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{{Lupus nephritis}} | {{Lupus nephritis}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}[[User:Okamal|Omer Kamal, M.D.]] [mailto:okamal@bidmc.harvard.edu%7C <nowiki>[2]</nowiki>] | ||
==Overview== | ==Overview== | ||
Another imaging modality that can be used for the diagnosis of systemic lupus erythematosus complications is the double-contrast technique for [[gastritis]] evaluation. Another imaging technique that can be helpful in the diagnosis of SLE complications, especially early manifestations, is the [[Technetium-99m]] scan. It can be used in different ways, including [[Scintigraphy|bone scintigraphy]] and [[Bone scan|bone scans]] to evaluate early and late [[bone]] complications, and for early evaluation of other organ complications including [[cardiac]], [[Hepatobiliary disease|hepatobiliary]], and [[pulmonary]] complications. | |||
==Other Imaging Findings== | ==Other Imaging Findings== | ||
* | * Upper [[gastrointestinal]] [[Esophagogram|barium study]]:<ref name="pmid9833786">{{cite journal |vauthors=Hizawa K, Iida M, Aoyagi K, Jo Y, Matsumoto T, Yao T, Yao T, Fujishima M |title=Double-contrast radiographic assessment of lupus-associated enteropathy |journal=Clin Radiol |volume=53 |issue=11 |pages=825–9 |year=1998 |pmid=9833786 |doi= |url=}}</ref> | ||
** In patients who represent with [[esophagitis]] due to SLE | |||
** Possible findings include: | |||
*** Mucosal [[granularity]] from [[reflux esophagitis]] | |||
*** [[Ulceration]] in severe cases | |||
* Double contrast technique:<ref name="pmid9833786">{{cite journal |vauthors=Hizawa K, Iida M, Aoyagi K, Jo Y, Matsumoto T, Yao T, Yao T, Fujishima M |title=Double-contrast radiographic assessment of lupus-associated enteropathy |journal=Clin Radiol |volume=53 |issue=11 |pages=825–9 |year=1998 |pmid=9833786 |doi= |url=}}</ref> | |||
** In the presence of [[gastritis]] or [[peptic ulcers]], for evaluation of [[stomach]] and [[duodenum]] | |||
*[ | ===== [[Technetium-99m]] scan ===== | ||
**[ | * Bone scan/[[Scintigraphy|Bone scintigraphy]]:<ref name="pmid3247661">{{cite journal |vauthors=Tsurko VV, Ivanova MM, Sysoev VF, Pushkova OV, Badokina GI |title=[Clinico-instrumental methods of diagnosing aseptic femur head necrosis in patients with systemic lupus erythematosus] |language=Russian |journal=Ter. Arkh. |volume=60 |issue=12 |pages=77–9 |year=1988 |pmid=3247661 |doi= |url=}}</ref><ref name="pmid9330932">{{cite journal |vauthors=Van de Wiele C, Van den Bosch F, Mielants H, Simons M, Veys EM, Dierckx RA |title=Bone scintigraphy of the hands in early stage lupus erythematosus and rheumatoid arthritis |journal=J. Rheumatol. |volume=24 |issue=10 |pages=1916–21 |year=1997 |pmid=9330932 |doi= |url=}}</ref> | ||
**[ | ** Photopenic areas will be seen primarily that will eventually progress to [[osteoblasts]] activity and increased [[radiotracer]] uptake at the margins of the [[infarction]] | ||
**Hand [[scintigraphy]] may be useful to differentiate SLE from [[RA]] in early stage disease<ref name="pmid9330932" /> | |||
** May show: | |||
*** [[Hyperemia]] of the affected bone | |||
*** [[Osteogenesis]] due to [[Avascular necrosis|avascular necrosis (AVN)]] | |||
*** An abnormal [[intraosseous]] [[Phlebology|phlebogram]] | |||
*** Elevated [[intramedullary]] pressure | |||
* Rest 99mTc-sestamibi SPET/[[Scintigraphy]] imaging:<ref name="pmid26825210">{{cite journal |vauthors=Tsai SC, Hsieh TY, Huang PW, Lin WY |title=Absolute Quantitative Evaluation of 67Ga Scintigraphy in Lupus Nephritis |journal=Clin Nucl Med |volume=41 |issue=6 |pages=442–6 |year=2016 |pmid=26825210 |doi=10.1097/RLU.0000000000001108 |url=}}</ref><ref name="pmid9712384">{{cite journal |vauthors=Lin WY, Cheng KY, Wang SJ |title=Ga-67 scintigraphy in lupus nephritis |journal=Clin Nucl Med |volume=23 |issue=8 |pages=517–20 |year=1998 |pmid=9712384 |doi= |url=}}</ref> | |||
