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Background and Purpose: The aim of our study was to evaluate brain perfusion in patients with vertigo using the SPECT technique., Methods: The study involved a group of 32 patients and was performed in the Neurological Department of the Medical University in Bialystok. Patients with vertigo of peripheral origin like middle ear pathology were excluded from the study. Tomographic pictures were taken with Nucline X-Ring camera after administration of Tc99m-ECD. Perfusion maps were estimated by qualitative and semi-quantitative methods., Results: In 8 patients (25%) perfusion maps were normal in the hemispheres, cerebellum and subcortical structures. In 10 patients (31.2%) there was a substantial decrease in perfusion in the left temporal region, in 8 patients (25%) -- hypoperfusion was seen in the right temporal region. In 4 patients (12.5%) there was a substantial decrease in perfusion in the cerebellum, in two persons -- in the frontal lobes., Conclusions: The results obtained so far confirm the major role of ischemia in etiology of the central origin vertigo and balance disturbances. It involves not only the brainstem and cerebellar structures, but the temporal lobes as well. The test has also proved that the qualitative and semi-quantitative methods of assessing brain perfusion with a SPECT are satisfactory in diagnostics of vertigo.

Subclinical hyperthyroidism is a state of increased thyroid function with few or no clinical definitive signs or symptoms of hyperthyroidism. It is characterised by a decrease of serum (TSH) concentration below 0.1 mU/L, when serum levels of total and free thyroxin and triiodothyronin concentration are within normal reference ranges. It is not a rare finding and rates between 0.02% and 11.3% have been reported in different groups. The clinical diagnosis of subclinical hyperthyroidism is very difficult in the absence of the typical symptoms of hyperthyroidism. Therefore the diagnostic evaluation is important, especially with the use of radioisotope scan. In nuclear medicine department we can confirm the provisional diagnosis by the use of thyroid scan. Recent studies reported the effects of subclinical hyperthyroidism on cardiovascular system, skeletal system, cognitive function, on quality of life and life expectancy especially in the elderly patient. Treatment is indicated in the presence of palpitation, or atrial fibrillation, in postmenopausal osteoporosis in women not on hormone replacement therapy, and in elderly patients in whom surgery is contraindicated. According to the opinions of European clinicians and clinician members of the American Thyroid Association, the majority recommend radical treatment for these patients. Radioiodine therapy is considered to be the treatment of choice in most of the patients with nodular goiter.

The pulmonary embolism (PE) is the common and severe complication of the deep vein thrombosis of the lower limbs. The lack of accurate diagnosis of PE is a cause of 5-10% of the hospital deaths. The aim of the study was to assess the incidence of the pulmonary embolism in patients with the deep vein thrombosis of the lower limbs with no clinical symptoms of pulmonary embolism. Pulmonary perfusion scintigraphy was performed in 25 patients with angiographic findings confirmative to the deep vein thrombosis of the lower limbs. The results of the study were analysed according to the PIOPED criteria. In the group of patients with common thrombosis of the deep vein a high probability of lung embolism was assessed in 70%, medium and low by 12% in each group, and very low in 6%. In the group of patients with femoral thrombosis of the deep vein a high probability of lung embolism was assessed in 60%, medium in 20% and very low in 20%. In the group of patients with calf thrombosis of the deep vein high, medium and very low probability of lung embolism was assessed by 25% in each group. Results of this study indicate the need of searching the pulmonary embolism in patients with thrombosis of the deep vein of the lower limbs despite the lack of clinical symptoms of the pulmonary embolism.

Radioisotope methods play a special role in cardiological diagnostics. At present, studies of myocardial perfusion also allow the estimation of cardiomyocyte metabolism. These methods are suitable for the detection of stunned, hibernating or scarred myocardium as well. The radiopharmaceuticals which accumulate in myocardium proportionally to regional blood flow (thallium-201, MIBI-Tc99m, teboroxime-Tc99m, tetrophosmin-Tc99m, furifosmin-tc99m) are used for the estimation of perfusion. In the nuclear medicine departments myocardial perfusion imaging can be performed with planar or tomographic (SPECT) methods. The techniques have high sensitivity (80%, 90%) and specificity (90%, 80%) for detection of coronary artery diseases. The radioisotopic methods have higher sensitivity than other noninvasive techniques (ECG sensitivity-60%, specificity-85%, ECHO sensitivity-81%, specificity-89%). Positron emission tomography is still the "gold" standard for the estimation of myocardial viability. This method uses substrates for different metabolic pathways (acetate-C-11, amino-acids-C-11, fatty acids-C-11, fluorodeoxyglocuse-F-18) labelled with positron emitters. Modifications in thallium protocols make estimation of myocardial metabolism possible. Recently MIBI-Tc99m has also been used in the assessment of myocardial viability. Results of these studies are of great clinical importance. They allow to predict a success of a surgical revascularysation and the return of normal myocardial function.