title: Evaluation of active bleeding into hematomas by technetium-99m red blood cell scintigraphy before angiography.
abstract: OBJECTIVE
  To evaluate the utility of technetium-99m red blood cell (Tc-99m RBC) scintigraphy in the diagnosis of active hemorrhage into large intra-abdominal hematomas before arteriography.
  
  
  METHODS
  This retrospective case series describes four patients (1 man and 3 women) with large abdominal wall and retroperitoneal hematomas confirmed by computed tomography who underwent Tc-99m RBC scintigraphy before angiography. Arterial transcatheter embolization was performed if active hemorrhage was found.
  
  
  RESULTS
  Three of the patients had positive findings on Tc-99m RBC scans, which showed spreading of the labeled erythrocytes into the hematoma space. Positive scintigraphy was diagnostic for active hemorrhage and helped localize the bleeding sites. Angiography confirmed the diagnosis in all patients with positive scintigraphy and ruled out active bleeding in the patient with a negative Tc-99m-labeled RBC scan.
  
  
  CONCLUSIONS
  Tc-99m RBC scintigraphy appears to be sensitive and accurate in detecting active hemorrhage into intra-abdominal hematomas.
authors.affiliation: Division of Interventional Radiology, University of California, San Francisco, California 94143-0628, USA. Mark.Wilson@radiology.ucsf.edu
authors.forename: Mark W
authors.initials: MW
authors.lastname: Wilson
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fidelman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Lull
authors.forename: Shelley R
authors.initials: SR
authors.lastname: Marder
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Laberge
authors.forename: Robert K
authors.initials: RK
authors.lastname: Kerlan
authors.forename: Roy L
authors.initials: RL
authors.lastname: Gordon
mesh_terms: D034861:Abdominal Wall / Q000098:blood supply / Q000000981:diagnostic imaging; D000328:Adult; D004912:Erythrocytes / Q000000981:diagnostic imaging*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging*; D006470:Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012187:Retroperitoneal Space / Q000098:blood supply / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013667:Technetium
chemical_list: D019275:Radiopharmaceuticals; D013667:Technetium