** A non-invasive method to identify subclinical [[myocardial]] involvement in systemic lupus erythematosus<ref name="pmid10398819">{{cite journal |vauthors=Schillaci O, Laganà B, Danieli R, Gentile R, Tubani L, Baratta L, Scopinaro F |title=Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus |journal=Eur J Nucl Med |volume=26 |issue=7 |pages=713–7 |year=1999 |pmid=10398819 |doi= |url=}}</ref><ref name="pmid10063945">{{cite journal |vauthors=Laganà B, Schillaci O, Tubani L, Gentile R, Danieli R, Coviello R, Baratta L, Scopinaro F |title=Lupus carditis: evaluation with technetium-99m MIBI myocardial SPECT and heart rate variability |journal=Angiology |volume=50 |issue=2 |pages=143–8 |year=1999 |pmid=10063945 |doi=10.1177/000331979905000208 |url=}}</ref> | |||
** Identify patients potentially at risk of later [[cardiac]] events<ref name="pmid10398819" /> | |||
** Diagnostic in the degree of [[Pulmonary|pulmonary injury]] in patients<ref name="pmid11961428">{{cite journal |vauthors=Shih CM, Shiau YC, Wang JJ, Ho ST, Kao A |title=Increased lung uptake of technetium-99m hexamethylpropylene amine oxime in systemic lupus erythematosus |journal=Respiration |volume=69 |issue=2 |pages=143–7 |year=2002 |pmid=11961428 |doi=56317 |url=}}</ref> | |||
** In the presence of [[acute cholecystitis]] symptoms, findings include: | |||
*** [[Gallbladder]] wall thickening | |||
*** Nonfunctioning [[gallbladder]] at [[hepatobiliary system]] | |||
==References== | ==References== | ||
Latest revision as of 17:31, 20 July 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D. [2]
Overview
Another imaging modality that can be used for the diagnosis of systemic lupus erythematosus complications is the double-contrast technique for gastritis evaluation. Another imaging technique that can be helpful in the diagnosis of SLE complications, especially early manifestations, is the Technetium-99m scan. It can be used in different ways, including bone scintigraphy and bone scans to evaluate early and late bone complications, and for early evaluation of other organ complications including cardiac, hepatobiliary, and pulmonary complications.
Other Imaging Findings
- Upper gastrointestinal barium study:[1]
- In patients who represent with esophagitis due to SLE
- Possible findings include:
- Mucosal granularity from reflux esophagitis
- Ulceration in severe cases
- Double contrast technique:[1]
- In the presence of gastritis or peptic ulcers, for evaluation of stomach and duodenum
Technetium-99m scan
- Bone scan/Bone scintigraphy:[2][3]
- Photopenic areas will be seen primarily that will eventually progress to osteoblasts activity and increased radiotracer uptake at the margins of the infarction
- Hand scintigraphy may be useful to differentiate SLE from RA in early stage disease[3]
- May show:
- Hyperemia of the affected bone
- Osteogenesis due to avascular necrosis (AVN)
- An abnormal intraosseous phlebogram
- Elevated intramedullary pressure
- Rest 99mTc-sestamibi SPET/Scintigraphy imaging:[4][5]
- A non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus[6][7]
- Identify patients potentially at risk of later cardiac events[6]
- Diagnostic in the degree of pulmonary injury in patients[8]
- In the presence of acute cholecystitis symptoms, findings include:
- Gallbladder wall thickening
- Nonfunctioning gallbladder at hepatobiliary system
References
- ↑ 1.0 1.1 Hizawa K, Iida M, Aoyagi K, Jo Y, Matsumoto T, Yao T, Yao T, Fujishima M (1998). "Double-contrast radiographic assessment of lupus-associated enteropathy". Clin Radiol. 53 (11): 825–9. PMID 9833786.
- ↑ Tsurko VV, Ivanova MM, Sysoev VF, Pushkova OV, Badokina GI (1988). "[Clinico-instrumental methods of diagnosing aseptic femur head necrosis in patients with systemic lupus erythematosus]". Ter. Arkh. (in Russian). 60 (12): 77–9. PMID 3247661.
- ↑ 3.0 3.1 Van de Wiele C, Van den Bosch F, Mielants H, Simons M, Veys EM, Dierckx RA (1997). "Bone scintigraphy of the hands in early stage lupus erythematosus and rheumatoid arthritis". J. Rheumatol. 24 (10): 1916–21. PMID 9330932.
- ↑ Tsai SC, Hsieh TY, Huang PW, Lin WY (2016). "Absolute Quantitative Evaluation of 67Ga Scintigraphy in Lupus Nephritis". Clin Nucl Med. 41 (6): 442–6. doi:10.1097/RLU.0000000000001108. PMID 26825210.
- ↑ Lin WY, Cheng KY, Wang SJ (1998). "Ga-67 scintigraphy in lupus nephritis". Clin Nucl Med. 23 (8): 517–20. PMID 9712384.
- ↑ 6.0 6.1 Schillaci O, Laganà B, Danieli R, Gentile R, Tubani L, Baratta L, Scopinaro F (1999). "Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus". Eur J Nucl Med. 26 (7): 713–7. PMID 10398819.
- ↑ Laganà B, Schillaci O, Tubani L, Gentile R, Danieli R, Coviello R, Baratta L, Scopinaro F (1999). "Lupus carditis: evaluation with technetium-99m MIBI myocardial SPECT and heart rate variability". Angiology. 50 (2): 143–8. doi:10.1177/000331979905000208. PMID 10063945.
- ↑ Shih CM, Shiau YC, Wang JJ, Ho ST, Kao A (2002). "Increased lung uptake of technetium-99m hexamethylpropylene amine oxime in systemic lupus erythematosus". Respiration. 69 (2): 143–7. doi:56317 Check
|doi=value (help). PMID 11961428.