(18)F-FDG-PET/CT imaging should be performed as late as reasonably possible after tracer administration in order to increase tumour-to-background contrast and thereby improve the sensitivity of demonstrating additional sites of disease. Dual-time-point (18)FDG-PET/CT may be of benefit in the evaluation of intra-abdominal lesions but does not improve the overall evaluation of pulmonary lesions.
The use of EES full metal jacket for long lesions is only associated with good short-term clinical and angiographic outcomes. Long-term follow-up has revealed a high cardiac death rate which may necessitate prolongation of dual antiplatelet therapy.
Pulmonary embolism (PE) remains a common preventable cause of death in hospitalized patients. The purpose of this study is to examine the in-hospital management, complications of treatment and clinical outcomes of inpatients undergoing lung scintigraphy for the diagnosis of PE in a regional hospital. Two hundred consecutive inpatients with suspected PE were enrolled. The results of lung scans, stratified according to the probability of pulmonary embolism, were correlated with anticoagulation status, discharge diagnosis, haemorrhagic complications and clinical outcome at 6 months. The use of complementary imaging investigations was also determined. Other imaging was performed infrequently (Doppler ultrasound in 18% of patients, CT pulmonary angiography (CT-PA) in 0.5% and conventional pulmonary angiography in 4% of patients). Long-term anticoagulation was initiated in 66 patients (33%), including 10 with intermediate probability lung scans (IPLS) who had no further investigations. Major haemorrhage occurred in 14% of all long-term anticoagulated patients followed up. The recognized recurrence rate was very low (3%) and there was no documented mortality from PE. Most patients with suspected PE are treated on the basis of the lung scan result without further tests. However, other imaging (especially CT-PA and conventional pulmonary angiography) should be performed prior to anticoagulation in patients with IPLS in whom the diagnosis is in doubt. Standard anticoagulation for 6 months appears to be effective for PE, and the recurrence rate is low. However, it has a significant risk of major haemorrhagic complications.
A retropharyngeal abscess is a potentially fatal deep neck infection. Classical symptoms include fever, neck swelling, sore throat, dysphagia, and cervical rigidity. Sometimes small children present with nonspecific symptoms. We report a rare case whereby the Ga-67 citrate scan was the first investigation to reveal an inflammatory process in the retropharyngeal or submastoid region of a 3-year-old child with sepsis. This directed the line of investigation to a more precise anatomic imaging modality, CT scanning, to localize the abscess. With prompt administration of intravenous antibiotics, the child recovered quickly and did not require surgery. The Ga-67 scan is thus a useful screening test to detect inflammatory foci because of its high sensitivity. It is also valuable in the follow-up of the patient's response to therapy.
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