What nuclear medicine tests are most helpful in gastrointestinal (GI) medicine? Nuclear medicine procedures have been used in the evaluation of nearly every GI problem. Current improvements in and widespread use of endoscopy, manometry, pH monitoring, and diagnostic radiologic imaging techniques (CT, MRI, US) have limited the use of nuclear medicine to specific clinical problems. …
Disadvantages of nuclear medicine procedures compared with other radiographic studies? Spatial resolution, usually on the order of 1 to 2 cm, is inferior to that of other imaging modalities. Imaging times can be long, sometimes up to 1 hour or more. Radiation risk is obviously greater than with magnetic resonance imaging (MRI) or ultrasound (US). …
Advantages of nuclear medicine procedures compared with other imaging modalities Provide functional information that is either not available by other modalities or is obtained at greater expense or patient risk. High-contrast resolution (target-to-background ratio) can be achieved in many instances by nuclear medicine techniques, allowing diagnostic studies despite poor spatial resolution. Relatively noninvasive studies are …
How is EUS helpful in idiopathic recurrent pancreatitis? EUS can provide an etiologic factor for 40% to 80% of idiopathic recurrent pancreatitis cases with negative abdominal ultrasound and CT scan. More than 60% of the EUS findings are biliary pathologic conditions (microlithiasis, sludge, or stone).
What are the limitations of EUS in diagnosing CP? Interobserver agreement for the diagnosis of CP is moderate with kappa of 0.45; for the individual EUS features of CP, there is poor to moderate agreement, with the highest agreement for ductal dilation and lobularity. Determination of whether EUS findings are pathologic or represent asymptomatic fibrosis, …
What is the accuracy of EUS for diagnosing CP? When using the standard EUS criteria for CP, the diagnosis of CP depends on the presence of varying numbers of EUS criteria. Increasing the threshold improves the specificity of EUS while sacrificing sensitivity. The presence of at least five EUS criteria is commonly used to diagnose …
Standard nine EUS criteria for CP Parenchymal criteria Hyperechoic foci: small distinct reflectors Hyperechoic strands: small, stringlike hyperechoic structures Lobularity: containing lobules—rounded homogeneous areas separated by strands of another echogenicity Cysts: abnormal anechoic round or oval structure Calcifications: hyperechoic lesion with acoustic shadowing Ductal criteria Main pancreatic duct dilation: > 3.5 mm in body or …