Gerald A. Kirk

Two patients with abnormal skeletal muscle uptake of Tc-99m hydroxymethylene diphosphonate following liver transplant: Nephrogenic fibrosing dermopathy and graft vs host disease

Tc-99m hydroxymethylene disphosphonate administered for skeletal scintigraphy may be seen in the extraosseous tissues for various etiologies. This report presents similar abnormal lower extremity skeletal muscle uptake in 2 patients status postorthotopic liver transplant. Although the history and scintigraphic appearance of the 2 were similar, subtle differences in cutaneous lesions and histology led to disparate diagnoses.

Particulate myocardial perfusion scintigraphy: Its clinical usefulness in evaluation of coronary artery disease

The determination of myocardial viability is a crucial parameter in the evaluation of a patient with coronary artery disease. Particulate myocardial perfusion scintigraphy (PMPS) is one of several methods available for this determination. A brief comparison between PMPS and two other commonly used methods is described in this review. The technique and analysis are described and applied to 194 patients with 366 surgically bypassed regions. The patients are analyzed for postoperative regional wall function and for total ventricular function as expressed by ejection fraction. PMPS is a highly accurate and unique study for clinically predicting myocardial viability.

Post-laryngectomy localization of I-131 at tracheostomy site on a total body scan.

A post-thyroidectomy, post-I-131-therapy patient had a laryngectomy and neck dissection for recurrent papillary thyroid carcinoma. A subsequent I-131 total body scan revealed persistent anterior neck activity, which disappeared upon removal of the tracheostomy tube and dressings.

Usefulness of Spect in Evaluating Osteosarcoma Metastases to the Lung

The differentiation of osteosarcoma metastases to the lung vs the ribs with bone scanning agents is not always clear. Single photon emission computed tomography is useful in such differentiation.

Esophageal bronchus in an infant diagnosed by fortuitous intubation of the esophagus during ventilation imaging.

A 7-month-old infant girl born with a hypoplastic left lung and an ostium primum atrial septal defect presented with a history of cough. A plain chest radiograph showed a persistent opacified hypoplastic left lung. A ventilation perfusion scintigram performed at the 23rd day of life showed matched normal distribution of activity throughout the right lung with diffusely and markedly decreased activity of the left lung. A follow-up ventilation scintigram at 7 months completed through a nasal cannula showed activity in the esophagus, stomach, and a portion of the left lung with little activity within the previously normal right lung. After cephalad repositioning of the cannula, a second attempt at ventilation showed normal activity within the right lung and persistent markedly increased activity in a left thoracic structure. In this patient, it was fortuitous that the esophagus initially had been intubated showing a connection between the foregut and the hypoplastic left lung. A subsequent esophagram showed an esophageal bronchus.