Revista Espa?ola de Medicina Nuclear (English Edition)最新文献

Transient apical dysfunction syndrome (TADS) is frequently misdiagnosed as an acute coronary syndrome (ACS). It is characterized by electrocardiographic alterations and elevated myocardial necrosis markers, accompanied by hypokinesia, akinesia or anteroapical dyskinesia, in absence of significant coronary disorders. It generally resolves in days or weeks with individualized support measures. We present the case of a female patient referred to our service for a myocardial perfusion imaging study due to a history suggestive of an acute coronary syndrome after a stressful event.

Splenosis is defined as the heterotopic autotransplantation of splenic tissue because of a ruptured spleen due to trauma or surgery. It is a benign and incidental finding, although imaging tests may sometimes orient toward malignancy simulating renal tumors, abdominal lymphomas, endometriosis, among other. We report the case of a 42-year old male in whom a MRI was performed after a study due to abdominal pain. Multiple enlarged lymph nodes were observed in the abdomen, suggestive of lymphoproliferative disease. As an important background, splenectomy was carried out due to abdominal trauma at age 9. After several studies, it was decided to perform a ^99mTc-labeled heat-damaged red blood cell scintigraphy that showed multiple pathological deposits distributed throughout the abdomen, and even the pelvis, being consistent with splenosis.

Objective

To evaluate the incidence of ¹⁸F-FDG focal uptake in the myocardium as well as its correlation with coronary vessel calcifications.

Material and methods

A total of 130 patients who underwent an oncological PET/CT study were reviewed retrospectively. Sixty-five had undergone a myocardial perfusion study because of clinical suspicion of coronary artery disease (group 1). There were no significant differences in age and gender regarding another group of the same series (n = 65; group 2). Focal myocardial ¹⁸F-FDG uptake and the presence of coronary vessel calcifications were identified by 2 independent observers.

Results

Group 1: in 18 out of 65 patients (28%) focal myocardial ¹⁸F-FDG uptake was identified (5 had 2 foci; total: 23 foci). In 43 out of 65 studies (66%), calcification was identified in the coronary vessels. Group 2: in 6 out of 65 patients (9%) focal myocardial ¹⁸F-FDG uptake was identified (1 had 2 foci; total: 7 foci). In 17 out of 65 studies (26%), calcification was identified in the coronary vessels.

Comparative analysis: focal myocardial ¹⁸F-FDG uptake and coronary vessel calcifications were more frequent in the group 1 patients (p < 0.01).

There was no correlation between the presence of coronary vessel calcifications and focal myocardial ¹⁸ F-FDG uptake in individual patients in both groups (group 1: p = 0.7; group 2: p = 0.163).

Conclusions

PET/CT allows simultaneous assessment of focal myocardial ¹⁸F-FDG uptake and myocardial vessel calcifications. Patients with clinical suspicion of coronary artery disease have a higher incidence of focal myocardial ¹⁸F-FDG uptake and coronary calcifications. However, ¹⁸F-FDG focal uptake is often observed in sites remote from those with calcification.

We present the case of a patient with breast cancer who underwent selective sentinel lymph node biopsy. An intramammary sentinel lymph node was identified with SPECT/CT in the preoperative lymphoscintigraphy. We describe our diagnostic and therapeutic procedure regarding this finding and the literature review to evaluate the clinical significance of their identification and metastases, especially in regards to more appropriate axillary management. Further studies with more statistical significance are necessary to elucidate the most suitable attitude when an intramammary sentinel lymph node is identified with the lymphoscintigraphy.

Differentiated thyroid cancer is a disease having a very good prognosis when treated adequately. Ablation treatment with ¹³¹I is frequently adjunct to surgery in these patients since it improves survival. Radioiodine whole-body scan is one of the imaging modality of choice in the follow-up of patients with this kind of pathology. After ablation treatment of the thyroid gland, any radioiodine accumulation in a non-physiological location usually means the presence of functioning metastasis. Recognition of potential false-positives is essential to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine. We report a case of uptake in the chest due to bronchiectasis, potentially masquerading as pulmonary metastasis.