in osteoporotic patients), even though it was about twice that obtained in the AP projection. Diagnostic sensitivity was also better with the AP projection. It is concluded that LAT spine BMD measurements can be assessed with acceptable precision although it is about twice as high as for AP spine measurements.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Densidade Óssea , Vértebras Lombares/diagnóstico por imagem , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Absorciometria de Fóton/métodos , Adulto , Idoso , Feminino , Colo do Fêmur/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
We report a patient with bilateral independent temporal lobe seizures in whom two [99mTc]HMPAO single photon emission computed tomograph (SPECT) scans were performed during two different seizures. In the first periictal SPECT, [99mTc]HMPAO was injected in the interval between two closely spaced seizures (one localized in the left temporal lobe and the other in the right temporal lobe). SPECT images showed hypoperfusion in the left lateral temporal lobe, hyperperfusion of the left mesial temporal region, and pronounced hyperperfusion in the right anterior temporal lobe. These results suggest both a postictal left temporal SPECT pattern and an ictal right temporal pattern. In the second periictal SPECT, [99mTc]HMPAO was injected immediately after a right temporal lobe seizure and showed right lateral temporal lobe hypoperfusion and right mesial hyperperfusion, suggesting a postictal right temporal SPECT pattern. Interpretation of the periictal SPECT should take into account EEG changes at the time or in the minutes immediately after injection of [99mTc]HMPAO.
Assuntos
Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/diagnóstico , Lateralidade Funcional , Lobo Temporal/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Lateralidade Funcional/fisiologia , Humanos , Tecnécio Tc 99m Exametazima , Lobo Temporal/irrigação sanguínea , Lobo Temporal/fisiopatologiaRESUMO
This study was performed to determine the value of dipyridamole-99m Tc-methoxy-isobutyl isonitrile perfusion (99mTC-MIBI) tomographic scintigraphy in the assessment of cardiac risk in patients being evaluated prior to combined pancreas-kidney transplantation (PKT). We performed perfusion tomographic scintigraphy using single photon emission computed tomography (SPECT) on 77 patients. The tomographic images did not show clinically relevant findings in 65 patients. In the remaining 12 patients, coronary arteriography was performed: 2 showed normal results, 4 showed no stenosis, and 6 showed significant stenosis ( > or = 70%). Seventy-two patients underwent PKT. During the follow-up (6-48 months), there were seven cardiac events, 4 patients with significant stenosis, and 3 with nonsignificant stenosis upon coronary arteriography, and all had pathological tomographic images. 99mTc-MIBI tomographic scintigraphy may be useful in identifying patients at low risk of incurring cardiac events after PKT and may, in a large group of patients, obviate the need for routine coronary angiography.