RESUMO
Sixteen symptom-free siblings of children with vesicoureteral reflux were found to have the condition and underwent renal scintigraphy with technetium 99m dimercaptosuccinic acid. Of these 16 children, 6 had scintigraphic evidence of renal damage. Screening for vesicoureteral reflux in siblings of children known to have the condition should therefore be carried out early in life; when reflux is present, an immediate assessment of the renal parenchyma should be made.
Assuntos
Nefropatias/diagnóstico por imagem , Rim/diagnóstico por imagem , Compostos de Organotecnécio , Succímero , Refluxo Vesicoureteral/complicações , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Nefropatias/etiologia , Masculino , Cintilografia , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Refluxo Vesicoureteral/genéticaRESUMO
Radionuclide angiography using iridium 191m was carried out in 34 premature infants and young children for detection and quantitation of left-to-right shunts. Ir-191m has a physical half-life of 4.96 seconds and can be imaged with conventional gamma scintillation cameras. The whole body radiation absorbed dose from Ir-191m is 3.5 mrad/mCi, which is about 40 times less radiation than with technetium 99m. Other advantages of Ir-191m include high photon flux for improved imaging and the possibility of multiple studies within a short period of time without background. Nine patients had simultaneous measurement of pulmonary-to-systemic flow ratio by Ir-191m angiography and oxymetry during cardiac catheterization; the correlation coefficient was 0.90. Radionuclide angiography with Ir-191m is a method with virtually no risk, rapid, accurate, and reproducible, and is ideally suited for the evaluation of left-to-right shunts in small children.
Assuntos
Angiografia/métodos , Cardiopatias Congênitas/diagnóstico por imagem , Irídio , Coração/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/diagnóstico por imagem , Isótopos , CintilografiaAssuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Artéria Pulmonar/anormalidades , Radioisótopos , Tálio , Adolescente , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/etiologia , Feminino , Coração/diagnóstico por imagem , Humanos , Lactente , Masculino , CintilografiaRESUMO
To determine the effects of the pulmonary hypoplasia present at birth in infants with congenital diaphragmatic hernia upon subsequent development of the lung, 19 patients who had undergone surgical repair before the age of one year were studied at ages 6 to 18 years. Total lung capacity and vital capacity averaged 99% of predicted value. Diffusing capacity for carbon monoxide was normal. Forced expiratory volume in one second averaged 89% of predicted value and 80% of vital capacity. Total respiratory system conductance and maximum expiratory flow volume curves obtained during air and helium-oxygen breathing were normal. Xenon 133 radiospirometry performed in nine patients revealed equal distribution of lung volumes on the two sides. Ventilation to the hernia side was reduced in only two patients. Blood flow to the hernia side was reduced in all nine patients. Chest radiographs supported the physiologic observations. These findings are consistent with the persistence of a reduction in the number of branches or generations of pulmonary arteries and bronchi on the side of the hernia. Since a substantial part of the vascular resistance resides in peripheral vessels, this developmental abnormality influences the distribution of pulmonary blood flow, although it has little effect on tests reflecting airway resistance or the distribution of ventilation.