Technetium-labelled red blood cell scintigraphy: is it useful in acute lower gastrointestinal bleeding?
Radionuclide scintigraphy is commonly utilized as a screening examination before performing more invasive procedures in the work-up of patients with lower gastrointestinal (GI) bleeding. We reviewed our institutional experience with technetium-labelled red blood cell scintigraphy (TRCS) in detecting and localising acute lower GI bleeding. The study group included 72 patients who had 80 red cells scans over a five year period. Thirty-eight scans were positive (47.5%), and 42 were negative (52.5%). Sites of lower GI bleeding were confirmed by endoscopy, arteriography, surgery and/or pathology in 22 of the 38 positive scans. There were four false-negative scans (9.5%). The overall sensitivity and specificity of TRCS in detecting lower GI bleeding was 84.6% (22/26) and 70.4% (38/54), respectively. The accuracy of localization of bleeding sites in the patients with confirmed positive scans was 72.7% (16/22). Thirty mesenteric arteriograms were performed on patients in this series. Eleven arteriograms were performed after negative TRCS; one was positive. Technetium-labelled red blood cell scintigraphy appears to be a useful screening examination for patients with lower GI bleeding who are hemodynamically stable. This may avoid the potential morbidity of arteriography in patients who are not actively bleeding.
Rantis
P C
PC
Department of Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois 60153, USA.
Harford
F J
FJ
Wagner
R H
RH
Henkin
R E
RE
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D004912:Erythrocytes / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D016698:Technetium Tc 99m Pyrophosphate; D013997:Time Factors; D014003:Tin Polyphosphates
D014003:Tin Polyphosphates; C017742:technetium Tc 99m stannous pyrophosphate; D016698:Technetium Tc 99m Pyrophosphate; D013670:Sodium Pertechnetate Tc 99m