RESUMEN
Single-photon emission computed tomography (SPECT) can be used as a non-invasive tool for the assessment of coronary perfusion. Aim: To assess ventricular perfusion and function by SPECT in patients with single vessel coronary artery disease. Material and Methods: Among patients with indications for a coronary artery angiography, those with significant lesions in one vessel, were selected for the study. Within 24 hours, cardiac SPECT examinations on basal conditions and after high doses of dipyridamole, were performed. SPECT data from 38 patients with a low probability of coronary artery disease was used for comparisons. Results: Ten patients aged 61 ± 8 years (seven men) were studied. Visual analysis of SPECT revealed signs suggestive of ischemia in eight patients. The remaining two patients did not have perfusion disturbances. SPECT detected eight of ten abnormal vessels reported in the coronary artery angiography. There were two false negative results Summed stress, summed rest and summed difference scores were 9.78 ± 6.51, 3.22 ± 5.07 and 6.33 ± 4.97, respectively. The ejection fractions under stress and at rest were 53 ± 11.7% and 61 ± 15.7% respectively (p < 0.01). The figures for the control group were 69.1 ± 13.5% and 75.2 ± 12.04% respectively (significantly different from patients). Two patients had a summed motion score above 14.9. Likewise, two patients had a summed thickening score above 10.9. Conclusions: SPECT detected 80% of coronary lesions found during coronary artery angiography. Visual analysis of perfusion is highly reliable for diagnosis. Quantitative parameters must be considered only as reference parameters.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de la Arteria Coronaria/fisiopatología , Disfunción Ventricular Izquierda/fisiopatología , Angiografía Coronaria , Enfermedad de la Arteria Coronaria , Variaciones Dependientes del Observador , Imagen de Perfusión , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada de Emisión de Fotón Único , Disfunción Ventricular IzquierdaRESUMEN
BACKGROUND: Single-photon emission computed tomography (SPECT) can be used as a non-invasive tool for the assessment of coronary perfusion. AIM: To assess ventricular perfusion and function by SPECT in patients with single vessel coronary artery disease. MATERIAL AND METHODS: Among patients with indications for a coronary artery angiography, those with significant lesions in one vessel, were selected for the study. Within 24 hours, cardiac SPECT examinations on basal conditions and after high doses of dipyridamole, were performed. SPECT data from 38 patients with a low probability of coronary artery disease was used for comparisons. RESULTS: Ten patients aged 61 ± 8 years (seven men) were studied. Visual analysis of SPECT revealed signs suggestive of ischemia in eight patients. The remaining two patients did not have perfusion disturbances. SPECT detected eight of ten abnormal vessels reported in the coronary artery angiography. There were two false negative results Summed stress, summed rest and summed difference scores were 9.78 ± 6.51, 3.22 ± 5.07 and 6.33 ± 4.97, respectively. The ejection fractions under stress and at rest were 53 ± 11.7% and 61 ± 15.7% respectively (p < 0.01). The figures for the control group were 69.1 ± 13.5% and 75.2 ± 12.04% respectively (significantly different from patients). Two patients had a summed motion score above 14.9. Likewise, two patients had a summed thickening score above 10.9. CONCLUSIONS: SPECT detected 80% of coronary lesions found during coronary artery angiography. Visual analysis of perfusion is highly reliable for diagnosis. Quantitative parameters must be considered only as reference parameters.
Asunto(s)
Enfermedad de la Arteria Coronaria/fisiopatología , Disfunción Ventricular Izquierda/fisiopatología , Anciano , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Imagen de Perfusión , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada de Emisión de Fotón Único , Disfunción Ventricular Izquierda/diagnóstico por imagenRESUMEN
BACKGROUND: The urea breath test (UBT) with a microdose of [14C] is a non-invasive and simple method for the assessment of gastric infection by Helicobacter pylori. The aim of this study was to compare the [14C]UBT with invasive methods widely used for assessment of H. pylori gastric infection, including histology with hematoxylin-eosin staining, the gastric smear technique using Giemsa staining, and the biopsy urease test. MATERIAL/METHODS: We evaluated patients referred to our clinic for elective upper gastrointestinal endoscopy excluding those on antibiotics and/or bismuth during the previous 4 weeks, patients on H+ blockers or H2 antihistamines during the previous 7 days, pregnant women, and patients who had undergone gastric surgery or had bleeding disorders. Eighty-nine patients ranging in age from 18-75 years were included in the final study population, 61 women and 28 men (mean age: 43(15 years). RESULTS: When histology alone was considered as the reference standard, sensitivity for the [14 C]UBT was 94%, with a specificity of 37%; when the Giemsa technique, sensitivity was 95%, and specificity 35%; and when the biopsy urease test, sensitivity was 94% and specificity 45%. With two or more invasive techniques together considered as the reference standard, the [14C]UBT had a sensitivity of 95%, with a specificity of 44%. CONCLUSIONS: [14C]UBT is an objective and reproducible technique, capable of sampling the whole gastric mucosa. It shows high sensitivity, but low specificity, which could be explained by limited gastric sampling plus subjective interpretation in the invasive techniques that are currently used as gold standard.
Asunto(s)
Pruebas Respiratorias/métodos , Radioisótopos de Carbono , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/metabolismo , Urea/metabolismo , Reacciones Falso Positivas , Femenino , Humanos , Masculino , Embarazo , Estándares de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estadística como Asunto , Urea/químicaRESUMEN
O refluxo biliar desempenha um importante papel na patogenia da esofagite, gastrite e úlcera gástrica. Recentemente, um método utilizando radioisótopos tem sido empregado como o mais fisiológico na avaliaçäo desta condiçäo. No presente artigo, estudou-se o refluxo enterogástrico, empregando o Tc-99m DISIDA em 37 pacientes em várias situaçöes, a saber: esofagite de refluxo, úlcera péptica, ressecçöes gástricas, vagotomia gástrica proximal e colecistite crônica calculosa. Em 19 pacientes, o esvaziamento vesicular foi estimulado com uma dieta hipercalórica altamente concentrada e nos restantes com a injeçäo endovenosa de 5 ng/kg (14 casos) ou 50 ng/kg de ceruleína. Os resultados obtidos sugerem que a injeçäo endovenosa de ceruleína nas doses de 5 ou 50 ng/kg está associada com refluxo enterogástrico significativo