4.1 - RADIONUCLIDE SPLENOPORTOGRAPHY IN THE PRE- AND POST-SURGICAL EVALUATION OF PATIENTS WITH SEVERE PORTAL HYPERTENSION SECONDARY TO HEPATIC FIBROSIS. Ramos CD, Barcelos IHK, Boin IFSF, Santos AO, Etchebehere ECSC, Silva RAM, Camargo EE. Division of Nuclear Medicine, Department of Radiology, and Gastroenterology Center, Campinas State University (UNICAMP), Campinas, Brazil. cdramos@mn-d.com Radionuclide splenoportography is a minimally invasive procedure that consists of a percutaneous splenic injection of [Tc-99m]MAA, followed by dynamic images in order to evaluate the portal venous system flow. Quantification of the portal-systemic shunt is performed by comparing the hepatic and the pulmonary uptake of the tracer. In this study this method was used to evaluate patients with severe portal hypertension secondary to hepatic fibrosis prior to and after surgery. Three male patients (ages 22, 35 and 49 years) with esophageal varices were evaluated. One patient was evaluated prior to surgery and the other two, after surgery. [Tc-99m]MAA (185 MBq) was injected with a fine needle guided by ultrasonography. Dynamic images were acquired at a rate of 1 image per second immediately after the splenic injection of the radiopharmaceutical and static images of the thorax and abdomen were acquired in the anterior and posterior projections. In the patient evaluated prior to surgery the study identified the type of collateral portal-systemic circulation, predominantly ascending, which correlated with the presence of esophageal varices, and also descending, which correlated with the retrograde flow from the inferior mesenteric vein. Quantification revealed a portal-systemic shunt of 70% of the total portal circulation. In the two patients evaluated after surgery the surgical splenic-renal shunt was open in one and occluded in the other. The patient with obstruction had an ascending collateral circulation through the gastric-esophageal region. Radionuclide splenoportography may be of great utility in the pre and post surgical evaluation of patients with portal hypertension, allowing the demonstration of the type of portal-systemic circulation, shunt quantification and evaluation of the flow of surgical shunts.

1.Cardiology |  2.Endocrinology | 3.Equipment: Quality Control | 4.Gastroenterology |  5.Infectious Diseases |  6.Nephro-Urology |  7.Oncology |  8.Orthopheadics | 9.PET/SPECT | 10.Pneumology |  11.Radiobiology |  12.Radiopharmacy |  13.Special Clinical Applications |  14.Neuropsychiatry |

4.2 - UNUSUAL PRESENTATION OF HEPATIC ADENOMA - Sc-Tc99m AND DISIDA-Tc99m SCINTIGRAPHY Rossi, G S ; Hyai, A; Fontes, L B A ; Sapienza, M T ; Watanabe, T ; Costa , P L A ;Buchpiguel, C A.; Hironaka F Hepatic adenomas usually present as low uptake regions on sulfur colloid scans, due to absent or hypofunctioning Kupffer cells. HIDA-Tc99m scintigraphy frequently shows retention in hepatocytes and a high uptake at late images, even greater than normal liver. We report the case of a patient with a hepatic lesion which presented active uptake of colloid. Scintigraphy with DISIDA-Tc99m showed early uptake with a fast washout. Surgical excision and histology confirmed hepatic adenoma, with the presence of Kupfer cells.

1.Cardiology |  2.Endocrinology | 3.Equipment: Quality Control | 4.Gastroenterology |  5.Infectious Diseases |  6.Nephro-Urology |  7.Oncology |  8.Orthopheadics | 9.PET/SPECT | 10.Pneumology |  11.Radiobiology |  12.Radiopharmacy |  13.Special Clinical Applications |  14.Neuropsychiatry |

4.3 - Tc- 99m - SULFUR COLLOID SCINTIGRAPHY TO EVALUATE IMPLANT OF SPLENIC TISSUE Sandro L. Chuquer, Adriana I. Joaquim, Fernando V. Sales, Alexandre M. Anacleto,José A. Vicentini e Eleuses V. Paiva - Serviço de Medicina Nuclear e de Cirurgia da Sociedade Portuguesa de Beneficência- São José do Rio Preto inuclear@nutecnet.com.br We report a case of a 17 yo man, who underwent total splenectomy for a ruptured spleen following abdominal trauma. Attempting to preserve splenic function, 7 fragments of spleen were implanted in the omentum, each measuring 4 X 4 X 3cm. Eight months following surgery, scintigraphy with 99m Tc -sulfur colloid was used to demonstrate viability of the implanted tissue. Others have used different methods to evaluate splenic function such as the Pits cell and the Howell Jolly bodies, however the scintigraphic method has demonstrated similar sensitivity, being widelly available in our medical center.

1.Cardiology |  2.Endocrinology | 3.Equipment: Quality Control | 4.Gastroenterology |  5.Infectious Diseases |  6.Nephro-Urology |  7.Oncology |  8.Orthopheadics | 9.PET/SPECT | 10.Pneumology |  11.Radiobiology |  12.Radiopharmacy |  13.Special Clinical Applications |  14.Neuropsychiatry |

4.4 - DIAGNÓSTICO DE HELICOBACTER PYLORI ATRAVÉS DO TESTE RESPIRATÓRIO DA URÉIA MARCADA COM C-14: REVISÃO DO MÉTODO Jales, RLC - UFRN A uréia marcada com C-14 permite a realização do TESTE RESPIRATÓRIO, útil no diagnóstico do Helicobacter pylori. O exame baseia-se na administração oral de 5m Ci da uréia-C-14m e posterior coleta do ar expirado. Nos casos positivos, a presença do Helicobacter pylori, grande produtor de ureuse, desdobrará a uréia, tendo como um dos subprodutos o CO2 (radiativo). A detecção é feita em um contador específico para radiação beta. O teste respiratório da uréia-C-14 é bem aceito pelos pacientes e pelos gastroenterologistas, por se tratar de uma técnica não-invasiva, de alta sensibilidade/especificidade. Este artigo também revisa o papel do H. pylori como agente infeccioso da doença rigorosa péptica e discute possíveis participações deste patógeno em doenças extra-digestivas. Objetiva-se portanto revisar a utilização médica do C-14 como uma das técnicas de diagnóstico em medicina nuclear e apresentação de resultados iniciais da prevalência desta bactéria na cidade de Natal-RN.

1.Cardiology |  2.Endocrinology | 3.Equipment: Quality Control | 4.Gastroenterology |  5.Infectious Diseases |  6.Nephro-Urology |  7.Oncology |  8.Orthopheadics | 9.PET/SPECT | 10.Pneumology |  11.Radiobiology |  12.Radiopharmacy |  13.Special Clinical Applications |  14.Neuropsychiatry |