Evaluating pediatric ureteropelvic junction obstruction:Dynamic magnetic resonance urography vs renal scintigraphy 99mtechnetium mercaptoacetyltriglycine

BACKGROUND Ureteropelvic junction obstruction(UPJO)is a common congenital urinary tract disorder in children.It can be diagnosed as early as in utero due to the presence of hydronephrosis or later in life due to symptomatic occurrence.AIM To evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography(dMRU)and scintigraphy 99m-technetium mercaptoacetyltriglycine(MAG-3)for the functional evaluation of UPJO.METHODS Between 2016 and 2020,126 patients with UPJO underwent surgery at Robert DebréHospital.Of these,83 received a prenatal diagnosis,and 43 were diagnosed during childhood.Four of the 126 patients underwent surgery based on the clinical situation and postnatal ultrasound findings without undergoing functional imaging evaluation.Split renal function was evaluated preoperatively using scintigraphy MAG-3(n=28),dMRU(n=53),or both(n=40).In this study,we included patients who underwent surgery for UPJO and scintigraphy MAG-3+dMRU but excluded those who underwent only scintigraphy MAG-3 or dMRU.The patients were divided into groups A(<10%discrepancy)and B(>10%discrepancy).We examined the discrepancy in split renal function between the two modalities and investigated the possible risk factors.RESULTS The split renal function between the two kidneys was compared in 40 patients(28 boys and 12 girls)using scintigraphy MAG-3 and dMRU.Differential renal function,as determined using both modalities,showed a difference of<10%in 31 children and>10%in 9 children.Calculation of the relative renal function using dMRU revealed an excellent correlation coefficient with renal scintigraphy MAG-3 for both kidneys.CONCLUSION Our findings demonstrated that dMRU is equivalent to scintigraphy MAG-3 for evaluating split renal function in patients with UPJO.

Place of Bone Scintigraphy in the Assessment of Extension and Follow-Up of Breast Cancer in Senegal: Study of 165 Cases in the Nuclear Medicine Department of Idrissa Pouye General Hospital (Dakar)

Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to metastases, with 73% of metastases occurring in the bone. In oncology, metastable technetium 99-labelled methylene bisphosphonate bone scintigraphy (BS) remains the standard examination for detecting and assessing the extent of bone metastases. The aim of this study was to assess the role of BS in the evaluation and follow-up of breast cancer in Senegal. Methodology: This was a retrospective study of breast cancer patients who underwent bone scintigraphy with 99mTc-HMDP in the nuclear medicine department of Idrissa Pouye General Hospital (IPGHO), from July 2009 to June 2022. Results: We enrolled 165 patients, mean age 46.79 years (27 - 87 years). BS was performed in 94.37% of cases for post-therapeutic monitoring and in 5.63% for pre-therapeutic assessment. Results were contributory in 131 patients (92.25%), of whom 72 cases (50.70%) were normal and 59 cases (41.55%) positive or presenting bone metastases;and non-contributory or doubtful in 11 cases (7.75%). Secondary bone locations were multiple in 57 cases (96.61%) and single or solitary in 2 cases (3.39%). The scintigraphic appearance of bone metastases was hyper-fixative in 58 cases (98.31%) and mixed in 1 case (1.69%). Bone lesions were quantified using the Soloway’s grading classification. Conclusion: BS with 99mTc-labelled bisphosphonates remains the examination of choice for skeletal exploration, in the detection and extension of bone metastases in breast cancer. Performance has been enhanced by the development of SPECT coupled with CT (SPECT-CT).

