ASNC WHAT IS THIS IMAGE? patient’s heart failure is low. However isotope uptake was noted in the sternum and several ribs. CT imaging Incidental detection of RIB fractures performed immediately post arrest showed evidence of with Tc-99m pyrophosphate scanning rib fractures (Figure 2), but an intact sternum (Figure 3). TEACHING POINT CLINICAL CASE Osteoblastic activity involves the active deposition of pyrophosphate into bone matrix. Radionuclide scintigraphy A 77-year-old man with history of atrial ﬁbrillation with Tc-99m PYP scanning is an extremely sensitive marker and hepatocellular carcinoma with a prior liver transplant of bone remodeling. Stress or ‘hairline’ fractures can also be developed pneumonia and suffered an in-hospital hypoxic detected by this method. Fractures between 24 hours and 6 respiratory arrest requiring 3 minutes of CPR with return months are generally PYP avid, with 90% not showing PYP of circulation. Two weeks after discharge, he presented uptake after 2 years. There is considerable heterogeneity in with dyspnea, bilateral pleural effusions, and lower the patterns of bone tracer uptake by the sternum. extremity edema. He was treated for heart failure, and an echocardiogram demonstrated normal ejection fraction with left ventricular hypertrophy. An electrocardiogram FEATURE RESULTS demonstrated low-voltage QRS complexes in the
Journal of Nuclear Cardiology – Springer Journals
Published: Jul 7, 2017
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