• Title/Summary/Keyword: ${99m}^Tc$

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Chorea in Systemic Lupus Erythematosus: Evidence for Bilateral Putaminal Hypermetabolism on F-18 FDG PET (전신성 홍반성 루푸스에서 F-18 FDG PET상 기저핵 포도당대사 증가 소견을 보이는 무도병 1예)

  • Seo, Wook-Jang;Chung, Son-Mi;Koh, Su-Jin;Lee, Chang-Keun;Kim, Jae-Seung;Im, Joo-Hyuk;Yoo, Bin;Moon, Hee-Bom
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.325-330
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    • 2003
  • Purpose: We describe a 54-year-old woman with systemic lupus erythematosus (SLE) who suddenly presented with chorea and had positive antiphospholipid antibodies. F-18 FDG PET showed abnormally increased glucose metabolism in bilateral putamen and primary motor cotex. Tc-99m ECD SPECT also showed abnormally increased regional cerebral blood flow in bilateral putamen. She was treated with corticosteroid and aspirin after which the symptoms improved. Four months later, follow up F-18 FDG PET showed improvement with resolution of hypermetabolism in bilateral putamen. This case suggests that striatal hypermetabolism is associated with chorea in SLE.

Management of Recurrent Thyroid Carcinoma with Negative Diagnostic Radioiodine Whole-Body Scan (진단적 방사성옥소 전신스캔이 음성인 갑상선 재발암의 진료)

  • Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.117-124
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    • 2001
  • Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

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A Comparative Study of SPECT, q-EEG and CT in Patients with Mild, Acute Head Trauma (경미한 급성 두부외상환자에서 SPECT, q-EEG 및 CT의 비교)

  • Lee, Suk-Ho;Kim, Jin-Seok;Moon, Hee-Seung;Lee, Sung-Ku;Kim, So-Yon;Kim, Young-Jung;Park, Byung-Yik;Lee, Gwon-Jeon;Kim, Kap-Deuk;Kim, Ho-Joeng;Cho, Kyeung-Hyeung;Seol, Hyun-Uk
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.165-169
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    • 1993
  • Functional cerebral impairments have been verified objectively by brain SPECT and q-EEG (quantitative electroencephalography). Microcerebral circulatory defects without anatomical changes can-not be detected by the brain CT or MRI. Brain SPECT using $^{99m}Tc$-HMPAO (Hexamethyl propyleneamine oxime) as a key radioisotope may be accepted as the useful method for identifying functional cerebral impairments. We studied 25 patients with mild head trauma to define whether the SPECT was helpful in detecting cerebral impairment. Results were as follows: The SPECT was positive in 23 patients out of 25, q-EEG positive in 16 patients and brain CT was positive in 3 cases. SPECT and q-EEG were more sensitive than CT, SPECT would be more useful method than brain CT to investigate cerebral function after head injury.

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Predictors of High-grade Vesicoureteral Reflux in Children with Febrile Urinary Tract Infections

  • Choi, Eom Ji;Lee, Min Ju;Park, Sin-Ae;Lee, Oh-Kyung
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.136-141
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    • 2017
  • Purpose: This study aimed to investigate clinical and radiological factors that may predict high-grade vesicoureteral reflux (VUR) in patients with febrile urinary tract infection (UTI). Methods: We retrospectively analyzed medical records of 446 patients diagnosed with febrile UTI from March 2008 to February 2017. All patients underwent renal-bladder ultrasonography (RBUS), 99mTc dimercaptosuccinic acid (DMSA) renal scan, and voiding cystourethrography (VCUG), and were divided in to 3 groups: a high-grade VUR group (n=53), a low-grade VUR group (n=28), and a group without VUR (n=365). Results: The recurrence and non-Escherichia coli infection rates in febrile UTI were significantly higher in the high-grade VUR group than in the other two groups (P<0.05). RBUS showed that hydronephrosis and ureter dilatation were more frequent in the high-grade VUR group than in the other groups (P<0.05). In the high-grade VUR group, a renal cortical defect was more likely to appear as multiple defects, and the difference in bilateral renal scan uptake between both kidneys was larger than in the other two groups (P<0.001). Conclusion: Recurrent UTI, non-E. coli UTI, abnormal findings on RBUS such as hydronephrosis and ureter dilatation, and abnormal findings in the DMSA renal scan such as multiple renal cortical defects and greater uptake difference were associated with high-grade VUR. VCUG should be selectively performed when RBUS and/or DMSA renal scan reveal significant abnormalities.

