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Papers by Amparo García-Burillo
Revista española de medicina nuclear e imagen molecular, Mar 1, 2021
Alzheimer's & Dementia, 2006
patients. Few studies have focused on the correlation between changes of these parameters in brai... more patients. Few studies have focused on the correlation between changes of these parameters in brain and CSF and the influence of APOE genotype. Objectives: The aim of this study was to investigate the influence of APOE ⑀4 genotype on brain functional changes in AD patients measured as cerebral glucose metabolism (CMRglc) and CSF levels of A 1-42 and Tau. Methods: The AD patient group, matched for age and education, consisted of 21 heterozygous and homozygous carriers (age 69.2 Ϯ 7.7, MMSE score 24.5 Ϯ 3.5, education 9.7 Ϯ 3.5 years, mean Ϯ SD) and 13 non-carriers (age 68.0 Ϯ 9.2, MMSE score 26.0 Ϯ 4.3, education 11.1 Ϯ 3.0) of the APOE ⑀4 allele. The AD patients were recruited from the
Medicina clínica, Jan 4, 1997
The percentage of peak predicted heart rate that is accepted to consider as sufficient a given ex... more The percentage of peak predicted heart rate that is accepted to consider as sufficient a given exercise test is 85%. However, the optimal value of such rate and other exercise parameters for the purposes of myocardial single-photon emission tomography is not well established. With the aim of establishing the minimal levels of maximal heart rate, product heart rate x systolic blood pressure and ventilatory oxygen uptake to obtain an adequate diagnostic efficacy of myocardial perfusion scintigraphy, 159 patients with coronary artery disease or suspicion of this without previous myocardial infarction were studied with stress test single photon emission tomography with 99mTc-methoxi-isobutil-isonitrile. All the patients were coronary angiography tested. Sensitivity and negative predictive value were significantly higher at levels of heart rate > 80% (93 vs 78%; p = 0.002 and 94 vs 56%; p = 0.0004), product heart rate x systolic blood pressure > 18,000 (88 vs 78%; p = 0.04 and 84 v...
Journal of Pediatric Endocrinology and Metabolism, 2020
ObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic facto... more ObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after ...
Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a s... more Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a surgical challenge.[1,2,3,4] We report a 72-years-old man with a recent diagnosis of prostate neoplasm who underwent a Technetium-99 hidroximethylene-diphosphonate (Tc-99m HMDP) bone scintigraphy which reveals, as an incidental finding, a left inguinoscrotal hernia containing a portion of the urinary bladder.
Endocrinología, Diabetes y Nutrición, 2019
Revista Española de Medicina Nuclear e Imagen Molecular, 2019
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition), 2019
Endocrine Abstracts, 2016
Endocrine Abstracts, 2016
Endocrine Abstracts, 2015
Thyroid cancer & Thyroid CONCLUSION: The Tg-B-0 has a high specificity but low sensibility in p... more Thyroid cancer & Thyroid CONCLUSION: The Tg-B-0 has a high specificity but low sensibility in predicting the evolution of disease. • When Tg-B-0<0,2mg/ml only 5% of the patients are PD after first ablation. The Tg-S-0: has not provides additional information. After radioiodine ablation, Tg-S-6 has the higher sensibility (87%) and high specificity (86%). MATERIALS AND METHODS: Basal thyroglobulin values (Tg-B) and rhTSH stimulated thyroglobulin (Tg-S) before ablation (0) and six months later (6) from 142 DTC patients, with post-surgical ablation therapy between 2003 and 2009 with a follow up of five years, were analyzed.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1998
Noninvasive diagnosis of coronary artery disease in women has some limitations due to a higher pe... more Noninvasive diagnosis of coronary artery disease in women has some limitations due to a higher percentage of false-positive results. In addition, a lower prevalence of disease can be observed in this population. In this study, we evaluated the diagnostic accuracy of 99mTc-methoxy-isobutyl-isonitrile (MIBI) SPECT in women and men, in a group of patients with proven coronary artery disease by coronary angiography (select minority) and in all patients where a noninvasive test (silent majority) was performed. Seven hundred and two consecutive patients without previous myocardial infarction were studied with 99mTc-MIBI myocardial SPECT. One hundred sixty-three patients had coronary angiography (select minority) and 539 did not (silent majority). All patients underwent exercise stress testing, and simultaneous dipyridamole was administered in 32% of patients who did not achieve maximum predicted heart rates. Diagnostic accuracy of the test was calculated for the select minority. Then, sen...