The Clinical Usefulness of ^(99m)Tc-Tetrofosmin Scintigraphy in the Diagnosis of Lung Neoplasmas and Mediastinal Lymphoid Node Involvement

In order to investigate the clinical significance of 99mTc-Tetrofosmin （TF） scintigraphy in the evaluation of lung cancer and mediastinal lymphoid node involvement, 33 patients with pulmo- nary neoplasmas were subjected to both 99mTc-TF scintigraphies and CT scans in one week before their operations or puncturations. All the images were judged visually and the emission images were analyzed with semi-quantitative methods in addition. The results of each group were compared. There was marked difference in target/non-target （T/N） ratio between the lung cancer group and the benign lesion group （P〈0.001）. Moreover, in the lung cancer group, T/N ratio in tomographies was signifi- cantly higher than that in planar images （P〈0.01）. The sensitivity and accuracy of semi-quantitative analysis in 99mTc-TF SPECT were significantly higher than those of CT in the diagnosis of pulmonary neoplasmas （P〈0.05 and P〈0.01 respectively）, so was the sensitivity of 99mTc-TF SPECT vs CT in the diagnosis of mediastinal lymphoid node metastasis （P〈0.05）. It was also found that epidermoid squamous cell carcinomas and adenocarcinomas had a higher T/N ratio than in small cell carcinomas （P〈0.05）, and 2 h washout rate （WR） of adenocarcinomas was higher than that of epidermoid squamous cell carcinomas （P〈0.05）. In conclusion, 99mTc-TF scintigraphy showed a favorable diag- nostic accuracy in appraising lung cancers and mediastinal lymph node metastases. Furthermore semi-quantitative technology can improve the accuracy, and is potential to offer some information about histological type of the cancer tissue. Therefore, 99mTc-TF scintigraphy will be a useful tool in the diagnosis and staging of lung cancer.

Is there a role for Tc-99m (V) DMSA scintigraphy in ischemic colitis?

AIM: To evaluate the role of pentavalent Tc-99m dimercaptosuccinic acid [Tc-99m (V) DMSA] in the diagnosis of ischemic colitis. METHODS: Fourteen patients with endoscopically and histologically confirmed ischemic colitis were included in the study. Tc-99m (V) DMSA scintigraphy was performed within 2 d after colonoscopy. Images were considered positive when an area of increased activity was observed in the region of interest and negative when no abnormal tracer uptake was detected. RESULTS: In 3 out of the 14 patients, Tc-99m (V) DMSA images showed moderate activity in the bowel. The scintigraphic results corresponded with the endoscopic findings. In the other 11 patients, no abnormal tracer uptake was detected in the abdomen. CONCLUSION: Besides the limited number of patients, Tc-99m (V) DMSA could not be considered as a useful imaging modality for the evaluation of ischemic colitis.

Quantitative index calculated by ^(99m)Tc-GSA scintigraphy

99mTc-galactosyl human serum albumin（GSA） scintigraphy is useful to evaluate hepatic function and hepatic functional reserve. A reliable SPECT and CT integrated system is now commercially available. Using this system, we can obtain 99mTc-GSA SPECT/CT fused imaging with a small registration error. Therefore, the 99mTc-GSA scintigraphy techniques prove more useful in clinical practice than have been previously reported. In the latest Annals of Surgical Oncology on Oct 2014, the uptake index（UI） values calculated from 99mTc-GSA scintigraphy are reported to be useful for predicting the functional reserve of the future remnant liver. In this paper, we describe the usefulness of 99mTc-GSA scintigraphy as well as some cautions that are necessary as regards using the system.

Surgical management of primary hyperparathyroidism guided by double-phase Tc-99m-MIBI scintigraphy

