Arq Bras Endocrinol Metabvol 47 nº 1 Fevereiro 2003 30 RESUMOO objetivo deste estudo foi avaliar a freqüência de osteoporose de acordo com os sítios ósseos avaliados, utilizando um estudo transversal de base clínica. Foram avaliados 610 exames densitométricos em relação a freqüência de osteoporose/osteopenia e concordância do diagnóstico de acordo com o local avaliado. Apesar de alta correlação da DMO entre os sítios ósseos, a freqüência de osteoporose variou de acordo com o sítio avaliado. Osteoporose esteve presente em 14 e 18% dos pacientes, quando considerado o colo do fêmur e fêmur total, e 42 e 30% quando considerados o triângulo do Ward e coluna (p< 0,05). Um quarto das mulheres consideradas em risco aumentado de fratura pelo exame da coluna lombar foi classificado como normal pelo estudo do colo do fêmur; 16% com risco aumentado pelo estudo do colo do fêmur foi classificado como normal no estudo da coluna. Este estudo demonstra que existe discordância nos resultados densitométricos de acordo com a área estudada, afetando a ocorrência de osteoporose. Para julgamento clínico de risco de fratura, a avaliação combinada de dois sítios ósseos é o procedimento mais adequado. In this study a cross-sectional survey was conducted to evaluate the frequency of osteoporosis according to the site used. Six hundred and ten densitometric exams were analyzed regarding the frequency of osteoporosis/osteopenia according to the bone site. Besides the high correlation of bone density among the different sites analyzed, the frequency of osteoporosis has significantly changed with respect to the bone site examined. Osteoporosis was present in 14% and 18% of the patients when neck or total femur were used for diagnosis, whereas these numbers were 42% and 30% for Ward's triangle and lumbar spine sites, respectively. About 25% of the patients who were considered at risk for bone fracture using the lumbar spine evaluation were considered at no risk when the femoral neck was used as reference; on the other hand, 16% considered at increased risk using the femur were considered at no risk at lumbar spine. In conclusion, the frequency of osteoporosis changes according to the site used. For fracture risk assessment, the use of at least two different bone sites would be the best approach. (Arq Bras Endocrinol Metab 2003;47/1:30-36)

The findings of brain SPECT suggest that perfusion abnormalities of the basal ganglia may persist even after the remission of abnormal movements in patients with Sydenham's chorea.

The early demonstration of lung involvement in systemic lupus erythematosus (SLE) patients is a difficult but important task. In the present study we attempted to identify abnormalities in pulmonary clearance of 99m Tc-DTPA in SLE, correlating their clearance data with clinical findings and disease activity. Forty-six consecutive SLE patients with and without active disease (LACC score) and 30 normal volunteers were studied. All subjects were submitted to pulmonary scintigraphy with 99m Tc-DTPA to evaluate the pulmonary clearance, and to a chest X-ray, and SLE patients were submitted to tests of disease activity, spirometry, arterial blood gases and tests to assess acute-phase proteins. Pulmonary clearance was faster in SLE patients with active disease when compared to normal controls [half-life of 67.04 min (51.52-82.55 min) in active SLE versus 85.87 min (78.85-92.87 min) in controls, P<0.05] and there was a higher frequency of abnormal clearance rates in patients with active disease (11 of 26 patients, 42.3%) when compared with SLE patients without disease activity (2 of 20 patients, 10%) (P = 0.04). A significant correlation was observed between the clearance rates and cough (P<0.05), but not between the clearance rates and dyspnea symptoms or radiological findings, duration of SLE disease, antinuclear antibody titers and patterns, C-reactive protein or anti-double stranded DNA antibodies. We conclude that the pulmonary clearance of 99m Tc-DTPA is increased in SLE patients with active disease.

OBJECTIVEThe purpose of the present study was to prospectively quantify the normal limits of brain perfusion using specific software in a group of asymptomatic young volunteers submitted to single-photon emission tomography (SPECT) with 99mTc-ethyl cysteinate dimer (99mTc-ECD).METHODSWe used 15 MBq/kg of intravenous 99mTc-ECD in 30 healthy volunteers submitted to brief neuropsychological tests and a clinical questionnaire. These data were normalized relative to the cerebellum (Group 1) and to the brain cortex (Group 2). Statistical analysis was performed with Student's t-test. The average radioactivity was 6.5 million counts/study.RESULTSThe normalized (Group I) revealed an average value of 78.03%, with standard deviation (SD) of 4.07. Two volunteers in this group had slightly greater than two standard deviations from the mean. When we used (Group II), the average value was 71.01%, with a SD of 4.66. We observed a difference between groups of 9% (P<0.001).CONCLUSIONThe present study suggests normal cortical perfusional values for a group of young asymptomatic volunteers, utilizing 99mTc-ECD. This allows further quantification of neuro-SPECT data, specifically comparisons across patient populations. Furthermore, this method represents a new tool that can be used to further explore the field of neuroimaging, particularly neuropsychiatry.

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