RESUMEN
The aim of this review was to recall the relevance of the myocardial perfusion scintigraphy procedure in the diagnosis of coronary artery disease. Myocardial perfusion scintigraphy is undergone after treadmill exercise or pharmacological stress by infusion of Dipyridamole. Thallium-201, sestamibi-Tc99m and tetrofosmine-Tc99m are the most frequently used tracers. Gated single photon emission computed tomography provides a combined evaluation of both myocardial perfusion and function. Myocardial perfusion imaging is an accurate tool for the diagnosis of coronary artery disease with a high sensitivity 93% and good specificity 80%. Its prognostic value is now well established among patients with known coronary artery disease. In particular for risk stratification and patient management decisions. Thallium-201 SPECT is clinically accurate in assessing myocardial viability. As it is for assessment after myocardial revascularisation. Thus myocardial perfusion scintigraphy is a reliable and a cost-effective investigation for coronary artery disease.
Asunto(s)
Corazón/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Humanos , CintigrafíaRESUMEN
Bone scans of 64 patients with newly diagnosed prostate cancer were retrospectively analysed. Metastases were present in 29 patients (45%). In 75% of these cases, the pattern was manifeastly metastatic. The third threshold has high negative and positive predictive values. The topography of metastatic lesions is in favour of a systemic spread. There were no metastatic cases with a PSA level under 10 ng/ml. Multiple IAU and intense IAU are the most specific patterns of metastatic lesions. Also, focal lesions on sacroiliacs are also in favour of metastatic origin. The distribution of metastases is globally similar to that of the bone marrow in adult and systemic spread is the most probable. Staging bone scan must be reserved to patients with PSA level greater than 10 ng/ml, poorly degree of differentiation and advanced clinical stage.
Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/patología , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/sangre , Cintigrafía , Estudios RetrospectivosRESUMEN
Radioodine-131 has an important place in the management of well-differentiated thyroid cancer. Patient preparation for radioiodine-131 administration must be rigorous and is based on the stimulation of endogenous TSH production, which requires a hypothyroid state after withdrawal of suppressive T4-therapy. The introduction of recombinant human TSH would simplify the protocol of preparation and improve the quality of life of patients. The diagnosis place of radioiodine-131 knew significant changes following the introduction of the serum thyroglobulin measurement. This tumour marker has a central role in the strategy of follow-up and tends to be the principal element of indication for a diagnosis exploration with radioidine-131. The systematic ablation of thyroid remnants remains controversial particularly in patients with good prognosis factors; the efficacy of low activities is also still debatable. The optimal follow-up strategy and the indication of remnant ablation must take in account the prognosis factors of survival and recurrence. Radioiodine-131 therapy permits frequently the cure of distant metastases, particularly in infraradiological pulmonary forms. This fact outlines the importance of an early detection of tumour recurrence based on the conjunction of radioiodine-131 and thyroglobulin. Side effects of radioiodine-131 therapy are generally limited if the precautionary measures are well applied; leukaemia constitutes the main risk but this complication is very uncommon and occurs after a high cumulative activity.