RESUMEN
Nuclear medicine is a diverse field with a large number of different studies spanning virtually all organ systems and medical specialties. Many nuclear medicine procedures are performed routinely; others may be performed only rarely, sometimes less than once per year. The infrequent nature of many studies makes it challenging to retain relevant knowledge and skills. This 2-part article provides a review of several infrequently performed studies. The topics discussed in Part 1 include dacroscintigraphy, LeVeen shunts, scintimammography, right-to-left shunts, left-to-right shunts, and heat-damaged red blood cells. After reading this article, the reader should be able to list and describe the indications for each study, list the doses and describe their proper method of administration, and describe problems that may arise during the imaging procedure and how they should be handled.
Asunto(s)
Medicina Nuclear/normas , Anomalías Cardiovasculares/diagnóstico por imagen , Humanos , Aparato Lagrimal/diagnóstico por imagen , Mamografía/métodos , Mamografía/normas , Medicina Nuclear/educación , Medicina Nuclear/métodos , Derivación Peritoneovenosa/métodos , Derivación Peritoneovenosa/normas , Radiofármacos/farmacocinética , Tecnecio/farmacocinética , Tecnecio Tc 99m Sestamibi/farmacocinética , Tomografía Computarizada de Emisión/métodos , Tomografía Computarizada de Emisión/normasRESUMEN
Resistant or refractory ascites is unusual in cirrhotic patients who comply with dietary sodium restriction and optimal diuretic therapy. Patients unresponsive to medical therapy often have end-stage liver disease and renal insufficiency, although reversible complicating factors must be excluded. For patients with truly refractory ascites, liver transplantation is the only option that improves chances of survival. When this is not feasible, therapeutic paracentesis is the procedure of choice for intractable ascites. Several surgical shunts have been used, but none have been found to be safer and more effective than large-volume paracentesis.
Asunto(s)
Ascitis/terapia , Cirrosis Hepática/complicaciones , Ascitis/epidemiología , Ascitis/etiología , Protocolos Clínicos/normas , Árboles de Decisión , Dieta Hiposódica , Diuréticos/administración & dosificación , Diuréticos/uso terapéutico , Drenaje/normas , Humanos , Cirrosis Hepática/fisiopatología , Trasplante de Hígado/normas , Derivación Peritoneovenosa/normas , Derivación Portosistémica Quirúrgica/normas , Pronóstico , Tasa de Supervivencia , Resultado del Tratamiento , Equilibrio HidroelectrolíticoRESUMEN
Denver shunt patency can be easily assessed by sequential scintigraphy with a Gamma camera after an intraperitoneal injection of 99mTc sulphur colloid. If the shunt is patent, the tracer will be seen throughout the shunt upto it's opening into the right atrium. The following case report illustrates the application and usefulness of this procedure.
Asunto(s)
Cirrosis Hepática/diagnóstico por imagen , Derivación Peritoneovenosa/normas , Grado de Desobstrucción Vascular , Adulto , Femenino , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/cirugía , CintigrafíaRESUMEN
A peritoneo-jugular shunt clinically effective in a 48 years old male patient with cirrhosis, is explored concomitantly with Doppler and infrared thermography. In this patient, without clinical signs of ascites, these two non invasive methods associated to sensitization techniques (decubitus, deep breathing, abdominal binding) specify the functioning conditions of the valve and permit to consider a close monitoring of these patients for screening and prevention of the frequent, asymptomatic obstruction of their shunt.