Objective:The aim of this work was to study the clinicopathological features of cases with primary hyperparathyroidism (PHPT) referred to National Cancer Institute (NCI), Cairo University in the last six years and to study the role of nuclear medicine techniques in the initial diagnosis and preoperative localization directing surgical management of these cases. Methods: This study included 27 patients with PHPT properly diagnosed and treated in the NCI, Cairo University from January 2005 to December 2010. Preoperative neck U/S and Tc-99m-MIBI scintigraphy were done in all cases. If preoperative localization detected a single lesion, unilateral exploration was done. Bilateral exploration was done if multiple foci of active parathyroid glands or no lesions were detected. Results: This study included 27 patients (8 males and 19 females). The median age was 43 years (range from 19 to 68 years). All cases presented with bone disease in the form of bony pain in 23 patients, bony swellings in 15 patients and pathological fractures in 6 cases. Twenty one patients (77.8%) had single adenoma, 5 cases (18.5%) had parathyroid hyperplasia, and only one case had double adenomas. The sensitivity of neck U/S in detecting single adenoma was 61.9% (13/21), with 81% positive predictive value (PPV) while the sensitivity of Tc-99m-MIBI scintigraphy was 90.5% (19/21) with 100% PPV. Based on preoperative localization tests, unilateral exploration was done in 19 patients with solitary adenomas. All cases in this group were cured with no reported case of persistent or recurrent hypercalcemia. Conclusion: Presentation of PHPT may mimic malignant bone tumors but fortunately these patients were correctly diagnosed with bone scan which confirm the presence of metabolic bone disease rather than bone metastases. This was followed by estimation of serum calcium and parathormone levels for confirmation. Unilateral exploration based on the combination of ultrasound and preoperative localization by Tc-99m-MIBI scintigraphy was effective and could replace the standard bilateral neck exploration in cases with solitary adenoma. Bilateral neck exploration was required for suspected bilateral disease, hyperplasia or non visualized parathyroids.

Contribution of ^99mTc-DPD Scintigraphy in the Diagnosis of Cardiac Amyloidosis in Black Africans

Cardiac amyloidosis presents a picture of hypertrophic cardiomyopathy with heart failure with preserved ejection fraction. It is largely underdiagnosed, especially in black Africans, and therefore falls under the category of heart disease classified as idiopathic. Light chain amyloidosis (AL) is mainly found in Caucasian subjects and the mutant variant of transthyretin (TTRm) in negroid subjects. Numerous studies have shown that ATTRm was found predominantly in black American and black British patients. In African countries the entity of idiopathic heart failure is quite important because of lack of diagnosis, ETT, MRI and immuno-histochemistry are expensive or not available. We can probably assume that the proportion of cardiac amyloidosis is quite important in black Africans. The question is if 99mTc-DPD really easy to perform, can probably help to investigate in the nuclear medicine department in Africa. No large-scale study has been able to demonstrate the prevalence or not of cardiac amyloidosis in black-African subjects and by extension reduce this nosological entity of idiopathic heart disease. The 99mTc-DPD scintigraphy using Perrugini’s visual sore allows localization and classification of amyloid damage. The mechanism of binding of 99mTc-DPD to amyloid fibril deposits is not well known, its binding to TTR-type (mutated or wild type) amyloidosis is greater than the AL variant. In the diagnostic algorithm, endomyocardial biopsy is the gold standard but remains invasive, ETT with the strain allows a presumptive diagnosis and remains an operative examination dependent and is not reproducible. Cardiac MRI allows some localization of amyloid deposits but still remains less sensitive than scintigraphy. In addition, performing the whole-body MRI is very restrictive (time, antenna change and cost). The aim of this literature review was to show the superiority of 99mTc-DPD scintigraphy compared to other diagnostic modalities and to consider its use given its simplicity when it comes to usage in Sub-Saharan Africa to diagnose the disease. cardiac amyloidosis and by extension reduce the number of cases of heart disease classified as idiopathic and thus allow early and appropriate management.