Revista española de cardiología, 1997
The aim of the study was to evaluate the diagnostic yield of 99m-Technetium-methoxy-isobutyl-ison... more The aim of the study was to evaluate the diagnostic yield of 99m-Technetium-methoxy-isobutyl-isonitrile (MIBI) SPET for identification of individual coronary artery disease and in the prediction of multivessel involvement. Stress/rest myocardial SPET and coronary arteriography were evaluated in 231 consecutive patients (age 58 +/- 10 years, 26% women) without prior myocardial infarction. 149 patients had coronary narrowing > 50%: 104 with multivessel disease and 45 with one vessel disease. Tomographic stress defect score was obtained by semiquantitative analysis (maximal score 65). Univariate and multivariate analysis was performed to identify discriminant parameters between one vessel and multivessel patients. The sensitivity and specificity for the identification of individual artery disease was 74% and 85% for left anterior descending artery, 79% and 85% for right coronary and 45% and 96% for circumflex artery. In the prediction of multivessel involvement the sensitivity was 6...
Revista Española de Medicina Nuclear, 2004
Resumen.-Objetivo: Valorar el rendimiento diagnóstico y la eficacia en la detección del tejido su... more Resumen.-Objetivo: Valorar el rendimiento diagnóstico y la eficacia en la detección del tejido suprarrenal normofuncionante de la gammagrafía cortical suprarrenal en el hiperaldosteronismo primario, siguiendo el protocolo que combina en un solo estudio la obtención de imágenes de frenación e imágenes tardías tras la supresión de la frenación con dexametasona. Material y métodos: Se estudiaron 20 pacientes remitidos a nuestro servicio con la sospecha de hiperaldosteronismo primario y se exploraron mediante gammagrafía combinada. 13 hombres y 7 mujeres, rango de edad de 31 a 73 años y edad media de 52 años. Se bloqueó la glándula tiroidea con Lugol y se administró al paciente dexametasona 1 mg c./6h desde 7 días antes de la dosis hasta el tercer día de la exploración, momento en el que se suspendió la frenación. El radiotrazador fue I-131-norcolesterol (37 MBq e.v.). Adquisición: Estudio planar posterior de 30 min. Detecciones a las 24 y/o 48h y al tercer día, después de la cual se suspendió la dexametasona y se obtuvo una última detección al 5.º y/o 7.º día. El resultado de la gammagrafía se confirmó con la valoración clínica final (VCF) del paciente. Resultados: 11 resultados positivos, 9 catalogados de adenoma hiperfuncionante (8 VP y 1 FP) y dos de hiperplasia bilateral (2VP); 7 fueron negativos (6 VN y 1 VCF no concluyente) y dos gammagrafías indeterminadas (1 incidentaloma y 1 VCF no concluyente). En todos los casos la gammagrafía del 5.º y/o 7.º día mostró la aparición de las glándulas suprarrenales normofuncionantes. Conclusiones: El estudio del funcionalismo suprarrenal mediante el protocolo combinado de gammagrafía suprarrenal con frenación y suspensión de la frenación con dexametasona permitió identificar con elevada precisión diagnóstica los hiperaldosteronismos primarios y caracterizar la función de las glándulas suprarrenales normales. PALABRAS CLAVE: Gammagrafía cortical suprarrenal. Dexametasona. Hiperaldosteronismo primario. ADRENAL SCINTIGRAPHY WITH AND WITHOUT DEXAMETHASONE SUPPRESSION IN THE STUDY OF PRIMARY ALDOSTERONISM Summary.-Aim of the study: To evaluate the diagnostic performance and efficacy of adrenal scintigraphy in primary aldosteronism following the protocol that combines adrenal suppression scintigraphy plus non-suppression study. Methods and procedures: 20 patients referred to our service with the suspicion of primary aldosteronism were studied by combined scintigraphy. Thirteen men and 7 women, mean age of 52 years, aged from 31 to 73 years, were included. Uptake of free iodine by the thyroid was inhibited by oral Lugol 5 % administration. Dexamethasone 4 mg per day was administered from day-7 to the third day of detection, when administration was stopped. Adrenal scintigraphy was performed after intravenous injection of I-131-norcolesterol (37 MBq). Images were taken at 24 and/or 48 hours and on the third day. Afterwards, dexamethasone administration was stopped and late images on 5 th and/or 7 th days were obtained. The scintigraphic result was confirmed with the final clinical evaluation (FCE) of the patient. Results: 11 patients presented pathological studies, 9 adenomas (8TP + 1FP) and 2 bilateral adrenal hyperplasia (2TP); 7 normal scintigraphies (6TN and 1 non-conclusive FCE) and 2 non-conclusive scintigraphies (1 incidentaloma and 1 non-conclusive FCE). Normal adrenal glands were visualized in all cases on the 5 th and/or 7 th day scintigraphy. Conclusion: The study of adrenal functionalism by the combined protocol of adrenal suppression study plus later non-suppression study made it possible to identify with high precision primary aldosteronism and to confirm the function of normal adrenal glands.
