Search

Radiogallium accumulated in a large cell carcinoma of the left lung. A bone scan in the patient showed bilateral intense uptake of Tc-99m MDP in the lung fields, as well as in the tibias, by an undefined mechanism

An 85-year-old woman with leiomyosarcoma occupying the abdominopelvic area had a renal dynamic study with Tc-99m DTPA. The tumor area initially showed almost no content of the radiopharmaceutical. At 24 hours, there was retention of activity in the leiomyosarcoma as compared with surrounding tissues (flip flop). It was noted that, based on literature reports, tumors of mesodermal origin (leiomyoma, spindle cell sarcoma, neurofibroma) may have the ability to concentrate Tc-99m DTPA.

Morphine sulfate has been used in hepatobiliary imaging to cause contraction of the sphincter of Oddi, thereby increasing pressure in the biliary tree. If the cystic duct is patent, the increased pressure usually causes bile to flow into the cystic duct with filling of the gallbladder. Using this technique, the authors have encountered two false-negative cases. Both patients received 0.04 mg/kg of morphine sulfate intravenously, 40 minutes after the intravenous administration of 5 mCi of technetium 99m-DISIDA. Although both patients filled their gallbladders within 1 hour, they both underwent surgical exploration because of high clinical suspicion of acute cholecystitis. Both were found to have acute cholecystitis.

A 64-year-old woman was febrile and had pain near the right hip. Blood cultures grew beta hemolytic streptococci. A bone scan showed reduced activity in the right femoral head and neck compared with the left femoral head and neck. She was treated with intravenous antibiotics and surgical decompression of a tense and bulging right hip joint. Five days later, a repeat bone scan revealed much of the femoral head activity to have returned. By day 20 after the initial bone image, there was intense activity throughout the femoral head and neck. Prompt relief of a distended hip joint can result in reperfusion of the femoral head and neck.