Özdemir, Semra Onsekiz Mart University - School of Medicine - Department of Nuclear Medicine, Turkey , Erselcan, Taner Cumhuriyet University - School of Medicine - Department of Nuclear Medicine, Turkey , Hasbek, Zekiye Cumhuriyet University - School of Medicine - Department of Nuclear Medicine, Turkey , Tandoğan, İzzet Cumhuriyet University - School of Medicine - Department of Cardiology, Turkey , Gümüş, Cesur Cumhuriyet Üniversitesi - Tıp Fakültesi - Radyoloji A D, Turkey

Incidentally detected large diaphragmatic hernia in Tl-201 myocardial perfusion scintigraphy; no substantial effect on the study results

33079

A case of diaphragmatic hernia, detected incidentally by Thallium 201 (Tl-201) myocardial perfusion scintigraphy (MPS), was presented. We recognized a large photon deficient area in the right lung and middle mediastinum regions, also attenuating cardiac activity in the first 10 projections during the evaluation of stress and rest single-photon emission computed tomography (SPECT) projections of the subject. Computed tomography (CT) examination of the mass revealed a diaphragmatic hernia of Morgagni type of from which the patient was unaware. We thought that this huge mass would have mask cardiac activity and cause important defects in cardiac sections and thus might lead to false results. Therefore, another rest examination was performed with a different acquisition angles that would avoid the attenuating effect of the mass on the heart. However, no substantial difference was observed, interestingly, between the outcomes of these two data sets. On the other hand presented case reminds that it is important to examine whole data set of a MPS study for incidental diagnosis.

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Thallium , 201 , diaphragmatic hernia

Cumhuriyet Medical Journal

491