The Clinical Analysis of 91 Cases of Coronary Artery Bypass Graft (관상동맥 우회술 91례의 임상적 고찰)

  • 김학제
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.453-463
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    • 1995
  • During 42 month period 91 consecutive patient underwent coronary artery bypass surgery. The mean age of these patient was 57 years [range from 28 to 78 years . There were 57 men and 34 women. The preoperative risk factors that include beyond the 50 % of total patients were male sex, obesity, hypo-high-density lipoproteinemia, smoking, hypercholesterolemia, hyper-low-density lipoproteinemia, hypertriglyceridemia and hypertension. Preoperatively 27 patients had stable angina pectoris and 39 patients of unstable angina pectoris. Twenty five patients had previous myocardial infarction history. The patterns of disease were 8 patients of single vessel involvement, 18 patients of double vessel involvement, 54 patients of triple vessel involvement and 11 patients of left main coronary artery disease. Fifty five patients were in Canadian Cardiovascular Society functional class III. Myocardial revascularization was performed under emergency conditions in 5 patients. Nine percent of patients had previous PTCA history. We performed 16 cases of sequential anastomosis, internal mammary artery harvest in 86 percent of total patients and total 284 distal anastomoses[mean 3.1 anastomosis per patient . The mean ACC time was 60.5 minutes and ECC time was mean 110 minutes. The combined surgeries were 16 cases of endarterectomy, 2 cases of LV aneurysmectomy, 1 case of Bentall operation, 1 case of repair of sinus of Valsalva, 1 case of ligation of coronary AV fistula and 1 case of excision of breast mass. The most common complication was wound infection[12 cases, 13 % . There was one hospital death due to postoperative respiratory failure and low output syndrome in patient with postinfarction VSD, LV aneurysm. Postoperative 88 patients were in Functional class I or II. The 99mTc-MIBI myocardial perfusion scan that used as evaluation of postoperative state was well correlated with patient`s symptoms instead of some disadvantages.

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The Effect of Seizure-Related Variables on Interictal Psychiatric Symptoms in the Intractable Epileptic Patients (난치성 간질환자에서 간질관련요인이 발작간 정신증상에 미치는 영향)

  • Kim, Jong-Hoon;Han, Wou-Sang;Lee, Sang-Kun;Lyoo, In-Kyoon;Ha, Kyoo-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.205-213
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    • 1997
  • The aim of this study is to find the relationship between interictal psychiatric symptoms and seizure-related variables such as structural changes, regional interictal perfusion changes, the number of interictal epileptic discharges and the presence of accompanying generalized tonic clonic seizure(GTC). The subjects were 75 patients (47 males : mean age $28.3{\pm}7.7$) with intractable epilepsy, Interictal psychiatric symptoms were rated by Symptom Checklist-90-R(SCL-90-R). Each of 4 seizure variables was measured by MRI, $^{99m}TC-HMPAO$ SPECT and the prolonged EEG monitoring. The mean SCL-90-R subscale T-scores and the ratio of the patients with definite psychiatric symptoms(T-score > 65 at any one subscale of SCL-90-R) were compared among the groups with different seizure variables. Demographic variables and clinical variables were not statistically different among the groups with different seizure variables. The patients with right mesial temporal sclerosis had higher mean SCL-90-R scores for obsessive compulsive symptom, interpersonal sensitivity, depression, hostility and psychotic symptoms than the patients with left mesial temporal sclerosis, and they also showed higher ratio of definite psychiatric symptoms. The presence of interictal epileptic discharges was related with higher T-scores of paranoid subscale. The areas of hypoperfusion, the presence of the GTC, and other clinical seizure variables showed no significant influences on the mean SCL-90-R subscale T-scores. from these results, the authors speculated that interictal subictal epileptic dischrages may be related with psychiatric symptoms of the intractable epileptic patients, especially with right mesial temporal sclerosis.

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Crossed Cerebellar Diaschisis : Comparison of SPECT, MRI, and Clinical Sign (교차소뇌해리현상 : SPECT와 MRI 소견의 비교와 임상징후)

  • Sohn, Hyung Sun;Kim, Euy Neyng;Shin, Kwang Hyun;Rha, Hyung Kyun;Choi, Chang Rack
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.794-799
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    • 2000
  • Objectives : The purpose of our study was to compare findings of brain SPECT representing crossed cerebellar diaschisis(CCD) with brain MRI, to evaluate relation between CCD and location of lesions on MRI and to elucidate clinically apparent cerebellar sign in patients with CCD. Methods : The study population was 20 patients representing CCD on SPECT. Percentage differences(${\triangle}%$) of activity on each cerebellar hemisphere were obtained from ipsilateral and contralateral cerebellum[${\triangle}%cbll=(IL-CL)/IL{\times}100$] and from cerebrum [${\triangle}%cbr=(CL-IL)/CL{\times}100$]. From MR studies, the percentage differences of signal intensity were also calculated as the same method. We compared the degree of percentage differences with location of cerebral lesions and with clinical cerebellar signs of the patients. Results : Among those representing CCD, the parietal lesions were the most common. There was significant correlation of the percentage differences in cerebellum between SPECT($18.8{\pm}7.22$) and MRI($4.4{\pm}3.38$) (p<0.05) and in cerebrum between SPECT($28.7{\pm}15.35$) and MRI($42.8{\pm}10.94$) (p<0.05). Cerebellar signs were observed in 3 of the 20 patients. However, there was no statistically significance between degree of percentage differences of each cerebellar hemisphere on SPECT and clinical cerebellar sign(p>0.05). Conclusion : Using the percentage differences in the cerebellum, the CCD evaluation can be easily done. On MRI, the signal changes of cerebellum were not as definite as SPECT. Despite of our assumption, there was no significant correlation between clinical cerebellar signs and CCD on SPECT.

