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uptake, but passive diffusion agents can also be valuable. Assessment of the abdomen requires delayed imaging and is best achieved with agents which do not show physiologic bowel excretion. Overall, mIn- leukocytes are ideally suited to this function (Fig. 17). Neither mIn- leukocytes nor 67Gallium show appreciable urinary tract excretion. These agents can be valuable for confirming pyelonephritis or

Figure 16. Infected right brachial-axillary graft. A 61 year old woman with end stage renal disease due to diabetic nephropathy and hypertension was receiving hemodialysis through a right brachial-axillary graft. She developed acute onset of fever (up to 40.1° C) associated with non-specific abdominal and low back pain. Blood cultures were positive for two different gram positive cocci: Staphylococcus aureus and alpha-hemolytic Streptococcus. Clinical examination was unhelpful as were many investigations (chest x-ray, chest/abdominal CT scan, echocardiogram and lumbar spine CT) and consultations conducted in an attempt to determine the cause of the fever. Dual-isotope scaning with 99mTc-erythrocytes (left) localized the fistula while the 111In-leukocyte scan (right) demonstrated intense leukocyte accumulation in the right brachial-axillary graft from a graft infection (arrow).

Figure 16. Infected right brachial-axillary graft. A 61 year old woman with end stage renal disease due to diabetic nephropathy and hypertension was receiving hemodialysis through a right brachial-axillary graft. She developed acute onset of fever (up to 40.1° C) associated with non-specific abdominal and low back pain. Blood cultures were positive for two different gram positive cocci: Staphylococcus aureus and alpha-hemolytic Streptococcus. Clinical examination was unhelpful as were many investigations (chest x-ray, chest/abdominal CT scan, echocardiogram and lumbar spine CT) and consultations conducted in an attempt to determine the cause of the fever. Dual-isotope scaning with 99mTc-erythrocytes (left) localized the fistula while the 111In-leukocyte scan (right) demonstrated intense leukocyte accumulation in the right brachial-axillary graft from a graft infection (arrow).

perinephric abscess. Gallium is preferred for chronic or granulomatous disorders, and when an occult tumor is a significant consideration.

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