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Biochemical Basis of Disease: Current Imaging Techniques in Rheumatology
Terms in this set (20)
In contrast to xray, CT and US, what does MRI allow to assess?
Both the soft tissue and the bone marrow affected by inflammation that precedes the development of destructive lesions observed by xray and CT
What are some basic indications for MRI examinations in rheumatoid patients?
- assessment of inflammatory lesions of joint cavities, sheaths and bursae
- assessment of inflammatory lesions and injuries within tendons
- assessment of bone lesions
- assessment of inflammatory lesions within muscles
- diagnostics of rheumatoid complications
What are the advantages of MRI?
- assessment of bone marrow and inflammatory lesions (bone marrow edema not detectable by any other method)
- assessment of all articular surfaces (exact determination of number of erosions and geodes, cartilage defects, etc.)
- assessment of spinal lesions
- higher specificity due to the ability to use multiple sequences and iv contrast enhanced scans
- capability to carry out semi-quantitative assessments of inflammatory lesions by assessing the intensity of enhancement
What is the difference between MRI scans of individual anatomical regions and whole body MRI scans?
scans of individual anatomical regions are performed using dedicated surface coils and whole body scans are performed to search for inflammatory foci
a functional examination that visualizes bone metabolic lesions developing in the course of benign and malignant diseases
How is scintigraphy helpful in benign lesions?
Helpful in differentiation of bone metabolic diseases, systemic diseases involving bones and joints, traumatic lesions, degenerative overload lesions and other bone and joint disorders of unknown etiology
In the diagnostics of melignancies, what role does scintigraphy play?
principle role in assessment of bone metastases along with determination of the stage and metabolic characteristics of the tumor
What is the difference between "hot spots" and "cold spots"?
Areas of increased accumulation of radioisotopes, known as hot spots are indicative of increased bone turnover, while areas of lower or no accumulation of radionuclide, known as cold spots, are indicative of bones being destroyed by expansive bone loss processes
What are scintigraphic bone scans divided into?
static scans and dynamic scans
static bone metabolic images being recorded usually several hours after administration of radionucleotide marker
continuous acquisition by gamma cameras allows tracing the radioisotope flow from the initial moment of administration over the arterial, mesenchymal and delayed
True or False: Bone scintigraphy is highly sensitive but not a very specific method
When is enhanced radioisotope uptake observed in bone scintigraphy?
in inflammatory, tumor and post-traumatic lesions, as well as other metabolic conditions characterized by enhanced osteoblastic-osteoplastic activity
What are the most common isotopic markers for scintigraphy in everyday clinical practice?
technitium 99mTc-labeled bisphosphonates, most commonly sodium mendronate (MDP)
What is the method of choice in the case of diagnosing spondyloarthritis?
scintigraphy with gallium citrate
What is the first line scintigraphic method?
involves the use of 111In oxine-labeled leukocytes and 99mTc-labeled sulfur colloid to examine the bone marrow reticuloendothelial system in order to identify the source of the infection and to differentiate the infection from marrow proliferation secondary to periprosthetic surgical procedure
What is the first line diagnostic method in differentiating the causes of hip endoprosthesis loosening?
Dynamic bone scintigraphy
Positron Emission Tomography (PET)
a type of scintigraphic molecular imaging based mostly on the metabolism of glucose within the bone and joint system as well as in the remaining body structures.
What are PET scans in rheumatoid patients based on?
What does the hybrid technology of PET/CT facilitate?
in obtaining structural computed tomography images during PET acquisition
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