Revista Española de Cardiología, 1997
Introducción y objetivos. Estudiar el rendimiento diagnóstico de la tomogammagrafía miocárdica co... more Introducción y objetivos. Estudiar el rendimiento diagnóstico de la tomogammagrafía miocárdica con tecnecio-99m-metoxi-isobutil isonitrilo en la detección de enfermedad individualizada de las arterias coronarias epicárdicas y su valor en la predicción de enfermedad multivaso. Método. Se han estudiado 231 pacientes (58 ± 10
Journal of the American College of Cardiology, 1997
Objectives. We attempted to demonstrate that simultaneous dipyridamole administration and maximal... more Objectives. We attempted to demonstrate that simultaneous dipyridamole administration and maximal subjective exercise in patients who are unable to achieve a good exercise level can improve the diagnostic efficacy of technetium-99m methoxy isobutyl isonitrile (99m Tc-MIBI) myocardial single-photon emisson computed tomography (SPECT). Background. The results of myocardial perfusion scintigraphy are unsatisfactory if the level of exercise achieved by the patient is insufficient. The use of dipyridamole with maximal subjective stress testing has been shown to improve the quality of the thallium-201 myocardial perfusion images, but there are no studies demonstrating that this combination improves the diagnostic accuracy of myocardial perfusion SPECT. Methods. Two hundred thirty-one consecutive patients, without a previous myocardial infarction, were classified into three groups: group 1, 91 patients with an adequate exercise test; group 2, 68 patients with an inadequate exercise test; group 3, 72 patients with an inadequate exercise test who then received intravenous dipyridamole (0.56 mg/kg body weight over 4 min) simultaneously with exercise. Results. Results for sensitivity (89%) and negative predictive value (83%) in group 3 were significantly better than those in group 2 (71% [p ؍ 0.03] and 56% [p ؍ 0.002], respectively) and not significantly different from those in group 1. The polar maps of 20 patients studied with and without dipyridamole at the same exercise level revealed a significantly greater extent of ischemia in each territory and in a global assessment (19 ؉ 20% vs. 8 ؉ 11%, p < 0.0001) when dypiridamole was administered during physical exercise. Conclusions. Intravenous dipyridamole administration during exercise testing is advisable in all patients who are unable to achieve an adequate exercise level. This approach permits physicians to avoid missing ergometric information while optimizing myocardial SPECT results.
Journal of Nuclear Cardiology, 1995
Fourteen patients (M 9, F 5; age 62+6 SD) with coronary artery disease (CAD) underwent dobutamine... more Fourteen patients (M 9, F 5; age 62+6 SD) with coronary artery disease (CAD) underwent dobutamine stress radionuclide ventriculo-graphy CRNV) before and after successful percutaneous translumina] coronary angioplasty (PTCA) to study the effect of PCTA on left ventricular systolic and diastolic functions. Dobutamine infusion was started at 5~g/kg/min with the increment of 5 /~g/kg/min every 10 minutes until angina, high blood pressure (SBP > 210 mm Hg) or maximum dose was achieved (20/~g/kg/min). Radionuclide ventriculography was performed before dobutamine infusion and at each dose level of dobutamine infusion thereafter. It revealed that before PTCA only peak ejection rate increased significantly (3.2+0.7 to 4.4+0.5 end-diastolic volume/sec, p<0.05) during dobutamine infusion, leaving the left ventricular ejection fraction (LVEF) (55+6% to 56x9%, NS) and left ventricular peak filling rate (PFR) (2.7+0.5 to 2.4+0.8 end-diastolic volume/sec, NS) unchanged. However, after successful PTCA both LVEF (54:t:10 to 65• p<0.01) and PFR (2.9+0.7 to 3.7+0.6 end-diastolic volume/sec, p < 0.05) increased significantly during dobutamine infusion. In addition, 9 of these 14 subjects who were found to have regional wall motion abnormality during dobatamine infusion before PTCA turned out to have near normal regional wall motion after successful PTCA. The preliminary results from this study indicate that 1) both systolic and diastolic functional impairment as well as regional wall motion abnormality can be restored by PTCA in patients with CAD, 2) dobutamine stress RNV is a safe, reliable and easily performed method in evaluating the functional status of left ventricle in CAD patients.
