Our results showed that Tc-99m HMPAO can be used to label ABMMN cells for in vivo cell visualization, and that brain SPECT imaging with labeled ABMMN cells is a feasible noninvasive method for studying the fate of transplanted cells in vivo. Additionally, our findings demonstrate the localization of these intra-arterially injected cells.
Dementia with Lewy bodies (DLB) is the second most common cause of dementia. The diagnosis of DLB is particularly important because these patients show good response to cholinesterase inhibitors. Clinical and neuroimaging criteria for DLB have not been acceptable for predictive accuracy. We report a case of progressive dementia in which the differentiation of DLB and Alzheimer disease (AD) on the basis of clinical criteria alone was not possible. The patient was admitted to the hospital because he became worse after he had started treatment for severe AD. Both MRI and brain magnetic resonance spectroscopy were normal. The patient underwent myocardial scintigraphy with I-123 MIBG showing marked reduction in cardiac MIBG accumulation. The heart to mediastinum ratio of MIBG uptake was impaired in both early and delayed images. FDG-PET scan before and after activation with a visual attention task showed occipital cortex hypometabolism as compared with AD and a normal control. This case illustrates the value of combining activated brain FDG PET and cardiac MIBG. The association of these 2 techniques could be used as a potential diagnostic tool in a patient with dementia misdiagnosed as AD.
SummaryObjective: To evaluate the prognostic value of stress myocardial perfusion scintigraphy (MPS) applied to patients with suspected acute coronary syndrome (ACS).Methods: Retrospective study. Patients with suspected acute coronary syndrome (ACS) admitted into the chest pain unit angina they underwent stress MPS. Results:Conclusion: Presence of ISQ was the major independent factor in prediction of adverse events for patients admitted into the CPU.
Background: The myocardial radionuclide imaging with mental distress seems to induce ischemia through a particular physiopathology when compared to radionuclide imaging with physical or pharmacological distress.Objective: To assess the prevalence of induced myocardial ischemia by mental distress in patients with thoracic pain and radionuclide imaging with normal conventional distress, with 99mTc-Sestamibi.Methods: Twenty-two patients were admitted with thoracic pain at emergency or were referred to the nuclear medicine service of our institution, where myocardial radionuclide imaging of distress or rest without ischemic alterations was carried out. The patients were, then, invited to go through an additional phase with mental distress induced by color conflict (Strop Color Test) with the objective of detecting myocardial ischemia. Two cardiologists and nuclear physicians performed the blind analysis of perfusional data and consequent quantification through Summed Difference Score (SDS), punctuating the segments that were altered after mental distress and comparing it to the rest period image. The presence of myocardial ischemia was considered if SDS ≥ 3.Results: The prevalence of mental distress-induced myocardial ischemia was 40% (9 positive patients). Among the 22 studied patients, there were no statistical differences with regard to the number of risk factors, mental distress-induced hemodynamic alterations, usage of medications, presented symptoms, presence or absence of coronary disease and variations of ejection fraction and final systolic volume of Gated SPECT. Researches that used echocardiogram and radioisotope ventriculography associated with mental distress showed that this is the responsible for alterations in ventricular function 5,6 . Studies that applied radionuclide imaging of myocardial perfusion during mental distress confirmed that the contraction alterations were induced by alterations in perfusion. Conclusion Prevalence of Induced Ischemia by Mental DistressThe necessity for myocardial ischemia diagnosis in patients with thoracic pain is extremely important for a better clinical handling, risk factor control and improvement of their life quality. In this decade, an acute syndrome, unleashed by mental distress and represented by thoracic pain, supraunevenness of ST segment at electrocardiogram, elevation of myocardial necrosis markers and peculiar alterations of myocardial contractility demonstrated in echocardiograph and ventriculograph findings, was described. The so called Takotsubo syndrome is characterized by a reduction in contractility of apical myocardial segments and hyper-contractility of basal segments of left ventricle 7 . Other IntroductionThe myocardial perfusion radionuclide imaging has been applied in medical practice as an important tool for the diagnosis of myocardial ischemia. Is value on such diagnosis has been widely studied, which allows its utilization in patients admitted in emergency units and ambulatories 1 . However, a group of patients may relate thoracic ...
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