A forty year old male presented with multiple dilated venous channels over the whole body involving both inferior and superior vena caval territories, along with features of chronic liver disease and portal hypertension. On investigation, he was found to have membranous obstruction of the inferior vena cava (MOIVC) as well as obstruction of both brachiocephalic and right subclavian veins and 'hereditary protein C deficiency'. He was managed successfully by percutaneous transluminal balloon angioplasty for the inferior vena cava (IVC) obstruction and was doing well on follow-up.
Aim:
Gastric emptying (GE) scintigraphy is commonly used as a standard diagnostic procedure for the assessment of functional dyspepsia (FD). Results of the study are often reported as either normal or delayed GE times. The aim of this study was to recognize various patterns of scintigraphy among both normal and abnormal emptying times.
Materials and Methods:
Fifty patients with suspected FD were included in the study. GE study was performed with a standardized vegetarian solid meal.
Results:
Out of 50 patients, 33 patients had deranged GE. Thirty patients had delayed GE. Three patients demonstrated gastric hurrying. Five different patterns were demonstrated in patients having similar emptying and retention times such as reduced fundus compliance, decreased fundic accommodation, antral dysmotility, gastric hurrying, and gastroesophageal reflux.
Conclusion:
According to our findings, it may be suggested that visual assessment of GE and identification of various pattern is a very important aspect of the GE study. It not only subcategorized patients but also decreases the number of “normal” studies. This finding may have an impact on patient management in the era of personalized medicine.
Purpose of the Study:
18
F-Fluorodeoxyglucose positron emission tomography/computed tomography (
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F-FDG PET/CT) is used in the management of recurrent differentiated thyroid cancer (DTC) patients presented with rising thyroglobulin (Tg) or anti-Tg antibody (Atg) levels and negative whole-body I-131 scan (WBS). We aimed to evaluate the utility of regional or limited PET/CT in a large population preset with variable Tg/(ATg) levels.
Materials and Methods:
In a retrospective study, we analyzed 137 PET/CT done on DTC patients presented with raised Tg/Atg and negative WBS. Retrospective evaluation of other available clinical information was done.
Results:
One hundred and thirty-seven patients aged 8–72 years (41 ± 17.7 years) were included in the study. Eighty-nine (64.9%) patients had positive findings on
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F-FDG PET-CT. It included thyroid bed recurrence, cervical, mediastinal lymphadenopathy, lung, and bone lesions. In addition, 36 patients had metabolically inactive lung nodules detected on CT. Serum Tg and female sex were the only predictors for a positive PET scan. In most (97.1%) of the patients, the disease was limited to the neck and thoracic region.
Conclusions:
PET/CT is an excellent imaging modality for evaluating DTC patients presented with biochemical recurrence. It not only finds the disease in more than 80% of the patients but also detects distant metastatic disease, which precludes regional therapies. Lesions were noted mostly in the neck and thoracic region with very few distant skeletal metastases (4/137 patients). In most of the patients, routine vertex to mid-thigh imaging could be avoided.
An end-stage renal disease patient underwent renal transplantation 18 years back and was on triple immunosuppression for acute rejection. She presented with left-sided abdominal lump and underwent ultrasound and noncontrast CT scan, which revealed an exophytic mass lesion in atrophic left kidney (16.2 × 13.1 × 14 cm). Baseline 18F-FDG PET/CT revealed a large avid exophytic mass (SUVmax 23, 17 × 14 × 13) in atrophic left kidney, with multiple retroperitoneal lymphadenopathies and a suspicious lung nodule. She underwent left open radical nephrectomy. Follow-up PET/CT after 1 month revealed multiple soft tissue deposits in operative bed and other unusual metastatic sites.
INTRODUCTIONGastric emptying time ½ (GET ½) is considered as the half time taken for chyme to pass into the duodenum. Gastric emptying depends upon numerous factors, both endogenous and exogenous. Nerve and hormones along with volume of meal, pH, particle size, composition and viscosity play part in gastric emptying.1 In infant population, gastric emptying also depends upon the maturity at the time of birth. The gastric emptying pattern is different in infants fed with breast milk and formula feeds and so gastric emptying has to be diligently worked out.
2There have been many studies performed using different radiopharmaceutical meals such as In-111 micro colloid in fixed quantity of milk, Tc-99m sulfur colloid in dextrose, Tc-99m labeled to chicken liver with establishment of various reference standards for liquid and solid emptying times. These studies have included age group varying from infancy till early childhood and age-related dependence was reported.3-8 The GET ½ or ABSTRACT Background: Gastric emptying time ½ (GET ½) is considered as the half time taken for chyme to pass into the duodenum. Gastric emptying depends upon numerous factors, both endogenous and exogenous. Nerve and hormones along with volume of meal, pH, particle size, composition and viscosity play part in gastric emptying. Aim of the study was to determine liquid gastric emptying Time ½ in infants and to evaluate impact of positive GER on Gastric Emptying Time. Methods: Total 149 full term babies from 29th day to 1 year of age; underwent Tc-99m labeled with Sulfur colloid GER scintigraphy using age specific formula. Babies with gastro-intestinal anomalies, lactose intolerance and low birth weight babies were excluded. The reference range of GET ½ was estimated from GER negative group and the same was compared with GER positive group. Results: Out of 149 babies 96 (64%) babies were GER positive and 53 (36%) were negative for GER. The liquid GET ½ values generated for 29 th day-3 months, 4-6 months, 7-9 months and 10 months -1year were 62.67 (12.42), 69.84 (13), 63.5 (9.7) and 53.2 (10) minutes respectively. The liquid GET½ was found to be delayed in severe GER positive group. Conclusions: The reference range for liquid GET½ was estimated from GER negative group utilizing the exclusion criteria thereby avoiding radiation exposure to normal controls. With increasing severity of GER there was consequent prolongation of liquid GET½.
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