Journal of Nuclear Cardiology, 1995
The feasibility of imaging FDG with SPECT has been shown recently. In the present study we have c... more The feasibility of imaging FDG with SPECT has been shown recently. In the present study we have compared FDG PET and FDG SPECTin 15 patients with coronary artery disease. Perfusion was evaluated with N-13 ammonia PET & early rest thallium SPECT. PET and SPECT studies were displayed as polar maps and divided in 13 segments. Based on PET and SPECT data, segments were scored as normal, viable or infarcted. Left ventricular function was evaluated using 2D echo, scoring each segment as normal (N), hypo-(H), or akinetic (A). Results: 195 segments were analyzed; 116 (59%) segments ~her normal or viable with PET and SPECT. Fifty (26%) segments were necrotic both with PET and SPECT. Twenty-nine (15%) segments were normal or viable with PET but infarcted with SPECT. Finally, 1 segment was infarcted with PET and viable with SPECT. Eighty percent of PET/SPECT infarct segments were A, 84% of PET/SPECT normal segments showed preserved function. PET normal/SPECT infarct segments showed in 70% preserved function. Thus, there is a good agreement between PET and SPECT to assess viability, although our data suggest that FDG SPECT may overestimate infarcted areas.
Journal of Nuclear Cardiology, 1995
Journal of Nuclear Cardiology, 1995
Revista española de medicina nuclear e imagen molecular, Mar 1, 2021
Alzheimer's & Dementia, 2006
patients. Few studies have focused on the correlation between changes of these parameters in brai... more patients. Few studies have focused on the correlation between changes of these parameters in brain and CSF and the influence of APOE genotype. Objectives: The aim of this study was to investigate the influence of APOE ⑀4 genotype on brain functional changes in AD patients measured as cerebral glucose metabolism (CMRglc) and CSF levels of A 1-42 and Tau. Methods: The AD patient group, matched for age and education, consisted of 21 heterozygous and homozygous carriers (age 69.2 Ϯ 7.7, MMSE score 24.5 Ϯ 3.5, education 9.7 Ϯ 3.5 years, mean Ϯ SD) and 13 non-carriers (age 68.0 Ϯ 9.2, MMSE score 26.0 Ϯ 4.3, education 11.1 Ϯ 3.0) of the APOE ⑀4 allele. The AD patients were recruited from the
Medicina clínica, Jan 4, 1997
The percentage of peak predicted heart rate that is accepted to consider as sufficient a given ex... more The percentage of peak predicted heart rate that is accepted to consider as sufficient a given exercise test is 85%. However, the optimal value of such rate and other exercise parameters for the purposes of myocardial single-photon emission tomography is not well established. With the aim of establishing the minimal levels of maximal heart rate, product heart rate x systolic blood pressure and ventilatory oxygen uptake to obtain an adequate diagnostic efficacy of myocardial perfusion scintigraphy, 159 patients with coronary artery disease or suspicion of this without previous myocardial infarction were studied with stress test single photon emission tomography with 99mTc-methoxi-isobutil-isonitrile. All the patients were coronary angiography tested. Sensitivity and negative predictive value were significantly higher at levels of heart rate > 80% (93 vs 78%; p = 0.002 and 94 vs 56%; p = 0.0004), product heart rate x systolic blood pressure > 18,000 (88 vs 78%; p = 0.04 and 84 v...
Journal of Pediatric Endocrinology and Metabolism, 2020
ObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic facto... more ObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after ...
Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a s... more Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a surgical challenge.[1,2,3,4] We report a 72-years-old man with a recent diagnosis of prostate neoplasm who underwent a Technetium-99 hidroximethylene-diphosphonate (Tc-99m HMDP) bone scintigraphy which reveals, as an incidental finding, a left inguinoscrotal hernia containing a portion of the urinary bladder.
Endocrinología, Diabetes y Nutrición, 2019
Revista Española de Medicina Nuclear e Imagen Molecular, 2019
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition), 2019
Endocrine Abstracts, 2016
Endocrine Abstracts, 2016
Endocrine Abstracts, 2015
Thyroid cancer & Thyroid CONCLUSION: The Tg-B-0 has a high specificity but low sensibility in p... more Thyroid cancer & Thyroid CONCLUSION: The Tg-B-0 has a high specificity but low sensibility in predicting the evolution of disease. • When Tg-B-0<0,2mg/ml only 5% of the patients are PD after first ablation. The Tg-S-0: has not provides additional information. After radioiodine ablation, Tg-S-6 has the higher sensibility (87%) and high specificity (86%). MATERIALS AND METHODS: Basal thyroglobulin values (Tg-B) and rhTSH stimulated thyroglobulin (Tg-S) before ablation (0) and six months later (6) from 142 DTC patients, with post-surgical ablation therapy between 2003 and 2009 with a follow up of five years, were analyzed.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1998
Noninvasive diagnosis of coronary artery disease in women has some limitations due to a higher pe... more Noninvasive diagnosis of coronary artery disease in women has some limitations due to a higher percentage of false-positive results. In addition, a lower prevalence of disease can be observed in this population. In this study, we evaluated the diagnostic accuracy of 99mTc-methoxy-isobutyl-isonitrile (MIBI) SPECT in women and men, in a group of patients with proven coronary artery disease by coronary angiography (select minority) and in all patients where a noninvasive test (silent majority) was performed. Seven hundred and two consecutive patients without previous myocardial infarction were studied with 99mTc-MIBI myocardial SPECT. One hundred sixty-three patients had coronary angiography (select minority) and 539 did not (silent majority). All patients underwent exercise stress testing, and simultaneous dipyridamole was administered in 32% of patients who did not achieve maximum predicted heart rates. Diagnostic accuracy of the test was calculated for the select minority. Then, sen...
Revista española de cardiología, 1997
The aim of the study was to evaluate the diagnostic yield of 99m-Technetium-methoxy-isobutyl-ison... more The aim of the study was to evaluate the diagnostic yield of 99m-Technetium-methoxy-isobutyl-isonitrile (MIBI) SPET for identification of individual coronary artery disease and in the prediction of multivessel involvement. Stress/rest myocardial SPET and coronary arteriography were evaluated in 231 consecutive patients (age 58 +/- 10 years, 26% women) without prior myocardial infarction. 149 patients had coronary narrowing > 50%: 104 with multivessel disease and 45 with one vessel disease. Tomographic stress defect score was obtained by semiquantitative analysis (maximal score 65). Univariate and multivariate analysis was performed to identify discriminant parameters between one vessel and multivessel patients. The sensitivity and specificity for the identification of individual artery disease was 74% and 85% for left anterior descending artery, 79% and 85% for right coronary and 45% and 96% for circumflex artery. In the prediction of multivessel involvement the sensitivity was 6...
