Evaluation of active bleeding into hematomas by technetium-99m red blood cell scintigraphy before angiography.
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.
Wilson
Mark W
MW
Division of Interventional Radiology, University of California, San Francisco, California 94143-0628, USA. Mark.Wilson@radiology.ucsf.edu
Fidelman
Nicholas
N
Lull
Robert J
RJ
Marder
Shelley R
SR
Laberge
Jeanne M
JM
Kerlan
Robert K
RK
Gordon
Roy L
RL
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
D019275:Radiopharmaceuticals; D013667:Technetium