Atlas of Diagnostic Nuclear Medicine

396 Pages·2001·45.219 MB·English

by  Dr. med. Anisah el Helou (auth.)

Anisah el Helou Atlas of Diagnostic Nuclear Medicine
Springer-Verlag Berlin Heidelberg GmbH
Anisah el Helou A a s o
Atlas o f
Diag o s ic
Diagnostic
uclea
Nuclear
• •
c e
M
Medicine
Foreward by H. Kriegel
With 368 Figures,
91 in Color,
in More Than 2000 Separate Illustrations
, Springer
Dr. med. Anisah el Helou
Postfach 102046
69010 Heidelberg
Germany
Translation:
Terry C. Te/ger, 6772 Waco War, Forth Worth, TX 76733, USA
Library of Congress Cataloging-in-Publieation Data
EI Helou, Anisah, 1938-Atlas of diagnostic nudear medicine / Anisah el Helou ; foreword by Heinz
Kriege!. p. ; em.
Includes bibliographieal referenees and index.
1. Radioisotope seanning-Atlases.l. Title.
[DNLM: 1. Radionuclide Imaging-Atlases. WN 17 E41a 2000[
RC78.7.R4 E436 2000
616.07'575-dc21
ISBN 978-3-662-05889-3 ISBN 978-3-662-05887-9 (eBook)
DOI 10.1007/978-3-662-05887-9
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is
concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcast~
ing, reproduetion on mierofilms or in any other way, and storage in data banks. Duplication of this pub
lieation or parts thereof is permitted only under the provisions of the German Copyright Law of Sep
tember 9, 1965, in its current version, and permission for lise must always be obtained from Springer
Verlag. Violations are hable für prosecution under thc German Copyright law.
© Springer-Verlag Berlin Heidelberg 2001
Originally published by Springer-Verlag Berlin Heidelberg New York in 2001.
Softcover reprint ofthe hardcover Ist edition 2001
Thc lise of general descriptive names, registered names, trademarks, ete. in this publications does not
imply, even in the absence of a specific statement, that such names are exempt from the relevant protcc
tive laws and regulations and therefore free for general use.
Production: PRO EDIT GmbH, 69126 Heidelberg, Germany
Cover design: design + production GmbH, Heidelberg, Germany
Typesetting and Reproduetion of the figures: AM-productions GmbH, 69168 Wiesloeh, Germany
Printed on acid-free paper SPIN: 10675815 21/3135/ML 543210
Fritz Straßmann
* 22.02.1902 in Boppard t 22.04.1980 in Mainz
Foreword
Today nuclear medicine must be considered an established speeialty,
an essential tool in medieal diagnosis and treatment, and an important
eomponent of medieal edueation. The use of "open radionuclides" has
provided the key to visualizing ehanges in biologie struetures as well
as deteeting pathophysiologie and spaee-oeeupying processes within
the body.
During the many years in whieh nuclear medieine has evolved,
numerous radiopharmaeeutieals have been tested both for the quality
of their diagnostie yield and for the safety of their radioaetive emis
sions. Meanwhile, the sensitivity and diagnostie eapabilities of nuclear
imaging equipment at hospitals, offices, and institutions have been sub
stantially improved, and quality standards for nuclear medieine proto
eols and examinations have been established on the basis of intensive
research.
While a great many eomprehensive referenee works have been pub
lished on the prineiples and praetices of radiology, there has been a
dearth of works dealing with "classie" nuclear medicine. Thus, an atlas
portraying the results of nuclear medicine examinations is a welcome
addition to the radiologie literature.
In eompiling the images, the author has drawn materials from the
files of her own nuclear medicine praetiee. Her seleetion of diagnostie
images vividly illustrates the range of applieations of radionuclide
imaging. The atlas also includes an historical overview outlining the
evolution of nuclear medicine.
It is hoped that this atlas will advanee the understanding of nuclear
medieine methods and examinations in allied speeialties and among
students of medieal imaging.
Munieh, Spring 2000
Heinz Kriegel
Preface
Nuclear medicine is a relatively young medical discipline. Serious
work with medical radioisotopes began at German universities in
1950. Before the first production facilities were established in Europe,
radioisotopes had to be flown into Germany from the United States.
As a result, radionuclide studies could not be performed during
inclement weather. The German Roentgenographic Society was the
first professional society to recognize the importance of nuclear medi
eine as a specialty and founded the Association for the Study of
Radioisotopes (RIAG). Next came the Association for the Study of
Radioisotopes in Internal Medicine (ARIGIM), whose first large sym
posium, held in Freiburg in 1962, had an attendance of approximately
100. On February 22,1963, the director of the former Czerny Hospital
in Heidelberg, Prof. Becker, ended the rivalry between the two soci
eties by persuading Prof. von Hevesy, a Nobel Prize winner, to serve