Revista Española de Medicina Nuclear, 2004
Resumen.-Objetivo: Valorar el rendimiento diagnóstico y la eficacia en la detección del tejido su... more Resumen.-Objetivo: Valorar el rendimiento diagnóstico y la eficacia en la detección del tejido suprarrenal normofuncionante de la gammagrafía cortical suprarrenal en el hiperaldosteronismo primario, siguiendo el protocolo que combina en un solo estudio la obtención de imágenes de frenación e imágenes tardías tras la supresión de la frenación con dexametasona. Material y métodos: Se estudiaron 20 pacientes remitidos a nuestro servicio con la sospecha de hiperaldosteronismo primario y se exploraron mediante gammagrafía combinada. 13 hombres y 7 mujeres, rango de edad de 31 a 73 años y edad media de 52 años. Se bloqueó la glándula tiroidea con Lugol y se administró al paciente dexametasona 1 mg c./6h desde 7 días antes de la dosis hasta el tercer día de la exploración, momento en el que se suspendió la frenación. El radiotrazador fue I-131-norcolesterol (37 MBq e.v.). Adquisición: Estudio planar posterior de 30 min. Detecciones a las 24 y/o 48h y al tercer día, después de la cual se suspendió la dexametasona y se obtuvo una última detección al 5.º y/o 7.º día. El resultado de la gammagrafía se confirmó con la valoración clínica final (VCF) del paciente. Resultados: 11 resultados positivos, 9 catalogados de adenoma hiperfuncionante (8 VP y 1 FP) y dos de hiperplasia bilateral (2VP); 7 fueron negativos (6 VN y 1 VCF no concluyente) y dos gammagrafías indeterminadas (1 incidentaloma y 1 VCF no concluyente). En todos los casos la gammagrafía del 5.º y/o 7.º día mostró la aparición de las glándulas suprarrenales normofuncionantes. Conclusiones: El estudio del funcionalismo suprarrenal mediante el protocolo combinado de gammagrafía suprarrenal con frenación y suspensión de la frenación con dexametasona permitió identificar con elevada precisión diagnóstica los hiperaldosteronismos primarios y caracterizar la función de las glándulas suprarrenales normales. PALABRAS CLAVE: Gammagrafía cortical suprarrenal. Dexametasona. Hiperaldosteronismo primario. ADRENAL SCINTIGRAPHY WITH AND WITHOUT DEXAMETHASONE SUPPRESSION IN THE STUDY OF PRIMARY ALDOSTERONISM Summary.-Aim of the study: To evaluate the diagnostic performance and efficacy of adrenal scintigraphy in primary aldosteronism following the protocol that combines adrenal suppression scintigraphy plus non-suppression study. Methods and procedures: 20 patients referred to our service with the suspicion of primary aldosteronism were studied by combined scintigraphy. Thirteen men and 7 women, mean age of 52 years, aged from 31 to 73 years, were included. Uptake of free iodine by the thyroid was inhibited by oral Lugol 5 % administration. Dexamethasone 4 mg per day was administered from day-7 to the third day of detection, when administration was stopped. Adrenal scintigraphy was performed after intravenous injection of I-131-norcolesterol (37 MBq). Images were taken at 24 and/or 48 hours and on the third day. Afterwards, dexamethasone administration was stopped and late images on 5 th and/or 7 th days were obtained. The scintigraphic result was confirmed with the final clinical evaluation (FCE) of the patient. Results: 11 patients presented pathological studies, 9 adenomas (8TP + 1FP) and 2 bilateral adrenal hyperplasia (2TP); 7 normal scintigraphies (6TN and 1 non-conclusive FCE) and 2 non-conclusive scintigraphies (1 incidentaloma and 1 non-conclusive FCE). Normal adrenal glands were visualized in all cases on the 5 th and/or 7 th day scintigraphy. Conclusion: The study of adrenal functionalism by the combined protocol of adrenal suppression study plus later non-suppression study made it possible to identify with high precision primary aldosteronism and to confirm the function of normal adrenal glands.
Revista Española de Cardiología, 1997
Introducción y objetivos. Estudiar el rendimiento diagnóstico de la tomogammagrafía miocárdica co... more Introducción y objetivos. Estudiar el rendimiento diagnóstico de la tomogammagrafía miocárdica con tecnecio-99m-metoxi-isobutil isonitrilo en la detección de enfermedad individualizada de las arterias coronarias epicárdicas y su valor en la predicción de enfermedad multivaso. Método. Se han estudiado 231 pacientes (58 ± 10
Journal of the American College of Cardiology, 1997
Objectives. We attempted to demonstrate that simultaneous dipyridamole administration and maximal... more Objectives. We attempted to demonstrate that simultaneous dipyridamole administration and maximal subjective exercise in patients who are unable to achieve a good exercise level can improve the diagnostic efficacy of technetium-99m methoxy isobutyl isonitrile (99m Tc-MIBI) myocardial single-photon emisson computed tomography (SPECT). Background. The results of myocardial perfusion scintigraphy are unsatisfactory if the level of exercise achieved by the patient is insufficient. The use of dipyridamole with maximal subjective stress testing has been shown to improve the quality of the thallium-201 myocardial perfusion images, but there are no studies demonstrating that this combination improves the diagnostic accuracy of myocardial perfusion SPECT. Methods. Two hundred thirty-one consecutive patients, without a previous myocardial infarction, were classified into three groups: group 1, 91 patients with an adequate exercise test; group 2, 68 patients with an inadequate exercise test; group 3, 72 patients with an inadequate exercise test who then received intravenous dipyridamole (0.56 mg/kg body weight over 4 min) simultaneously with exercise. Results. Results for sensitivity (89%) and negative predictive value (83%) in group 3 were significantly better than those in group 2 (71% [p ؍ 0.03] and 56% [p ؍ 0.002], respectively) and not significantly different from those in group 1. The polar maps of 20 patients studied with and without dipyridamole at the same exercise level revealed a significantly greater extent of ischemia in each territory and in a global assessment (19 ؉ 20% vs. 8 ؉ 11%, p < 0.0001) when dypiridamole was administered during physical exercise. Conclusions. Intravenous dipyridamole administration during exercise testing is advisable in all patients who are unable to achieve an adequate exercise level. This approach permits physicians to avoid missing ergometric information while optimizing myocardial SPECT results.
