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La miocarditis viral es resultado de una inflamación del miocardio provocada por diferentes virus. Esta enfermedad cardíaca constituye sin duda una urgencia cardiovascular en el adulto por las complicaciones que ocasiona. El cuadro clínico se caracteriza por arritmias e insuficiencia cardíaca que pueden conducir a la muerte. La secuela más frecuente de la miocarditis viral a largo plazo es la miocardiopatía dilatada. En el presente trabajo se revisa etiología, fisiopatología, sintomatología, diagnóstico y tratamiento de la miocarditis viral en el adulto.Viral myocarditis is the result of a myocardial inflammation provoked by different viruses. This cardiac disease is doubtless a cardiovascular urgency in the adult due to its complications. The clinical picture is characterized by arrhythmias and cardiac failure that may to lead to death. The more frequent long-term myocarditis sequela is the dilated myocardiopathy. In present paper etiology, pathophysiology, symptomatology, diagnosis and treatment of viral myocarditis in the adult are reviewed.

SPECT/CT has represented not only the possibility of acquiring anatomical and functional images in one single study, but also a revolution for the clinical management of several diseases, taking the better of each one of these imaging modalities. The present work is aimed at presenting an overview of the most important applications of the SPECT/CT in the field of oncology, cardiology and neurology. New technological advances in the design of innovative solid state detectors and related equipment have had a positive effect on the performance of this kind of dual modality. This hybrid technique improves the sensitivity and the specificity of gammagraphic studies, as well as shortens the acquisition times and gives attenuation correction of co-registered images, which, in turn, makes their analysis easier. Some of the main applications for the study of oncological diseases are the following: localization and follow-up of different kinds of tumors, their metastasis and relapses, as well as the optimization of radiotherapy doses. This technique has been useful to evaluate the coronary artery disease allowing an adequate attenuation correction of images, the determination of calcium score, and performing angio-CT studies, according to the CT quality. SPECT/CT has also gained ground in the assessment of some neurological diseases. Conclusions: The introduction of new technological advances and radiopharmaceuticals thus predicting a more relevant place for SPECT/CT in clinical practice.

Se estudiaron 35 pacientes adultos con anemia drepanocítica. Se establecieron 2 grupos: grupo 1: 24 enfermos sin antecedentes de crisis del sistema nervioso central (15 hombres; 9 mujeres) y grupo 2: 11 casos con antecedentes de crisis (6 hombres; 5 mujeres). El promedio de edad fue de 31 años en el sexo masculino y de 29 años en el femenino. Todos los enfermos estaban en condiciones basales. El tiempo transcurrido entre la crisis y el estudio fue de 4,7 años. No hubo diferencia significativa en las cifras de hemoglobina y los reticulocitos entre ambos grupos. Se encontró aumento significativo de la velocidad sanguínea cerebral en todos los pacientes del grupo 1 y del grupo 2 (p < 0,05 y p < 0,001, respectivamente). En 13 pacientes del grupo 1 (54,1 %) el flujo sanguíneo cerebral presentó modificación, mientras que en todos los pacientes del grupo 2 se encontró alterado. En 13 casos del grupo 1 (76,4 %) el electroencefalograma fue normal y en el 87,5 % de los enfermos del grupo 2 estaba alterado. En 4 pacientes del grupo 1 (23,5 %) la actividad eléctrica cerebral presentó alguna modificación. En 19 individuos del grupo 1 (95 %) la tomografía axial computarizada fue normal y en 3 casos del grupo 2 (37,5 %) se observó alguna alteración.35 adult patients with drepanocytic anemia were studied. They were divided into 2 groups: group 1 was composed of 24 patients without history of central nervous system crisis (15 males and 9 females), whereas group 2 included 11 cases with crisis history (6 males and 5 females). Average age was 31 years old for males and 29 for females. All the patients were under basal conditions. The time elapsed between the crisis and the study was 4.7 years. No significant differences were observed between the hemoglobin figures and the reticulocytes of both groups. A marked increase of the brain blood velocity was found in all the patients from group 1 and group 2 (p < 0.05 y p < 0.001, respectively). In 13 patients from group 1 (54.1 %) the brain blood flow presented modifications, whereas it was altered in all patients from group 2. In 13 cases from group 1 (76.4 %) the electroencephalogram was normal, but it was altered in 87.5 % of the patients from group 2. In 4 patients from group 1 (23.5 %), the brain electrical activity showed some modification. Computerized axial tomography was normal in 19 patients from group 1. Some alteration was detected in 3 cases from group 2 (37.5 %).

To determine the utility of scintigraphy with -MIBI for non-invasively assessment and prediction of multidrug resistance in patients with lymphoma. 152 patients were evaluated (120 with lymphoma and 32 with benign diseases of the lymph nodes). The biopsy of lymph nodes constituted the gold standard. Static images of thorax, abdomen and pelvis were acquired at 20 min, 2h, 3h and 4h after the intravenous administration of 925-1110 MBq (20-30 mCi) of -MIBI. The uptake indexes were determined for each time and the index of maximum uptake (ICmax) of the radiopharmaceutical for all patients was also calculated. The index of maximum uptake was compared with the clinical and hematological response to chemotherapy. The studies with -MIBI showed values of sensibility, specificity and diagnostic accuracy of 96%, 75% and 92%, respectively. Once chemotherapeutic treatment was concluded, 48 of the 120 studied patients with lymphoma showed complete remission of the disease, meanwhile 32 of them showed partial remission and non response to chemotherapy was observed in 40 cases. The outcomes of the present work revealed that a high index of maximum uptake (ICmax ³6) could be an indicator of good response to chemotherapy, values of ICmax in a range from 3 to 6 were associated to either complete or partial remission and a ICmax £3 could be an indicator of poor response to chemotherapy. The scintigraphy with -MIBI was a useful tool for the study of patients with lymphoma and the assessment of their response to chemotherapy.