Effect of the Energy Window Width on the Estimation of Renal Function from Dynamic Renal Scintigraphy with ^99mTc-MAG3

Objective: The width of the photopeak energy window influences the image quality and quantitative accuracy of gamma camera imaging. We compared 20% and 15% energy windows in renal scintigraphy with 99mTc-mercaptoacetyltriglycine (MAG3), especially in terms of camera-based quantitative estimation of renal function. Materials and Methods: Forty patients who underwent dynamic renal scintigraphy with 99mTc-MAG3 were enrolled in this study. Images were acquired simultaneously using two energy windows centered at 140 keV and with widths of 20% and 15%. Fractional renal uptake was calculated as the ratio of initial renal uptake estimated by patient imaging to injected dose estimated by syringe imaging, and was converted to MAG3 clearance using an empirical equation determined previously from data obtained with a 20% energy window. Relative function of the right kidney was also assessed. Visual evaluation was performed to compare image quality between the 20% and 15% energy windows. Results: Both total kidney MAG3 clearance and relative function of the right kidney were identical between the 20% and 15% energy windows. Image quality was also similar irrespective of the energy window width. Conclusions: The camera-based method established using a 20% energy window is applicable for the estimation of renal function using a 15% energy window, and data obtained using 20% and 15% windows are interchangeable.

Correlation between ^99mTcO₄<sup style="margin-left:-7px;">-</sup>Thyroid Scintigraphy and Blood Test in Primary Hyperthyroidism

Background: The 99mTcO4- thyroid scintigraphy is commonly used for hyperthyroidism diagnosis. Uptake value of 99mTcO4- on thyroid scintigraphy is an indicator of hyperthyroidism activity. Although, the correlation between free T3 value and free T4 value is not necessary clear in primary hyperthyroidism. Introduction: This study investigated the correlation between results of blood test and uptake of 99mTcO4- on thyroid scintigraphy in primary hyperthyroidism. Methodlogy: In this retrspective study, uptake was calculated in patients diagnosed with primary hyperthyroidism (Graves’ disease/Basedow’s disease) based on clinical findings, blood tests, thyroid ultrasound, and 99mTcO4- thyroid scintigraphy (uptake ≥3%) at St. Marianna University School of Medicine Hospital between 1 January 2010 and 31 December 2019. This uptake of 99mTcO4- was compared with results of blood tests. Results: Fifty-four consecutively arriving patients at the hospital (12 men, 42 women;mean age 43.0 ± 14.0 years) were selected. Free T3 (n = 54) was 14.6 ± 6.8 pg/mL, free T4 (n = 53) was 5.0 ± 2.3 ng/mL, and uptake on thyroid scintigraphy was 10.0% ± 7.1%. The correlation coefficients were 0.60 (p < 0.01) between free T4 (all case), 0.39 (p < 0.01) between free T4 (under 7 ng/mL), 0.12 (p = 0.70) between free T4 (above 7 ng/mL) and 99mTcO4- thyroid scintigraphy uptake. Conclusion: In primary hyperthyroidism (Graves’ disease), there is a correlation between free T4 value and 99mTcO4- thyroid scintigraphy uptake, but there is no correlation in patients with high free T4 level.

^(99m)Tc-MIBI与^(99m)Tc-Octreotide生长抑素受体显像诊断乳腺癌的对比研究

目的:比较99mTcMIBI与99mTcOctreotide生长抑素受体显像对乳腺癌诊断的临床价值。材料和方法:对36例怀疑为乳腺癌的患者术前行99mTcMIBI显像,48小时后行99mTcOctreotide生长抑素受体显像,以术后病理检查结果作为金标准。结果:36例中,25例为乳腺癌,其中11例发生腋窝淋巴结转移;11例患者为乳腺良性病变。两种显像方法对乳腺癌诊断的灵敏度、特异性、准确性分别为92.0%、63.6%、83.3%和92.0%、27.3%、72.2%。结论:99mTcMIBI显像与99mTcOctreotide生长抑素受体显像对乳腺癌均有较好的诊断价值,但99mTcOctreotide生长抑素受体显像诊断特异性较低。由于本研究的病例数有限,有待于进一步的工作深入探讨。

