Scintigraphic findings of dysplasia epiphysealis hemimelica - A case report

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Gastric emptying of water in children with severe functional fecal retention

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The objective of this study was to evaluate gastric emptying (GE) in pediatric patients with functional constipation. GE delay has been reported in adults with functional constipation. Gastric emptying studies were performed in 22 children with chronic constipation, fecal retention and fecal incontinence, while presenting fecal retention and after resuming regular bowel movements. Patients (18 boys, median age: 10 years; range: 7.2 to 12.7 years) were evaluated in a tertiary pediatric gastroenterology clinic. Gastric half-emptying time of water (reference range: 12 +/- 3 min) was measured using a radionuclide technique immediately after first patient evaluation, when they presented fecal impaction (GE(1)), and when they achieved regular bowel movements (GE(2)), 12 +/- 5 weeks after GE(1). At study admission, 21 patients had reported dyspeptic symptoms, which were completely relieved after resuming regular bowel movements. Medians (and interquartile ranges) for GE(1) and GE(2) were not significantly different [27.0 (16) and 27.5 (21) min, respectively (P = 0.10)]. Delayed GE seems to be a common feature among children with chronic constipation and fecal retention. Resuming satisfactory bowel function and improvement in dyspeptic symptoms did not result in normalization of GE data.463293298Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Detection of synchronous carcinomas of the colon with F-18 fluorodeoxyglucose - A case report

Colon and rectal carcinomas are common in North America and Northwestern Europe, In South America, the risk of this disease is not as great, Adenocarcinomas are the most common types of tumors, and they occur mainly in the descending colon, sigmoid, and rectum. A patient with a possible right colon carcinoma was examined using F-18 FDG.25537037

Cr-51-EDTA measurements of the glomerular filtration rate in patients with sickle cell anaemia and minor renal damage

Background Creatinine clearance has been reported to be inaccurate for the estimation of glomerular filtration rate (GFR) in patients with sickle cell anaemia (SCA). Inulin clearance, the reference method for GFR estimation, is impractical for routine use in these patients, and Cr-51-EDTA measurements of the GFR have been rarely reported in this disease. Methods In order to obtain reference Cr-51-EDTA values in this disease, we studied 70 patients (40 females; 13-59 years of age, mean: 31.6 years) with homozygous SCA, normal serum creatinine and urinary albumin excretion 50 years). Results The mean GFR (+/- standard deviation) obtained for the 70 patients was 111.5 +/- 23.1 ml.min(-1). Analysis of variance for evaluation of the possible interaction effect between Cr-51-EDTA clearance and sex, age, urinary albumin and haematocrit demonstrated patient age as the only factor influencing Cr-51-EDTA clearance (P<0.001). The Spearman correlation coefficient showed a significant relationship between Cr-51-EDTA clearance and patient age (r= - 0.44, P= 0.0001), but not between Cr-51-EDTA and urinary albumin (r= - 0.17, P= 0.1546) or haematocrit (r=0.079, P=0.5121). The group aged 20-29 years presented the highest Cr-51-EDTA clearance mean value (126.7 +/- 20.4 ml.min(-1)), with a progressive reduction in the older groups. Conclusion Young adults with homozygous SCA, normal serum creatinine and micro-albuminuria or normo-albuminuria present supranormal Cr-51-EDTA GFR values. These values rapidly decrease after 30 years of age. We did not find association between urinary albumin and GFR in these patients.271295996

High pre-therapy [Tc-99m]pertechnetate thyroid uptake, thyroid size and thyrostatic drugs: predictive factors of failure in [I-131]iodide therapy in Graves' disease

Background and objective Several factors may interfere with the success rate of radioiodine therapy (RIT) in Graves' disease. Our aim was to evaluate, retrospectively, some of these factors in the outcome of RIT. Methods Patient gender, age at diagnosis, ophthalmopathy, disease duration, thyroid size, drug used as clinical treatment, thionamide withdrawal period during RIT preparation, FT4, TSH and [Tc-99m]pertechnetate thyroid uptake prior to RIT were studied as potential interference factors for RIT success. Eighty-two Graves' disease patients were submitted to RIT after thionamide treatment failure. Prior to RIT, 67 patients were receiving methimazole and 15 propylthiouracil. Thirty-three patients received thionamides during RIT; in 49 patients the medication was withdrawn for 2-30 days. [Tc-99m]pertechnetate thyroid uptake was determined before RIT. Fixed doses of 370 MBq of [I-131]iodide were administered to all patients. Results Eleven patients became euthyroid; 40 became hypothyroid and 31 remained hyperthyroid. There was no association between outcome and age at diagnosis, gender, ophthalmopathy, pre-RIT FT4, TSH, antithyroid antibodies or thyrostatic drug. Multiple logistic regression showed higher probability of treatment success in patients with thyroid mass < 53 g (odds ratio (OR) = 8.9), with pre-RIT thyroid uptake < 12.5% (OR=4.1) and in patients who withdrew thionamide before RIT (OR=4.9). Conclusions Fixed doses of 370 MBq of radioiodine seem to be practical and effective for treating Graves' disease patients with [Tc-99m]pertechnetate uptake < 12.5% and thyroid mass < 53 g. This treatment is clearly not recommended for patients with large goitre. In contrast to what could be expected, patients with a high pre-RIT thyroid uptake presented a higher rate of RIT failure.261195796

