Carla Rachel Ono1, Miguel Lia Tedde2, Paulo Rogerio Scordamaglio3, Carlos Alberto Buchpiguel1. 1. Nuclear Medicine Division, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil. 2. Department of Thoracic Surgery, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HC-FMUSP), São Paulo, SP, Brazil. 3. Respiratory Endoscopy Division, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor/HC-FMUSP), São Paulo, SP, Brazil.
Abstract
OBJECTIVE: To evaluate the use of pulmonary inhalation-perfusion scintigraphy as an alternative method of investigation and follow-up in patients with bronchopleural fistula (BPF). MATERIALS AND METHODS: Nine patients with BPFs were treated through the off-label use of a transcatheter atrial septal defect occluder, placed endoscopically, and were followed with pulmonary inhalation-perfusion scintigraphy, involving inhalation, via a nebulizer, of 900-1300 MBq (25-35 mCi) of technetium-99m-labeled diethylenetriaminepentaacetic acid and single-photon emission computed tomography with a dual-head gamma camera. RESULTS: In two cases, there was a residual air leak that was not identified by bronchoscopy or the methylene blue test but was detected only by pulmonary inhalation-perfusion scintigraphy. Those results correlated with the evolution of the patients, both of whom showed late signs of air leak, which confirmed the scintigraphy findings. In the patients with complete resolution of symptoms and fistula closure seen on bronchoscopy, the scintigraphy was completely negative. In cases of failure to close the BPF, the scintigraphy confirmed the persistence of the air leak. In two patients, scintigraphy was the only method to show residual BPF, the fistula no longer being seen on bronchoscopy. CONCLUSION: We found pulmonary inhalation-perfusion scintigraphy to be a useful tool for identifying a residual BPF, as well as being an alternative method of investigating BPFs and of monitoring the affected patients.
OBJECTIVE: To evaluate the use of pulmonary inhalation-perfusion scintigraphy as an alternative method of investigation and follow-up in patients with bronchopleural fistula (BPF). MATERIALS AND METHODS: Nine patients with BPFs were treated through the off-label use of a transcatheter atrial septal defect occluder, placed endoscopically, and were followed with pulmonary inhalation-perfusion scintigraphy, involving inhalation, via a nebulizer, of 900-1300 MBq (25-35 mCi) of technetium-99m-labeled diethylenetriaminepentaacetic acid and single-photon emission computed tomography with a dual-head gamma camera. RESULTS: In two cases, there was a residual air leak that was not identified by bronchoscopy or the methylene blue test but was detected only by pulmonary inhalation-perfusion scintigraphy. Those results correlated with the evolution of the patients, both of whom showed late signs of air leak, which confirmed the scintigraphy findings. In the patients with complete resolution of symptoms and fistula closure seen on bronchoscopy, the scintigraphy was completely negative. In cases of failure to close the BPF, the scintigraphy confirmed the persistence of the air leak. In two patients, scintigraphy was the only method to show residual BPF, the fistula no longer being seen on bronchoscopy. CONCLUSION: We found pulmonary inhalation-perfusion scintigraphy to be a useful tool for identifying a residual BPF, as well as being an alternative method of investigating BPFs and of monitoring the affected patients.
Authors: Paulo Rogério Scordamaglio; Miguel Lia Tedde; Hélio Minamoto; Carlos Augusto Cardoso Pedra; Fábio Biscegli Jatene Journal: J Bras Pneumol Date: 2009-11 Impact factor: 2.624
Authors: C Deschamps; A Bernard; F C Nichols; M S Allen; D L Miller; V F Trastek; G D Jenkins; P C Pairolero Journal: Ann Thorac Surg Date: 2001-07 Impact factor: 4.330
Authors: Mark D Walsh; Anthony D Bruno; Mark W Onaitis; Detlev Erdmann; Walter G Wolfe; Eric M Toloza; L Scott Levin Journal: Ann Thorac Surg Date: 2011-03 Impact factor: 4.330
Authors: Miguel L Tedde; Paulo R Scordamaglio; Helio Minamoto; Viviane R Figueiredo; Carlos C Pedra; Fabio B Jatene Journal: Ann Thorac Surg Date: 2009-09 Impact factor: 4.330
Authors: Ana Cristina Lopes Albricker; Cláudia Maria Vilas Freire; Simone Nascimento Dos Santos; Monica Luiza de Alcantara; Mohamed Hassan Saleh; Armando Luis Cantisano; José Aldo Ribeiro Teodoro; Carmen Lucia Lascasas Porto; Salomon Israel do Amaral; Orlando Carlos Gloria Veloso; Ana Cláudia Gomes Pereira Petisco; Fanilda Souto Barros; Márcio Vinícius Lins de Barros; Adriano José de Souza; Marcone Lima Sobreira; Robson Barbosa de Miranda; Domingos de Moraes; Carlos Gustavo Yuji Verrastro; Alexandre Dias Mançano; Ronaldo de Souza Leão Lima; Valdair Francisco Muglia; Cristina Sebastião Matushita; Rafael Willain Lopes; Artur Martins Novaes Coutinho; Diego Bromfman Pianta; Alair Augusto Sarmet Moreira Damas Dos Santos; Bruno de Lima Naves; Marcelo Luiz Campos Vieira; Carlos Eduardo Rochitte Journal: Arq Bras Cardiol Date: 2022-04 Impact factor: 2.000
Authors: Felipe Alves Mourato; Ana Emília Teixeira Brito; Monique Sampaio Cruz Romão; Renata Guerra Galvão Santos; Cristiana Altino de Almeida; Paulo José de Almeida Filho; Aline Lopes Garcia Leal Journal: Radiol Bras Date: 2020 Jan-Feb