99Tc^m-MDP三相骨显像联合CT成像对创伤后骨髓炎的诊断价值

目的探讨99 Tc m-MDP三相骨显像(TPBS)联合CT扫描诊断创伤后骨髓炎的临床应用价值。方法回顾性分析北京积水潭医院76例创伤后骨折愈合不良患者(男49例,女27例,年龄19~65岁)的临床及影像学资料,患者均行99 Tc m-MDP三相骨显像和骨折部位CT扫描,根据术后临床诊断及随访结果,分析三相骨显像中单一应用血流相、血池相和CT以及联合应用三相骨显像与CT扫描诊断创伤后骨髓炎的灵敏度、特异性和准确性,并通过统计学分析进行比较。结果对于创伤后骨髓炎的诊断,单一应用血流相的灵敏度为88.1%(37/42),特异性为73.5%(25/34),准确性为81.6%;单一应用血池相的灵敏度为85.7%(36/42),特异性为67.6%(23/34),准确性为77.6%;单一应用CT扫描的灵敏度为73.8%(31/42),特异性为64.7%(22/34),准确性为66.7%。三相骨显像联合CT扫描诊断骨折术后感染的灵敏度为90.5%(38/42),特异性为85.3%(29/34),准确性为88.2%。99 Tc m-MDP TPBS联合CT的诊断特异性及准确度高于单一应用血流相或血池相,99 Tc m-MDP TPBS联合CT的诊断灵敏度、特异性及准确度高于单一应用CT扫描,差异具有统计学意义。结论99 Tc m-MDP三相骨显像联合CT扫描能够通过提高诊断特异性从而提高诊断准确性,在创伤后骨髓炎的诊断中具有重要的增益价值。

^(99)Tc^m(V)-DMSA与^(99)Tc^m-MIBI亲肿瘤显像在诊断甲状腺髓样癌中的对比

对62例甲状腺髓样癌(MTC)患者手术前行SPECT亲肿瘤显像,其中99Tcm(V)-DMSA显像组32例,99Tcm-MIBI显像组30例;并对两组患者早期和延迟影像的定性和半定量分析结果进行比较。结果显示:两种显像方法对MTC原发灶诊断的阳性率无显著性差异(P>0.05),但半定量分析结果显示99Tcm(V)-DMSA对原发灶显像的早期摄取比、延迟摄取比、滞留指数明显高于99Tcm-MIBI显像,差异有显著性(P<0.001),提示99Tcm(V)-DMSA显像更具有优越性。

^(99)Tc^m-MIBI心、肝时相显像对门脉性肝硬化门-体分流诊断的研究

通过心、肝时相显像对门脉性肝硬化门-体分流诊断的研究,验证门-体分流值的临床意义。方法是对10例正常者及36例门脉性肝硬化患者采用Tcm-MIBI直肠给药,分别在15—240min内的7个不同时相获取99H/L比值及SI,以便对肝硬化所致的门-体分流及程度进行分析。结果显示正常组与肝硬化A、B、C组H/L比值有极显著性差异(t分别为15.87、11.76、16.11,P<0.001),SI与H/L比值有良好匹配性。肝硬化Child-pugh分级之间均有显著性差异(P<0.001)。C组6例患者所测的SI与手术中所测的门静脉自由压具有良好的相关性(r=0.926,P<0.001)。以上结果说明该方法可客观反映门脉性肝硬化门-体分流的程度,有助于肝硬化的分级及门脉压力的了解,可为临床提供有价值的诊断依据。

^(99m)Tc-octreotide的标记及受体分析

目的探讨直接法标记99mTc-octreotide的方法学及其与大鼠脑皮质细胞的亲和力。方法用直接法标记99mTc-octreotide,探讨其最佳标记条件;并以~99mTc-octreotide作为配基,检测大鼠脑皮质细胞与其结合的平衡解离常数。结果99mTc—octreotide标记率为53％～57％,经Sephadex G-10纯化后放化纯大于95％;受体分析显示大鼠脑皮质细胞与99mTc-octreotide保持了较高的亲和力(Kd=10.4nM)。结论 本标记方法是可行的,99mTc—octreotide有希望作为具有临床实用价值的生长抑素受体显像剂。

