Asunto(s)
Colon/anomalías , Diafragma/diagnóstico por imagen , Hallazgos Incidentales , Hígado/diagnóstico por imagen , Anciano , Colon/diagnóstico por imagen , Diafragma/fisiopatología , Estudios de Seguimiento , Humanos , Hígado/fisiopatología , Linfoma no Hodgkin/diagnóstico por imagen , Linfoma no Hodgkin/patología , Masculino , Estadificación de Neoplasias , Tomografía de Emisión de Positrones , Síndrome , Tomografía Computarizada por Rayos XAsunto(s)
Corteza Cerebral/anomalías , Lisencefalias Clásicas y Heterotopias Subcorticales en Banda/diagnóstico por imagen , Tomografía de Emisión de Positrones , Corteza Cerebral/patología , Niño , Lisencefalias Clásicas y Heterotopias Subcorticales en Banda/fisiopatología , Electroencefalografía/métodos , Fluorodesoxiglucosa F18 , Humanos , MasculinoRESUMEN
This report presents unusual positron emission tomography findings in an 11-year-old male with Rasmussen's encephalitis. This patient underwent fluorine-18 fluorodeoxyglucose positron emission tomography to localize his ictal focus before surgical consideration. Positron emission tomography disclosed marked hypermetabolism in the left cerebral hemisphere and basal ganglia with subnormal right cerebral activity and crossed cerebellar diaschisis. The heterogeneous distribution of metabolism suggests a combination of areas in different stages of ictal and postictal involvement. The hypermetabolic region in the left hemisphere was larger in size and extent (now including the left frontoparietal lobe) than the sole hypermetabolic left temporal lobe on his positron emission tomography from 2 years ago. While this positron emission tomography pattern of progression appears most commonly in Rasmussen's encephalitis case studies, few serial reports exist. The complex positron emission tomography findings of this case emphasize the importance of knowing the history of recent seizures, seizure type, clinical status at time of injection, and electroencephalographic correlation before interpreting functional neuroimaging studies. Finally, positron emission tomography studies can help clarify whether patients with Rasmussen's encephalitis with dominant hemisphere involvement are appropriate candidates for surgery or not.
Asunto(s)
Ganglios Basales/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Encefalitis/diagnóstico por imagen , Tomografía de Emisión de Positrones , Ganglios Basales/metabolismo , Corteza Cerebral/metabolismo , Niño , Dominancia Cerebral , Electroencefalografía , Encefalitis/complicaciones , Encefalitis/metabolismo , Epilepsia/diagnóstico por imagen , Epilepsia/etiología , Epilepsia/metabolismo , Fluorodesoxiglucosa F18 , Humanos , Masculino , RadiofármacosRESUMEN
We present a case of an 85-year-old woman with medically refractory essential thrombocythemia and subsequent venous thrombosis. She received conservative phosphorus-32 sodium phosphate therapy for 3 mCi, approximately half the usual dose. One month later, she received a second intravenous phosphorus-32 treatment of 3.5 mCi. She responded successfully to both treatments with drops in her platelet count and experienced no adverse effects. Our case is noteworthy in the effectiveness from a conservative dose while avoiding hematologic complications.
Asunto(s)
Plaquetas/efectos de la radiación , Radioisótopos de Fósforo/administración & dosificación , Trombocitemia Esencial/patología , Trombocitemia Esencial/radioterapia , Anciano de 80 o más Años , Esquema de Medicación , Femenino , Humanos , Recuento de Plaquetas , Radiofármacos/administración & dosificación , Resultado del TratamientoRESUMEN
BACKGROUND AND PURPOSE: Multiple biomarkers are used to quantify the severity of traumatic brain injury (TBI) and to predict outcome. Few are satisfactory. CT and conventional MR imaging underestimate injury and correlate poorly with outcome. New MR imaging techniques, including diffusion tensor imaging (DTI), can provide information about brain ultrastructure by quantifying isotropic and anisotropic water diffusion. Our objective was to determine if changes in anisotropic diffusion in TBI correlate with acute Glasgow coma scale (GCS) and/or Rankin scores at discharge. METHODS: Twenty patients (15 male, five Female; mean age, 31 years) were evaluated. Apparent diffusion coefficients (ADCs) and fractional anisotropy (FA) values were measured at multiple locations and correlated with clinical scores. Results were compared with those of 15 healthy control subjects. RESULTS: ADC values were significantly reduced within the splenium (Delta18%, P =.001). FA values were significantly reduced in the internal capsule (Delta14%; P <.001) and splenium (Delta16%; P =.002). FA values were significantly correlated with GCS (r = 0.65-0.74; P <.001) and Rankin (r = 0.68-0.71; P <.001) scores for the internal capsule and splenium. The correlation between FA and clinical markers was better than for the corresponding ADC values. No correlation was found between ADC of the internal capsule and GCS/Rankin scores. CONCLUSION: DTI reveals changes in the white matter that are correlated with both acute GCS and Rankin scores at discharge. DTI may be a valuable biomarker for the severity of tissue injury and a predictor for outcome.