Nuclear-Medizin最新文献

In order to analyze cerebral blood flow for diagnostic purposes, Indium 113m-DTPA was i.v. injected into seated patients, and time-activity curves were registered by a multifacet gamma camera (Fucks-Knipping) from 8 regions of interest, from the median area and from the right and left side of the head: 3 from the hemisphere, 3 from the brain stem, 2 from the large arteries of the neck. The results from 14 patients with chronic impairment of cerebral blood flow were compared with normal data from 20 healthy individuals. The time activity curves were analyzed for peak-height, mean transit time, and ratio peak to plateau height. The individual parameters were investigated for the degree of their correlation in a multiparameter system. The results from the patients indicated for the different single parameters a non-uniform response. There was also no correlation between the deviation of different parameters, between single pathological parameters and the degree and the site of blood flow impairment. On the other hand, a positive correlation was found between the number of pathological parameters and the degree of blood flow impairment irrespective of the site of its localization. Reason for this result probably is the variable location and degree of blood flow compensation by collaterals, which predominantly are expected at the cerebral base. The data indicate the potential usefulness of the application of the multiparameter analysis to quantitatively detect the degree of impairment of cerebral blood flow without regard to its topography. In this respect, the method, here described, promises to be of clinical value for non-invasive and non-hazardous diagnostic screening of cerebral blood flow.

This case report demonstrates an hepatic amebic abscess by scintigraphy, utilizing a new radiopharmaceutical designed specifically for that purpose. The abscess is delineated as a positive lesion after twenty four hours. The agent 131I-labeled bromometronidazole, may prove to be specific for the diagnosis of these abscesses.

Thirtyeight patients with suspected thrombosis in the legs were investigated scintigraphically using 99mTc-tripolyphosphate. The ratio between the activity in the leg with suspected thrombosis and the other leg was calculated. The results were compared with those obtained with phlebography. A pathologically high activity ratio was found in all but one of the 18 patients in whom phlebography showed a thrombus. The ratio was normal in 13 of the 20 patients with normal phlebographic findings. The possible use of the method described as a postoperative screening test is discussed.

Ten healthy volunteers were examined radiospirometrically using 133Xenon in physiologic saline i.v. and with 133Xenon gas inhalation. The measurements were done using a gamma camera (Nuclear Chicago, Pho/Gamma III) in the PA projection in both sitting and supine positions. For evaluation, each lung was divided into three regions: upper, middle, and lower fields. Using a computer (DEC, GAMMA 11), the minute exhalation value, the perfusion and ventilation indices, and the ventilation/perfusion quotient were calculated. In the upright position the ventilation and perfusion indices increase from cranial to caudal. In the horizontal position the regional lung functions tend to equalize. The vital capacity is larger in the vertical position than in the horizontal position, particularly in the right lung. The values are shown in tabular form.

25 patients with known cerebral disease (either CVA's or primary or secondary tumours) diagnosed by clinical and angiographic criteria were submitted to a double isotope imaging technique using 99mTcO4- and 99mTc-EHDP. The different biological behaviour of these radiopharmaceuticals has provided specific and differential diagnosis between vascular and neoplastic disease of the brain. 99mTc-EHDP is shown to be the tracer of choice for the imaging of CVA's and 99mTcO4- is confirmed as the tracer of choice for the imaging of primary or secondary tumours in the brain.

Following operation or/and radioiodine therapy in 69 patients with malignant tumors of the thyroid gland the plasma level of TSH was increased independently of the level of thyroid hormone and of a clinical finding of hypothyroidism. In all cases it was possible to stimulate the secretion of TSH with TRH (p less than 0,0005). Therefore, application of TRH may be helpful to increase the uptake of iodine by metastases. On the other hand substitution of thyroid hormones--thyroxine or triiodothyronine or both combined--resulted in normal levels of TSH and normal response to TRH.

In patients with ischemic heart disease the evaluation of regional myocardial perfusion by 133Xenon intracoronary injection using a gamma camera computer system allows the detection of regional alterations of myocardial perfusion. While at rest a minority of the patients studied shows large alterations, during pacing induced angina a severe reduction of regional myocardial perfusion can be evidenced both in initial distribution scintigrams, when the injection is performed during angina, and on the washout curves when angina is induced immediately after the injection, during the course of the washout.

Using Indium-113m and the Gamma Retina V (Fucks-Knipping Camera), the minimal cardiac transit times (MTTs) were measured radiocardiographically from the right auricle to the aortic root. This analysis served to determine the relation between stroke volume and the segment volume of the part of circulation between the right auricle and the aortic root. In 39 patients with myocardial insufficiency of different clinical degree the effectiveness of digitalization was, up to a period of 5 years, measured by means of the volume relation mentioned above. The following conclusions can be drawn from the results: digitalization of patients with myocardial insufficiency leads to an improvement of the impaired relation of central volumes. In patients with diminished cardiac reserve the improvement is drastic and often results in a nearly complete normalization. The data remain constant during therapy even for an observation period of 5 years. Digitalization of patients with congestive heart failure only leads to a partial improvement. In contrast to patients with diminished cardiac reserve this effect is temporary. The different behaviour of the relation between stroke volume and segment volume in patients with diminished cardiac reserve and congestive heart failure under prolonged administration of digitalis points to the necessity of treatment with digitalis in the early stage of myocardial disease.

Results are reported of quantitative adrenal scintigraphy with 131I-cholesterol in 8 patients with normal adrenal function before and after ACTH-stimulation and cortisol-suppression respectively, in one case with an adrenal metastasis from a pulmonary cancer, in two cases with Cushing's disease and in 7 cases with Conn's disease. In normal cases and in patients with M. Cushing a diagnosis of adrenal cortical function is possible with this method but can usually be replaced by more specific biochemical studies of serum and urine. The scintigraphic method is in addition of value in localization studies and can in unequivocal cases replace the selective adrenal phlebography. In patients with M. Conn increased uptake values (bilateral adrenal cortex hyperplasia) as well as reduced or non-detectable uptakes were observed, one of these cases suffering from a cortex carcinoma with M. Conn.

The authors describe a radioisotopic method for the oviduct patency control in patients suffering from primary or secondary sterility. The application of 133Xe causes at least about 3-4 times less radiation than hysterosalpingographical tests. Ease of interpretation facility, painlessness and comparability of the results were noticed.