Hepatobiliary scintigraphy for detecting biliary strictures after living donor liver transplantation

AIM:To investigate the diagnostic accuracy of hepatobiliary scintigraphy(HBS) in detecting biliary strictures in living donor liver transplantation(LDLT) patients.METHODS:We retrospectively reviewed 104 adult LDLT recipients of the right hepatic lobe with duct-toduct anastomosis,who underwent HBS and cholangiography.The HBS results were categorized as normal,parenchymal dysfunction,biliary obstruction,or bile leakage without re-interpretation.The presence of biliary strictures was determined by percutaneous cholangiography or endoscopic retrograde cholangiopancreatography(ERCP).RESULTS:In 89 patients with biliary strictures,HBS showed biliary obstruction in 50 and no obstruction in 39,for a sensitivity of 56.2%.Of 15 patients with no biliary strictures,HBS showed no obstruction in 11,for a specificity of 73.3%.The positive predictive value(PPV) was 92.6%(50/54) and the negative predictive value(NPV) was 22%(11/50).We also analyzed the diagnostic accuracy of the change in bile duct size.The sensitivity,NPV,specificity,and PPV were 65.2%,27.9%,80% and 95%,respectively.CONCLUSION:The absence of biliary obstruction on HBS is not reliable.Thus,when post-LDLT biliary strictures are suspected,early ERCP may be considered.

新的心血池显像剂^（99）Tc^m－DTPA－HSA的实验研究

￣（９９）Ｔｃ￣ｍ－ＤＴＰＡ－ＨＳＡ心血池显像剂于２０只家兔进行实验研究，并与￣（９９）Ｔｃ￣ｍ－ＲＢＣ（体内法）及￣（９９）Ｔｃ￣ｍ－ＨＳＡ进行比较。由￣（９９）Ｔｃ￣ｍ－ＤＴＰＡ－ＨｓＡ所得心血地显像的图像清晰。生物学分布研究表明，￣（９９）Ｔｃ￣ｍ－ＤＴＰＡ－ＨＳＡ在肝和肺的地聚较￣（９９）Ｔｃ￣ｍ－ＲＢＣ及￣（９９）Ｔｃ￣ｍ－ＨＳＡ略低。心／肝放射性比值，￣（９９）Ｔｃ￣ｍ－ＤＴＰＡ－ＨＳＡ为０．８５，￣（９９）Ｔｃ￣ｍ－ＲＢＣ为０．９５，￣（９９）Ｔｃ￣ｍ－ＨＳＡ为０．６２。动物研究结果证明，ＤＴＰＡ与ＨＳＡ螯合后制成的心血池显像剂稳定性好，所得心血池显像清晰，且仅一次注射，值得进一步研究。

Role of scintigraphy in inflammatory bowel disease

The diagnosis of inflammatory bowel disease(IBD) depends on direct endoscopic visualization of the colonic and ileal mucosa and the histological study of the obtained samples.Radiological and scintigraphic methods are mainly used as an adjunct to endoscopy.In this review,we focus on the diagnostic potential of nuclear medicine procedures.The value of all radiotracers is described with special reference to those with greater experience and more satisfactory results.Tc-99m hexamethylpropylene amine oxime white blood cells remain a widely acceptable scintigraphic method for the diagnosis of IBD,as well as for the evaluation of disease extension and severity.Recently,pentavalent Tc-99m dimercaptosuccinic acid has been recommended as an accurate variant and a complementary technique to endoscopy for the follow-up and assessment of disease activity.Positron emission tomography alone or with computed tomography using fluorine-18 fluorodeoxyglucose appears to be a promising method of measuring inflammation in IBD patients.

