Assuntos
Dor no Peito , Isquemia Miocárdica/patologia , Dor , Síndrome Coronariana Aguda/diagnóstico , Idoso , Angiografia Coronária/métodos , Diagnóstico por Imagem/métodos , Humanos , Masculino , Imagem de Perfusão do Miocárdio/métodos , Compostos Radiofarmacêuticos/farmacologia , Descanso , Tecnécio Tc 99m Sestamibi/farmacologiaRESUMO
Dementia with Lewy bodies (DLB) is the second most common cause of dementia. The diagnosis of DLB is particularly important because these patients show good response to cholinesterase inhibitors. Clinical and neuroimaging criteria for DLB have not been acceptable for predictive accuracy. We report a case of progressive dementia in which the differentiation of DLB and Alzheimer disease (AD) on the basis of clinical criteria alone was not possible. The patient was admitted to the hospital because he became worse after he had started treatment for severe AD. Both MRI and brain magnetic resonance spectroscopy were normal. The patient underwent myocardial scintigraphy with I-123 MIBG showing marked reduction in cardiac MIBG accumulation. The heart to mediastinum ratio of MIBG uptake was impaired in both early and delayed images. FDG-PET scan before and after activation with a visual attention task showed occipital cortex hypometabolism as compared with AD and a normal control. This case illustrates the value of combining activated brain FDG PET and cardiac MIBG. The association of these 2 techniques could be used as a potential diagnostic tool in a patient with dementia misdiagnosed as AD.
Assuntos
3-Iodobenzilguanidina , Doença de Alzheimer/diagnóstico por imagem , Fluordesoxiglucose F18 , Coração/diagnóstico por imagem , Doença por Corpos de Lewy/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Humanos , Aumento da Imagem/métodos , Masculino , Cintilografia , Compostos RadiofarmacêuticosAssuntos
Células da Medula Óssea/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Transplante de Células-Tronco Hematopoéticas/métodos , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/cirurgia , Tecnécio Tc 99m Exametazima , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Compostos Radiofarmacêuticos , Resultado do TratamentoRESUMO
The authors report a case of small bowel bleeding diagnosed by Tc-99m-labeled red blood cell (RBC) scintigraphy during the postoperative period after aortic valve replacement. There is a relationship between aortic valve stenosis and gastrointestinal bleeding in elderly patients, called Heyde syndrome. The described patient had chronic anemia that worsened after surgery. RBC scintigraphy localized the source of bleeding from jejunal angiodysplasia confirmed by mesenteric angiography. This case illustrates the diagnostic information provided by RBC scintigraphy in this syndrome.