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Resume Objectifs L’analyse de la contraction ventriculaire gauche a une importance majeure dans le diagnostic et la prise en charge des patients atteints de cardiopathies. Le but de notre etude a ete de comparer les parametres etudiant la cinetique globale et segmentaire du ventricule gauche fournis par la tomoventriculographie isotopique et par la scintigraphie de perfusion myocardique. Materiel et methodes Deux groupes ont ete constitues, le premier comprenant 23 scintigraphies de perfusion a la 99m Tc-Tetrofosmine et le second 50 scintigraphies de perfusion au chlorure de 201 Thallium, dont les donnees ont ete comparees a celles de tomoventriculographies isotopiques realisees de facon rapprochee. Resultats Nous avons obtenu de bonnes correlations ( r = 0,81 a 0,94) en ce qui concerne les parametres fonctionnels globaux (fraction d’ejection et volumes telediastolique et telesystolique) dans les deux groupes. D’assez bonnes correlations existaient egalement a l’echelle segmentaire ( r = 0,49 a 0,62), entre la fraction d’ejection segmentaire obtenue en tomoventriculographie et l’epaississement parietal (« Thickening ») ou le deplacement de la surface endocardique en systole (« Motion ») calcules en scintigraphie de perfusion. Ces correlations etaient significativement plus faibles dans le groupe bilante par scintigraphie au chlorure de 201 Thallium, et ce d’autant plus pour les segments hypokinetiques. Conclusion Bien que ces deux explorations scintigraphiques utilisent des approches tres differentes, la tomoventriculographie isotopique et la scintigraphie de perfusion myocardique permettent une etude de la contraction ventriculaire gauche a l’echelle globale et segmentaire, avec des donnees bien correlees mais restant neanmoins non interchangeables.

Aims We compared histological patterns after lumpectomy for non-palpable breast cancers preoperatively localized by radioguided occult lesion localization plus sentinel node localization (SNOLL) versus wire-guided localization. Methods To ensure a homogeneously treated cohort and rigorous comparisons, only patients with invasive cancer and measurable opacity by imaging were included. Exclusion criteria were one or more parameters that could interfere with localization and/or the surgical procedure. Forty-three SNOLL were compared with 86 WGL plus sentinel node (SN) localization. Cancer localization effectiveness was based on careful assessment of histological data from only the first resected glandular specimen, as any additional resection specimens were guided by intraoperative histological examination. Results Reexcisions to ensure free tissue margins were performed during the same procedure in 13.9% of SNOLL versus 31.3% of WGL; p = 0.02. Significantly more women in SNOLL (53.4%) also had free nearest margins of >9 mm after the first procedure compared with WGL (33.7%); p = 0.03. The median centricity ratio after the first procedure was better in SNOLL (2.8, range 1.3–14) than WGL (5, range 1–50); p = 0.008. The median number of SN detected by lymphoscintigraphy was the same in SNOLL and WGL (1, range 0–9, vs. 1, range 0–8). Intraoperative SN detection by blue dye and/or gamma probe was successful for 97.6% of SNOLL versus 93% of WGL. Conclusion In this study, SNOLL was effective and safe, and this procedure significantly improved the rate of negative margins in the first specimen and the rate of reexcision for positive margins compared with WGL.