Interesting images
Subacute cerebral infarction incidentally detected by 99mTc-MDP bone scan
Infarto cerebral subagudo detectado accidentalmente mediante gammagrafía ósea con 99mTc-MDP
Xun Tian
, Rui Su, Chenyang Dai, Wei Lu
Corresponding author
Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin, China
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"Tamanyo" => 225829 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">123</span>I-MIBG scintigraphy was performed with planar anterior/posterior acquisitions of abdomen, 4 and 24<span class="elsevierStyleHsp" style=""></span>h after the intravenous injection of 370<span class="elsevierStyleHsp" style=""></span>MBq of radiopharmaceutical. 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No focal uptake in the left adrenal gland or other abnormalities were identified.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Valentina Scolozzi, Germano Perotti, Giovanni Gambaro, Giuseppe Celi, Alessandro Giordano" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Valentina" "apellidos" => "Scolozzi" ] 1 => array:2 [ "nombre" => "Germano" "apellidos" => "Perotti" ] 2 => array:2 [ "nombre" => "Giovanni" "apellidos" => "Gambaro" ] 3 => array:2 [ "nombre" => "Giuseppe" "apellidos" => "Celi" ] 4 => array:2 [ "nombre" => "Alessandro" "apellidos" => "Giordano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X18301057" "doi" => "10.1016/j.remn.2018.07.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X18301057?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808918300806?idApp=UINPBA00004N" "url" => "/22538089/0000003800000004/v1_201907020628/S2253808918300806/v1_201907020628/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2253808919300436" "issn" => "22538089" "doi" => "10.1016/j.remnie.2019.04.001" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1062" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Med Nucl Imagen Mol. 2019;38:243-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting image</span>" "titulo" => "Melorheostosis: a rare sclerosing bone dysplasia. 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Utilidad de la gammagrafía ósea" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2167 "Ancho" => 1433 "Tamanyo" => 142269 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bone scintigraphy with <span class="elsevierStyleSup">99m</span>Tc-methylene diphosphonate: intense diffuse uptake in right femur, extending outside the borders of the bone and deforming the bone. The anterior border of the iliac crest is also affected as well as the acetabular region and homolateral patella. Additional osteoblastic focus in the upper third of the tibia.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E.R. 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She had no known history of cerebrovascular disease. The whole-body <span class="elsevierStyleSup">99m</span>Tc-MDP bone scintigraphy revealed a focal tracer uptake in the left side of the head, suggestive of skull metastasis, with no evidence of radiotracer uptake in the rest of the skeleton (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A, arrow). SPECT/CT images of the corresponding area were then performed for further evaluation, which demonstrated the activity was located in the left parietal lobe but not in the skull, and there was no abnormality on non-diagnostic CT images (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C, from top to bottom, axial and coronal CT images, corresponding SPECT and fused image, respectively, arrows). The next day, the subsequent MRI images showed only slightly high signal intensity on diffusion weighted imaging (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A, arrow) and obvious enhancement in the same area as SPECT/CT images (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B, arrow). Subsequently, a diagnosis of subacute cerebral infarction was made.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Incidental cerebral uptake of <span class="elsevierStyleSup">99m</span>Tc-MDP is rare, accounting for less than 0.2% of patients undergoing bone scintigraphy, which includes intracranial meningioma, metastatic neuroblastoma, dural metastasis, and Sturge–Weber syndrome, etc.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a> Previous reports state that brain ischaemia can also lead to elevated <span class="elsevierStyleSup">99m</span>Tc-MDP activity in the affected parts of the brain which is due to a breakdown in the normal blood–brain barrier and the appearances can revert to normal 4 months following infarction.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> In previously published cases there was usually a hypoattenuation area corresponding to the radiotracer uptake lesion.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> However, in our case, the CT did not show any special finding. We consider that the non-diagnostic CT used in our daily SPECT/CT acquisition process is a potential reason.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">This paper was sponsored by <span class="elsevierStyleGrantSponsor" id="gs1">National Natural Science Foundation of China</span> (<span class="elsevierStyleGrantNumber" refid="gs1">81801732</span>).</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Tian X, Su R, Dai C, Lu W. Infarto cerebral subagudo detectado accidentalmente mediante gammagrafía ósea con <span class="elsevierStyleSup">99m</span>Tc-MDP. Rev Esp Med Nucl Imagen Mol. 2019;38:245–246.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1532 "Ancho" => 1500 "Tamanyo" => 231973 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The whole-body <span class="elsevierStyleSup">99m</span>Tc-MDP bone scintigraphy showed a focal tracer uptake in the left side of the head. (A, arrow) SPECT/CT revealed the activity was located in the parietal lobe but not in the skull, and there was no abnormality in the non-diagnostic CT images (B and C, arrows).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 559 "Ancho" => 900 "Tamanyo" => 50567 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Subsequent MRI images showed slightly high signal intensity on diffusion weighted imaging and obvious enhancement (A and B, arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dural metastasis demonstrated on Tc-99m MDP bone scintigraphy in staging workup for a patient with breast cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.X. Truong" 1 => "A.C. Ting" 2 => "M.A. Rossleigh" 3 => "S.L. Carroll" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.rlu.0000204488.87491.73" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2006" "volumen" => "31" "paginaInicial" => "223" "paginaFinal" => "224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16550022" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intracranial Tc99m MDP uptake in Sturge–Weber syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Hui" 1 => "K.K. 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Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000001458" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2017" "volumen" => "42" "paginaInicial" => "127" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27879488" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003800000004/v1_201907020628/S2253808919300199/v1_201907020628/en/main.assets" "Apartado" => array:4 [ "identificador" => "47121" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003800000004/v1_201907020628/S2253808919300199/v1_201907020628/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808919300199?idApp=UINPBA00004N" ]
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