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Clinical Features of Complicated Meckel's Diverticulum Requiring Operation in Children (소아에서 수술을 요한 멕켈게실의 임상상)

  • Lee, Seong-Cheol;Mok, Woo-Kyun;Seo, Jung-Min;Jung, Sung-Eun;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.33-39
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    • 1995
  • The incidence of Meckel's diverticulum(MD) in general population has been assessed as 2 percent. The major complications of MD are bleeding, perforation, and intestinal obstruction. In spite that the complication rate of Meckel's diverticulum is relatively high(about 4.2% during a lifetime), the preoperative diagnostic rate of complicated MD is very low. Authors investigated the clinical characteristics of complicated MD to improve the diagnostic rate. 16 patients with complicated Meckel's diverticulum who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from June 1985 to December 1993 were reviewed. Among the 16 patients with complicated MD, 12 patients(75%) were under 2 year-old and male were predominant(88%). The most common complication was bleeding patients with bleeding MD (8 cases) were diagnosed preoperatively as MD. 8 patients with other complications(perforation : 4 cases, obstruction : 4 cases) could not be suspected as complicated MD except one patient who had previous history of melena. These patients were diagnosed after exploratory laparotomy under the various impression other than MD. Among 12 patients with ulcer related complications such as bleeding and perforation, heterotopic gastric mucosa was found in 11 patients. In conclusion, in any children with unexplained acute abdomen, especially under 2 years old, complicated MD must be included in differential diagnosis. In children with obscure lower gastrointestinal bleeding, $^{99m}Tc$-pertechnetate scintigraphy is a useful diagnostic tool to rule out bleeding MD.

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Juxtacortical Osteogenic Sarcoma of Chondroblastic Type on the Maxilla (상악골에 발생된 연골형성현 측피질골육종)

  • Choi Sun-Young;Choi Eun-Suk;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.2
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    • pp.539-563
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    • 1998
  • 39-year-old female had been treated for the exophytic mass on buccal aspect of the left, maxillary posterior area 2 years and 8 months ago. Tentative diagnosis was obtained as fibrous dysplasia on clinical and radiographic examinations and histopathologic findings revealed as osteochondroma after bone trimming at that time. She revisited for the treatment of recurred lesions. We reviewed this case with clinical. radiologic and histopathologic standpoints retrospectively, and came to a conclusion that the tumor primarily occurred was juxtacortical osteogenic sarcoma and recurred due to inadequate treatment and then expanded over intramedullary. This case shows that the diagnosis of osteosarcoma should take account of the patient history, clinical. radiographic and histopathologic findings and it requires attentive follow up check. Retrospectively reviewed results were as follows ; At first visit, oral examination revealed a bony hard swelling on the buccal aspect of the left maxillary posterior area. Radiographically, a dense radiopaque mass was noted on the site. The lesion showed hot uptake of /sup 99m/Tc-MDP. Histopathologic diagnosis was done as osteochondroma, but it was considered as osteogenic sarcoma when compared with the recurrent lesion. When she revisited for the treatment of multiple bony swelling on the left maxilla, radiograms showed typical features of malignancy such as widening of periodontal ligament space and sunray appearace, and coincided with benign characters as follows; relatively well circumscribed lesion and expansion and displacement of the adjacent structures. Finally, histopathologic findings of the lesion was well differentiated chondroblastic osteogenic sarcoma.

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Warthin's Tumor of the Parotid Gland (이하선의 Warthin씨 종양)

  • Lee Kang-Young;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.177-180
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    • 1996
  • Warthin's tumor is a benign and slow growing tumor found exclusively in the parotid gland or the periparotid lymph nodes. It mostly affects males between the age of forty to seventy years and is closely related with smoking history. Between January 1981 and June 1996, 42 patients underwent surgical excision of Warthin's tumor of the parotid gland; which made up 10.6% of all parotid gland surgeries(398 cases) during the same period. Their ages ranged from 36 to 75 years with a mean age of 56 years. There were 33 male and 9 female patients with a 4.3 : 1 male to female ratio. The majority of the tumors were situated in the parotid tail whereas one was in the deep lobe. Bilateral simultaneous involvements of the parotid gland were found in 4 patients(9.5%) ; therefore total of 46 parotid glands were involved. Four(8.7%) of the 46 parotid glands had multifocal tumors ranginging from two to three lumps. Tumor sizes varied from 1.5 to 6.0cm with mean diameter of 3.lcm. Of the 42 patients, 26(61.9%) were diagnosed preoperatively or peroperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 46 tumors, 30 underwent a superficial(n=29) or total(n=1) parotidectomy and for 16 cases with tumors suspected preoperatively or peroperatively of being single Warthin's tumor, only enucleation was performed. No cases of recurrence were identified during the follow up period regardless of type of operation performed, however the postoperative complication rate was much higher in the parotidectomy group(33.3%) than in the enucleation only group(12.5%). We feel that an enucleation procedure may be appropriate for the patients with single Warthin's tumor.

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