Normal values of [Tc-99m]pertechnetate uptake and excretion fraction by major salivary glands

The assessment of the functional status of the salivary glands has been used in the scintigraphic evaluation of xerostomia. Several quantitative methods derived from standard dynamic scintigraphy have been suggested. However, the indices proposed are quite variable and unlikely to be useful in clinical practice. The objectives of this study were to obtain reference values of major salivary glands uptake and excretion fraction in healthy subjects and to obtain normal ratios of Tc-99m-pertechnetate uptake by the major salivary glands in comparison to the thyroid gland uptake. The standardization of these values has the purpose of making this evaluation faster and more objective. Fifty volunteers without clinical evidence of xerostomia or thyroid disease underwent static salivary glands scintigraphy with Tc-99m-pertechnetate. Static images were obtained at 20 minutes and then at 3 minutes after oral stimulation with lemon juice. Percent uptake, excretion fraction and salivary gland to thyroid ratio rates were calculated for the parotid and the submandibular glands. The mean of the uptake values at 20 minutes for the right and left parotid glands were respectively 0.31% and 0.26%, and for the submandibular glands 0.15%. The excretion fraction of the tracer after the lemon juice stimulation was 70% for the parotids glands, 50% for the right and 49% for the left submandibular glands. The mean +/- SD salivary gland to thyroid count ratio was 0.79 +/- 0.45 for the right parotid, 0.78 +/- 0.5 for the left parotid, 0.67 +/- 0.33 and 0.66 +/- 0.34 for the right and left submandibular glands, respectively. Salivary glands scintigraphy with uptake and excretion fraction calculation is an easy to perform, non-invasive and objective method to investigate salivary glands function. These findings help the nuclear physician to interpret salivary gland scintigraphy more objectively, even in patients with thyroid gland dysfunction in whom Tc-99m-pertechnetate thyroid uptake may be abnormal.27439540

Tc-99m-sestamibi thyroid uptake in euthyroid individuals and in patients with autoimmune thyroid disease

Purpose: We investigated the biokinetics of Tc-99m-sestamibi in the thyroid of euthyroid volunteers (EVs) and in patients with autoimmune thyroid diseases and determined the best time interval between Tc-99m-sestamibi injection and calculation of uptake. Methods: Forty EVs, 30 patients with Graves' disease (GD), 15 patients with atrophic Hashimoto's thyroiditis (AHT) and 15 patients with hypertrophic Hashimoto's thyroiditis (HHT) underwent Tc-99m-sestamibi thyroid scintigraphy. Dynamic images were acquired for 20 min, and static images were obtained 20 min, 60 min and 120 min post injection. Five-, 20-, 60- and 120-min uptake, time to maximal uptake (T-max) and T-1/2 of tracer clearance were calculated. Thyroid hormones and antibodies were measured. Tc-99m-pertechnetate uptake was investigated in GD patients. Results: T-max was approximately 5 min in all four groups. The mean T-1/2 value for EVs was similar to the GD value and lower than the HHT and AHT values. The mean (+/- SD) 5-min uptake was 0.13% (+/- 0.05%) for EVs. The 5-min uptake in GD was higher than that in EVs(P < 0.001) and correlated with free thyroxine (r=0.54) and with Tc-99m-pertechnetate uptake (r=0.68). Uptake in HHT was higher than that in AHT (P=0.0003) and EVs (P=0.002). Uptake in AHT was lower than uptake in EVs (P=0.0001). Conclusion: Five minutes is the optimal time interval between Tc-99m-sestamibi injection and calculation of thyroid uptake. Five-minute uptake differentiates euthyroid individuals from GD patients. There is a high correlation between Tc-99m-sestamibi and Tc-99m-pertechnetate uptake in GD. The reduced Tc-99m-sestamibi uptake in AHT patients is probably due to glandular destruction and fibrosis. Inflammatory infiltrate and high mitochondrial density in thyrocytes possibly explain the increased uptake in GD and HHT.32670270

Tc-99m MDP uptake in uterine leiomyoma

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