Earl K. Dore

Cardiac shunt assessment in children with macroaggregated albumin technetium-99m.

Right-to-left cardiac shunting is calculated following intravenous administration of macroaggregated albumin (MAA) tagged with 99mTa MAA entering the pulmonic circuit lodges in its capillary bed while that bypassing the lungs is impacted in the systemic circuit. A total body count is obtained with a gamma camera. Lung activity is measured separately. From these activity counts, the magnitude of right-to-left cardiac shunting is determined.

Detection of craniosynostosis by bone scanning

Growth patterns of the cranial sutures were studied by bone scanning in 29 children, 13 of whom had craniosynostosis. Primary craniosynostosis was initiated by localized bony fusion across a suture, associated with an abnormal accumulation of bone-seeking radiopharmaceuticals. As the abnormal fusion process extended along the suture, there was a corresponding spread of radionuclide. With complete fusion, uptake diminished. In addition to calvarial scanning, three abnormal sutures were scanned following surgical excision, which allowed direct comparison in vivo and in vitro. Calvarial bone scanning is helpful in the early detection of primary craniosynostosis.

Thoracic Duct Leakage in Neonatal Chylothorax Visualized by 198Au Lymphangiography

A case of congenital chylothorax is presented to demonstrate the use of radionuclide lymphangiography in detecting this entity. Seepage from the thoracic duct into the pleural space was successfully shown. Radionuc1ide lymphangiography is a safe noninvasive method of demonstrating the anatomical integrity of the thoracic duct.

The Radiorenocystogram in Chronic Pyelonephritis

The Hippuran-I131 renocystogram is a reliable external method for detecting functional differences between kidneys (1). Chronic pyelonephritis is especially suitable for investigation with this procedure because it characteristically causes more tissue damage and functional suppression of one kidney than the other (2, 3). While a group of pyelonephritic patients was being studied with serial renocystograms to determine if functional disturbances could be improved by specific treatment, the following observations were made. First, renogram abnormalities associated with this disease are: reduction in the slopes of the tubular segments, delayed onset of excretion, and excretion segments which descend from peak levels at disproportionately slow rates. Second, differences between left and right renal tracings may be accentuated if fluids are restricted eight to twelve hours before the test, whereas they are usually minimized and occasionally concealed if the patient is well hydrated. Third, these aberrations i...