Asian Journal of Nuclear Medicine

Volume 2 Number 1, March 2002



目的 評價放射性核素顯像對胃腸出血的診斷價值。方法 本科對自1994年2月至2000年4月受檢的65例臨床懷疑活動性胃腸出血患者進行了標記紅細胞顯像,並對其中14例20歲以下患者加做了Meckel憩室顯像。結果 胃腸出血患者核素顯像陽性率為60.0%。其中僅延遲顯像陽性者14例,佔35.9%。核素檢查前曾使用過止血藥的患者陽性率僅為18.2%,遠低於未曾使用者陽性率68.5%(37/54)。Meckel憩室核素顯像診斷準確性為92.9%。結論 核素顯像在診斷胃腸出血的定位上具有簡便、經濟、無創、靈敏、可長時間觀察和多次重複等特點,是當前內窺鏡和DSA檢查的必要補充。Meckel憩室核素顯像可能是目前胃粘膜異位症定位及定性診斷的首選方法。

【關鍵詞】 核素顯像;胃腸出血;Meckel憩室

The clinical evaluation of gastrointestinal bleeding scintigraphy

Chen Libo, Jin Changqin, Luo Quanyong, Lu Hankui, Zhu Jifang, Zhu Ruisen
Department of Nuclear Medcine, Shanghai 6th People's Hospital,Shanghai 200233, China

Objective To assess the clinical utility of 99mTc-labeled red blood cells (RBCs) and 99mTc-pertechnetate in the diagnosis of gastrointestinal (GI) bleeding and suspected Meckel's diverticulum respectively. Methods A total of 65 patients suspected of having active gastrointestinal bleeding undertook GI bleeding scintigraphy using 99mTc-labeled RBCs during the period from Feb. 1994 to Apr. 2000. Meckel's diverticulum scintigraphy was performed additionally in 14 patients under the age of 20. Results We found a sensitivity of 60% on red cell scintigraphy in the detection of gastrointestinal (GI) bleeding and 35.9% of the positive results (14 cases) were found on delayed imaging. Only 18.2% of patients who had been administered haemostatics showed positive results, which is much less than that (68.5%) of those who hadn't. The accuracy of Meckel's diverticulum scintigraphy is 92.9%. Conclusion Scintigraphy with labeled RBCs is a necessary complement to endoscopy and angiography because it provides a convenient, economic, non-invasive and sensitive method to locate gastrointestinal bleeding site and permits continuous monitoring over hours. Sodium pertechnetate scintigraphy in Meckel's diverticulum as a method to diagnose and locate ectopic gastric mucosa may be the procedure of choice at present.

Key Words: Radionuclide scintigraphy; gastrointestinal bleeding; Meckel's diverticulum

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