La Radiologia medica
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La Radiologia medica · Jul 1993
Comparative Study[The diagnosis of lung inflammation in AIDS patients. The use of 99mTc-labelled human polyclonal immunoglobulins and a comparison with 67Ga citrate and high-resolution computed tomography].
Technetium-99m (99mTc) labelled polyclonal human immunoglobulin (HIG) is a new agent for the localization of active inflammatory diseases. The results obtained with HIG in 29 AIDS patients referred for suspected lung infections are reported (Table I). The patients also underwent Gallium-67 citrate scanning (GS), chest radiography (Rx), high-resolution thin-layer computed tomography (HRCT) and broncho-alveolar lavage (BAL). ⋯ In conclusion, as for PCP and abscesses, the results obtained with 99mTc-HIG are usually in agreement with GS findings, while HIG scans seem to be negative in mycobacterial infections. Moreover, HIG scintigraphy seems to be suitable for the evaluation of treatment results in PCP (this subject deserves further research). To assess respiratory impairment a semiquantitative index (ISQ) of 99mTc-HIG lung uptake is suggested, which showed a significant linear correlation with arterial pO2.
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Tubercular abscesses are relatively common complications of tubercular spondylodiscitis. Fifty-one patients with suspected abscesses were selected from a group of 97 patients with tubercular spondylodiscitis and submitted to US. In 10 cases CT was performed before US and detected 7 abscesses, all of them confirmed by US. ⋯ The results proved US to allow the early and unquestionable diagnosis of tubercular abscesses and to confirm clinical suspicion. Moreover, US is also useful to guide percutaneous drainage and to follow the patients after drainage. As for CT, it remains the method of choice to depict vertebral involvement, but, in our series, it exhibited no significant advantages over US in the study of abscessual lumbar collections.
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La Radiologia medica · May 1993
[Percutaneous neurolysis of the celiac plexus. Description of a new CT-guided technique and preliminary results].
June 1991 to June 1992, twelve CT-guided percutaneous celiac plexus neurolyses were performed by a new simplified technique with the patient in left-hand side decubitus and a single right lumbar needle access. CT guidance allows the interventional radiologist to locate the best access point on the skin, to give the needle the appropriate depth and inclination to avoid passing through pleura, parenchyma and vessels, and finally to check the correct position of the needle tip and the spread of neurolytic solution. ⋯ The analgesic value of celiac plexus neurolysis has been proved complete and lasting. The technique is quick and safe (apart from inevitable hypotension due to splanchnic vasodilatation).