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Title: Menstruation. A hazard in radionuclide renal transplant evaluation

Abstract

Serial Tc-99m DTPA studies were performed to evaluate renal transplant blood flow and function in a 34-year-old woman. A hypervascular pelvic mass with increased blood pool activity was intermittently identified. This hypervascular lesion suggested a pathologic condition of the pelvis, and its blood pool simulated bladder activity, confusing interpretation of renal function. This perplexing vascular lesion was the uterus, with varying degrees of blood flow and blood pool activity depending on the timing of the renal study in relation to the menstrual cycle.

Authors:
;
Publication Date:
OSTI Identifier:
5124291
Resource Type:
Journal Article
Resource Relation:
Journal Name: Clin. Nucl. Med.; (United States); Journal Volume: 6
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; KIDNEYS; SCINTISCANNING; TRANSPLANTS; BLOOD FLOW; DTPA; ESTROUS CYCLE; RESPONSE MODIFYING FACTORS; TECHNETIUM 99; AMINO ACIDS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARBOXYLIC ACIDS; CHELATING AGENTS; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DRUGS; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOPROTECTIVE SUBSTANCES; TECHNETIUM ISOTOPES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Orzel, J.A., and Jaffers, G.J. Menstruation. A hazard in radionuclide renal transplant evaluation. United States: N. p., 1986. Web. doi:10.1097/00003072-198606000-00010.
Orzel, J.A., & Jaffers, G.J. Menstruation. A hazard in radionuclide renal transplant evaluation. United States. doi:10.1097/00003072-198606000-00010.
Orzel, J.A., and Jaffers, G.J. 1986. "Menstruation. A hazard in radionuclide renal transplant evaluation". United States. doi:10.1097/00003072-198606000-00010.
@article{osti_5124291,
title = {Menstruation. A hazard in radionuclide renal transplant evaluation},
author = {Orzel, J.A. and Jaffers, G.J.},
abstractNote = {Serial Tc-99m DTPA studies were performed to evaluate renal transplant blood flow and function in a 34-year-old woman. A hypervascular pelvic mass with increased blood pool activity was intermittently identified. This hypervascular lesion suggested a pathologic condition of the pelvis, and its blood pool simulated bladder activity, confusing interpretation of renal function. This perplexing vascular lesion was the uterus, with varying degrees of blood flow and blood pool activity depending on the timing of the renal study in relation to the menstrual cycle.},
doi = {10.1097/00003072-198606000-00010},
journal = {Clin. Nucl. Med.; (United States)},
number = ,
volume = 6,
place = {United States},
year = 1986,
month = 6
}
  • Magnetic resonance imaging (MRI) was compared with radionuclide scintigraphy (RNS) in 16 patients with renal transplants undergoing renal failure to determine which modality could best discriminate between rejection, acute tubular necrosis (ATN), and cyclosporin nephrotoxicity (CN). Although all rejecting transplants had reduced corticomedullary differentiation (CMD) on T1-weighted MR images, four of five cases of ATN had appearances that could not be distinguished from rejection. A normal CMD suggests nonrejection, but diminished CMD is nonspecific. Tc-99m DTPA/I-131 hippuran RNS was superior to MRI in differentiating rejection from ATN. Although ATN and CN have similar RNS patterns, this distinction can usually bemore » made based on the clinical time course. Other potential uses of MRI in the evaluation of the renal transplants are discussed.« less
  • Radionuclide studies in a renal-transplant patient with congestive heart failure suggested vascular steal from the renal allograft by a contralateral femoral arteriovenous fistula. These reliable, noninvasive diagnostic procedures have potential use in similar settings to evaluate allograft perfusion and function. Correction by removal of the fistula was demonstrated.
  • The diagnostic accuracy, ease, and technical feasibility of imaging with $sup 131$I- or $sup 125$I-fibrinogen, $sup 99$/sup m/Tc-sulfur colloid, and $sup 67$Ga-citrate in renal transplant rejection are compared. Radiofibrinogen data resulted from literature review, radio-colloid data from 125 studies in 52 transplant patients, and gallium citrate data from 24 examinations in seven renal transplant patients performed simultaneously with the radiocolloid studies. Specificity of graft labeling during rejection appears to be similar with radiofibrinogen, $sup 99$/sup m/Tc-sulfur colloid, and $sup 67$Ga-citrate. For routine clinical use $sup 99$/sup m/Tc-sulfur colloid surpasses radiofibrinogen and radiogallium because of its better imaging qualities with amore » permissible radiation dose, leading to better separation of positive and negative results. The $sup 99$/sup m/Tc-sulfur colloid accumulates in areas of intravascular fibrin thrombosis in acute and chronic rejecting renal transplants. Hence, the mechanisms for accumulation of $sup 99$/sup m/Tc-sulfur colloid and labeled fibrinogen in rejecting transplants would seem to be similar. Such physiologic properties as rapid blood clearance and such physical properties as short physical half-life combine to produce reliable graft visualization with adequate definition, thus favoring $sup 99$/sup m/Tc-sulfur colloid as the single agent of choice for clinical evaluation of renal transplant rejection at this time. (auth)« less