Journal of Nuclear Cardiology, 1995
Fourteen patients (M 9, F 5; age 62+6 SD) with coronary artery disease (CAD) underwent dobutamine... more Fourteen patients (M 9, F 5; age 62+6 SD) with coronary artery disease (CAD) underwent dobutamine stress radionuclide ventriculo-graphy CRNV) before and after successful percutaneous translumina] coronary angioplasty (PTCA) to study the effect of PCTA on left ventricular systolic and diastolic functions. Dobutamine infusion was started at 5~g/kg/min with the increment of 5 /~g/kg/min every 10 minutes until angina, high blood pressure (SBP > 210 mm Hg) or maximum dose was achieved (20/~g/kg/min). Radionuclide ventriculography was performed before dobutamine infusion and at each dose level of dobutamine infusion thereafter. It revealed that before PTCA only peak ejection rate increased significantly (3.2+0.7 to 4.4+0.5 end-diastolic volume/sec, p<0.05) during dobutamine infusion, leaving the left ventricular ejection fraction (LVEF) (55+6% to 56x9%, NS) and left ventricular peak filling rate (PFR) (2.7+0.5 to 2.4+0.8 end-diastolic volume/sec, NS) unchanged. However, after successful PTCA both LVEF (54:t:10 to 65• p<0.01) and PFR (2.9+0.7 to 3.7+0.6 end-diastolic volume/sec, p < 0.05) increased significantly during dobutamine infusion. In addition, 9 of these 14 subjects who were found to have regional wall motion abnormality during dobatamine infusion before PTCA turned out to have near normal regional wall motion after successful PTCA. The preliminary results from this study indicate that 1) both systolic and diastolic functional impairment as well as regional wall motion abnormality can be restored by PTCA in patients with CAD, 2) dobutamine stress RNV is a safe, reliable and easily performed method in evaluating the functional status of left ventricle in CAD patients.
Journal of Nuclear Cardiology, 1995
The feasibility of imaging FDG with SPECT has been shown recently. In the present study we have c... more The feasibility of imaging FDG with SPECT has been shown recently. In the present study we have compared FDG PET and FDG SPECTin 15 patients with coronary artery disease. Perfusion was evaluated with N-13 ammonia PET & early rest thallium SPECT. PET and SPECT studies were displayed as polar maps and divided in 13 segments. Based on PET and SPECT data, segments were scored as normal, viable or infarcted. Left ventricular function was evaluated using 2D echo, scoring each segment as normal (N), hypo-(H), or akinetic (A). Results: 195 segments were analyzed; 116 (59%) segments ~her normal or viable with PET and SPECT. Fifty (26%) segments were necrotic both with PET and SPECT. Twenty-nine (15%) segments were normal or viable with PET but infarcted with SPECT. Finally, 1 segment was infarcted with PET and viable with SPECT. Eighty percent of PET/SPECT infarct segments were A, 84% of PET/SPECT normal segments showed preserved function. PET normal/SPECT infarct segments showed in 70% preserved function. Thus, there is a good agreement between PET and SPECT to assess viability, although our data suggest that FDG SPECT may overestimate infarcted areas.
Journal of Nuclear Cardiology, 1995
Journal of Nuclear Cardiology, 1995