RESUMEN
OBJECTIVE: To evaluate pulmonary arteries in patients with tetralogy of Fallot following surgery with quantified lung perfusion scintigraphy and magnetic resonance imaging. MATERIAL AND METHODS: From January 1985 to December 1999, 47 patients who underwent surgery between 1985 and 1999 were studied. To obtain values of normality, 45 infants with no pulmonary artery disease were assessed with lung perfusion scintigraphy (right lung flow: 54-61%, left lung flow: 38.7-46%) and magnetic resonance imaging axial view (right/left pulmonary artery branch diameter ratio: 1-1.1). Patients with stenosis underwent catheterization. RESULTS: Group 1: 27 patients with normal parameters. Group 2: nine patients with left pulmonary branch stenosis and irregularities in all parameters; left/right branch diameter ratio 0.51 and left lung perfusion 26.3 +/- 7.9%, r correlation ratio 65%, p < 0.005, left branch pressure gradient 34.4 +/- 17.9 mm Hg, rate-gradient r 89%, p < 0.001. Group 3: five patients with right pulmonary branch stenosis and irregularities in all parameters; right/left branch diameter ratio 0.52, reduced right lung perfusion 32 +/- 11%, with a stenotic branch gradient of 40 +/- 19 mm Hg., rate/gradient ratio r 72%, p < 0.005; gradient/perfusion ratio r 82%, p < 0.003. Group 4: Six patients with bilateral stenosis, reduced diameter in the stenotic area with normal perfusion in both lungs and bilateral gradient. Eighteen patients with stenosis underwent re-operation, with favorable outcome in 14. CONCLUSION: Magnetic resonance imaging and quantified lung perfusion scintigraphy provide useful information in the follow-up of tetralogy of Fallot.
Asunto(s)
Imagen por Resonancia Magnética , Tetralogía de Fallot/diagnóstico por imagen , Tetralogía de Fallot/patología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Perfusión , Arteria Pulmonar , Cintigrafía , Tetralogía de Fallot/cirugíaRESUMEN
The reception of Gallium Citrate 67 (C. de Ga-67) has been studied in 27 patients with active pulmonary TBC shown bacteriologically. The findings of the gammagraphy with C. de Ga-67 have been compared with those of the simple thorax radiology. We have objectified 96% sensitivity in the examination of the tuberculous lesions by isotopic techniques. These have shown, as well, a high performance in the detection of active tuberculous areas at hiliar, mediatinic and extrathoracic level, greater than that of the simple radiography, as well as to evaluate the activity of apparently residual lesions in the thorax radiography. We conclude that the gammagraphy with C. de Ga-67 is a bloodless method which complements radiology in the diagnosis of activity, extension and location of pulmonary tuberculosis.