Detection of deep vein thrombosis: combined flow and blood pool radionuclide venography vs contrast venography

This study was performed to validate the combined study of flow radionuclide venography (FRV) with subsequent 99mTc-red blood cell(RBC) blood pool radionuclide venography(BRV) for the detection of deep vein thrombosis (DVT). Findings in 32 patients with suspected DVT of lower extremities (n = 52) were compared with those of corresponding contrast venograms (CV) serving as a reference method. FRV was performed by using three separate doses of a large 99mTc04-bolus (10-12 cc) injection. The findings were as follows: concerning the detection of DVT in calf veins, agreement between FRV and CV, FRV+BRV and CV, and BRV and CV were 67%, 73% and 60%, respectively. For femoral veins, agreement between FRV and CV was 96%, while it was 87% between BRV and CV. When FRV and BRV of femoral veins were evaluated in combination, 100% agreement between radionuclide and radiologic method was observed. For iliac veins there was no disagreement in comparison of the methods either singly or in combination. In 7.6% of the extremities, collaterals not demonstrated by CV and BRV were visualized only by FRV. Although the radioactive agent was injected in a relatively large volume, all of the calf veins could not be filled even when they were completely patent. It was concluded that a combined study of FRV with BRV improved the diagnostic value of radionuclide venography for the detection of DVT in calf and femoral veins.

Pre and postoperative assessment of regional cerebral blood flow in hydrocephalus by 99mTc-hexamethyl-propylenamine oxime SPECT

Cerebrovascular changes resulting from hydrocephalus still remain to be investigated. It has been suggested that hydrocephalus distorts the large feeding arteries and that the collapse of capillaries results in decreased cerebral blood flow. This clinical study was designed to evaluate the effect of shunting on regional cerebral blood flow in patients with obstructive hydrocephalus of varying duration. Technetium-99m hexamethyl propyleamine oxime (99mTc-HMPAO) was used to measure the cerebral perfusion, semiquantitatively, since the pattern of its distribution in brain is somewhat similar to that of regional cerebral blood flow (rCBF), and the pre and postoperative semiquantitative rCBF values of each lobe were calculated. Fifteen patients (8 F, 7 M) underwent both CT and single photon emission tomography (SPECT) using 99mTc-HMPAO examination before and 1 week after shunting. Mean percentage of all lobes were calculated by subtracting the preoperative mean rCBF of all lobes from the corresponding postoperative values. The patients were classified into 3 groups according to the mean percentage of all lobes. Group A: showed a marked increase in mean cortical blood flow (+ 16.00 +/- 2.9%), group B: a moderate increase (11.27 +/- 4.8%), and in group C: there was the least improvement in mean cortical blood flow (+ 1.17 +/- 2.7%). The mean duration of hydrocephalus of group A, group B and group C was 5 +/- 0.5 weeks, 8 +/- 1 weeks and more than 12 weeks, respectively. Psychological testing and clinical observation of the daily activities of the patients postoperatively showed some correlation with increased rCBF and clinical improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of the functional status of the fallopian tubes in unexplained infertility with radionuclide hysterosalpingography

The functional status of the Fallopian tubes in patients with unexplained infertility (UI) was evaluated with radionuclide hysterosalpinography (RN-HSG). The rate of bilateral tubal occlusion with RN-HSG in women with UI (3/18 = 16.7%) was considerably higher than in a group of fertile and male-infertile women (0/28 = 0%), implying that a number of cases with UI might be associated with functional rather than anatomical tubal defects. RN-HSG is a simple, innocuous and potentially useful method for assessing functional tubal occlusion, and it might give a better understanding of the functional status of the tubes in UI.

Detection of intracardiac left-to-right shunts in children by contrast echocardiography and the radionuclide technique

This study was carried out in the Departments of Pediatrics and Nuclear Medicine at Hacettepe University Faculty of Medicine between April 1986 and March 1988 with the aim of detecting left-to-right shunts in 70 patients with isolated ventricular septal (VSD) defect, isolated atrial septal defect (ASD) and patent ductus arteriosus, by using the radionuclide technique together with contrast echocardiography. In some patients, the results were confirmed by both cardiac catheterization and angiocardiography. Most of the data were confirmed during surgery. A good correlation was found between the results of contrast echocardiography and radionuclide angiography. The difference between the QP/QS value and the grade of positive contrast effect was tested statistically and "p" was found to be less than 0.001. Therefore, we conclude that these methods could be applied together to determine the indication for surgery in cases with ASD or VSD.

Cerebellar infarction: computed tomography, magnetic resonance and IMP-single photon emission tomography findings

In this report, a rare case of a child with cerebellar infarction (CI) confirmed by vertebral angiography, magnetic resonance imaging (MRI), computed tomography (CT) and N-isopropyl-p123-I-iodoamphetamine single photon emission tomography (IMP-SPECT) is presented. It was concluded that although all imaging modalities could demonstrate CI, MRI is superior to the other methods because of its fine display of anatomical detail, its lack of bony artifacts and its ability to show infarction in early stages.

Lymphoscintigraphic evaluation of primary congenital lymphedema

A-four-year-old girl with primary nonfamilial congenital lymphedema was evaluated by lymphoscintigraphy using 99mTc-Dextran. It was demonstrated that there was no accumulation of radioactivity in the left inguinal and femoral lymph nodes and faint accumulation in the contralateral lymph node. It was concluded that lymphoscintigraphy is a safe, reliable, noninvasive technique which is helpful in the evaluation of a patient with lymphedema, especially small children in whom conventional contrast lymphangiography offers some challenges.