Incidental accumulation of Technetium-99m pertechnetate in subacute cerebral infarction: A case report

BACKGROUND When interpreting nuclear medicine images,unexpected findings are sometimes encountered.Recognizing these findings and determining the mechanism of their occurrence could have a significant impact on early diagnosis of critical diseases and the appropriate management of patients.CASE SUMMARY A 59-year-old man was admitted to the emergency room due to left hemiparesis,left hemifacial palsy,and mild dysarthria.After 2 wk of hospitalization,the patient complained of dry eyes and mouth.Thus,salivary scintigraphy was performed to evaluate the functional status of his salivary glands.Incidental accumulation in the right frontoparietal area was found on salivary scintigraphy.Fluid-attenuated inversion recovery phase magnetic resonance(FLAIR phase MR)image showed diffuse high signal intensity in the same area.Anterior and posterior horns of the right lateral ventricle were obliterated and the midline was slightly shifted to the left side due to right frontoparietal swelling.On salivary scintigraphy,Tc-99m pertechnetate was incidentally accumulated in a subacute cerebral infarction lesion.Two years after the diagnosis of acute infarction,the second series of salivary scintigraphy showed no abnormal activity in the brain.FLAIR phase MR image also demonstrated markedly decreased high signal intensity in the previous infarction lesion without evidence of swelling indicating chronic cerebral infarction.CONCLUSION This case highlights that Tc-99m pertechnetate could accumulate in a subacute cerebral infarction lesion.The mechanism of an unexpected uptake of Tc-99m pertechnetate in unusual sites should be evaluated and kept in mind for better interpretation.

Leukocyte-technetium-99m uptake in Crohn's disease:Does it show subclinical disease?

AIM:To evaluate inflammatory activity in patients with Crohn's disease (CD) using technetium-99m-hexamethylpropyleneamine oxime (99mTc-HMPAO) granulocyte scintigraphy.METHODS: Twenty patients (7 male and 13 female) with CD and five healthy volunteers were selected for 99mTc-HMPAO granulocyte scintigraphy. The Crohn's Disease Activity Index (CDAI), blood tests and C-reactive protein (CRP) of each patient were performed 7 d before the scintigraphic images. The leukocytes were labeled according to the International Society of Radiolabeled Blood Elements (ISORBE) consensus protocol and the scintigraphic images, including single photon emission computed tomography, were obtained 30 min and 2 h after injection of the radiolabeled leukocytes.RESULTS:The labeling yield of the leukocytes with the lipophilic complex 99mTc-HMPAO was 55.0%±10%. Six of the 20 patients (30%) presented congruent results for the three parameters investigated (CDAI, Scintigraphic Index and CRP). On the other hand, 14 patients (70%) did not show congruent results. There was no significant correlation between the indices analyzed according to the Spearman test (P>0.05,n=20).CONCLUSION: The results suggest that 99mTc-HMPAO-labeled leukocyte scintigraphy could be important for determining inflammatory activity in CD even in the absence of clinical symptoms.

Dynamic Renal Scintigraphy in Diagnosis of Upper Urinary Tract Obstruction in Transplanted Kidney

Nuclide renal dynamic imaging was performed on 88 transplanted kidney. Two kinds of renal scintigraphic characteristics were identified in recipients with supravesical obstruction of the graft. First, the regular type was characterized by radioactivity defect area in kidney parenchyma during early uptake period followed by ureteropelvic retention. Second, the tubular type was typified by cortical retention and attenuation in collecting system during the whole test period with a special sign of “hollow kidney”. Non obstructive dilated calyces showed similar signs as the regular type. Acute rejection reaction and tubule necrosis demonstrated obstructive time activity curves. However, the radioactivity retention appeared in cortex. It was suggested that dilated calyces and obstructive renogram might not be reliable evidence for upper urinary tract obstruction. The signs of radioactivity attenuation in kidney parenchyma during early uptake period followed by ureteropelvic retention may be more valuable for the evaluation. As for tubular obstruction, specified “hollow kidney” was the characteristic sign which is helpful for the diagnosis.