as the first joint chairman. Shortly thereafter, the Society of Nuclear
Medicine was founded at the request of small groups of European
specialists. By its tenth annual meeting, the Society had a roster
of 600 members from 22 countries.
There is scarcely any other specialty in which the natural seien ces,
technology, physiology, and the various clinical disciplines are so closely
uni ted as in nuclear medicine. As a result, nuclear medicine relies to
a unique degree on interdisciplinary cooperation for its effectiveness
and continued development.
This atlas provides an ideal supplement to existing textbooks
of nuclear medicine. By emphasizing images over written text, the
Atlas of Nuclear Medicine can provide physicians, medical students,
and other interested readers with an overview of the capabilities and
limitations of radionuclide imaging. Advances in equipment technology
and radiopharmaceuticals have been so rapid that some of the chapters
may not reflect cutting-edge methodology. It should be kept in mind,
however, that innovations are not always good and that time is needed
to establish the validity of new techniques.
I dedicate this atlas to my esteemed teacher, Prof. Fritz Strass mann,
and hope that it will advance his wish that nuclear medicine be used
for positive and peaceful purposes. I am grateful to his wife, Irmgard
Strassmann, for providing me with his photograph. I also express
thanks and appreciation to all my colleagues who worked tirelessly
and in great detail, going beyond their regular duties. Without them,
this book would not have been possible.
Heidelberg, Spring 2000
A. el Helou
Contents
1 Head and Neck .................................... .
1.1 Brain ............................................... .
1.1.1 Cerebrovascular Disease ............................. .
1.1.2 Brain Tumors ....................................... .
1.1.3 Sensitivity of Radionuclide Imaging
in Cerebral Diagnosis ................................. 2
1.2 Parotid Gland ........................................ 5
1.3 Thyroid Gland ....................................... 5
1.4 Parathyroid Gland .................................... 6
2 ehest 59
2.1 Lungs 59
2.2 Breast 60
2.3 Mediastinum ....................................... . 60
2.3.1 Major Vessels ....................................... . 60
2.3.2 Heart .............................................. . 61
3 Abdomen .......................................... . 179
3.1 Gastrointestinal Tract ................................ . 179
3.2 Kidneys ............................................ . 180
3.3 Adrenals ........................................... . 180
4 Bone .............................................. . 279
4.1 Sources of Error in Scan Interpretation ................ . 279
4.2 Benign and Malignant Bone Lesions, Fractures,
Systemic Diseases ................................... . 279
5 Miscellaneous ..................................... . 329
5.1 Arteries, Veins, and Lymphatics ....................... . 329
5.2 Bone Marrow ....................................... . 329
Appendix........................................... 347
A Historical Development .............................. 347
Al Head and Neck ...................................... 347
A2 Chest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
A3 Abdomen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
A4 Bone ................................................ 373
B Definitions and Units ................................. 375
Subject Index ....................................... 383
Abbreviations
AP, PA, LPO, ete. Projections (anteroposterior, posteroanterior,
left posterior oblique, ete.)
ATP Adenosine tri phosphate
BBB Blood-brain barrier
Bq Becquerel (1 Bq = 1 disintegration/s)
CCK Cholecystokinin
CHD Coronary heart disease
Ci Curie (1 Ci = 3.7x1010 Bq)
CNS Central nervous system
CT Computed tomography
DMSA Dimercaptosuccinic acid
DTPA Diethylene triamine penta-acetic acid
EANM European Association of Nuclear Medicine
ECAT Emission computed axial tomography
ECG Electrocardiography
EDTA Ethylene dia mine tetra-acetic acid
EF Ejection fraction
EHDP Ethylhydroxydiphosphonate
ERCP Endoscopic retrograde cholangiopancreatography
HDA Heptadecanic acid
HIDA See IDA
HMPAO Hexamethylpropylene amine oxime
HL Half-life
HSA Human serum albumin
HVL Half-value layer
lodine
IBZM lodobenzamide
ICDR lododeoxycytidine
IDA Iminodiacetic acid
L Lumbar vertebra (L 1, L2, ete.)
LAD Left anterior descending coronary artery
LCA Left coronary artery
LCX Left circumflex artery (circumflex branch
of the left coronary artery)
MAA Macroaggregated albumin
MAG3 Mercaptoacetyltriglycine
MDP Methylene diphosphonate
MI Myocardial infarction
MIBG Meta-iodobenzylguanidine
MIBI Methoxyisobutylisonitrile
MRI Magnetic resonance imaging
OIF Octa iodofl uorescei n
p.i. Postinjection
RA Rheumatoid arthritis
PET Positron emission tomography (positron ECAT)