The lymphoscintigraphic manifestation of (99m)Tc-dextran lymphatic imaging in primary intestinal lymphangiectasia.
OBJECTIVE
The aim of this study was to analyze the imaging characteristics of (99m)Tc-dextran ((99m)Tc-DX) lymphatic imaging in the diagnosis of primary intestinal lymphangiectasia (PIL).


METHODS
Forty-one PIL patients were diagnosed as having PIL with the diagnosis being subsequently confirmed by laparotomy, endoscopy, biopsy, or capsule colonoscopy. Nineteen patients were male and 22 were female. A whole-body (99m)Tc-DX scan was performed at 10 min, 1 h, 3 h, and 6 h intervals after injection. The 10 min and 1 h postinjection intervals were considered the early phase, the 3 h postinjection interval was considered the middle phase, and the 6 h postinjection interval was considered the delayed phase.


RESULTS
The imaging characteristics of (99m)Tc-DX lymphatic imaging in PIL were of five different types: (i) presence of dynamic radioactivity in the intestine, associated with radioactivity moving from the small intestine to the ascending and transverse colon; (ii) presence of delayed dynamic radioactivity in the intestine, no radioactivity or little radioactivity distributing in the intestine in the early phase, or significant radioactivity distributing in the intestine in the delayed phase; (iii) radioactivity distributing in the intestine and abdominal cavity; (iv) radioactivity distributing only in the abdominal cavity with no radioactivity in the intestines; and (v) no radioactivity distributing in the intestine and abdominal activity.


CONCLUSIONS
(99m)Tc-DX lymphatic imaging in PIL showed different imaging characteristics. Caution should be exercised in the diagnosis of PIL using lymphoscintigraphy. Lymphoscintigraphy is a safe and accurate examination method and is a significant diagnostic tool in the diagnosis of PIL.
Departments of aNuclear Medicine bRadiology, Beijing Friendship Hospital cDepartment of Nuclear Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China dRadiology of Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Zhe
Z
Wen
Guansheng
G
Tong
Yong
Y
Liu
Jacqui K
JK
Meeks
Daqing
D
Ma
Jigang
J
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003911:Dextrans; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008201:Lymphangiectasis, Intestinal / Q000000981:diagnostic imaging*; D061305:Lymphoscintigraphy; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D012189:Retrospective Studies; D055815:Young Adult
D003911:Dextrans; D015609:Organotechnetium Compounds; C034146:technetium Tc 99m dextran