Chen Paul Ning-Chuan, Brown Richard Kevin
Department of Radiology, University of Michigan Hospital, Ann Arbor, MI, USA.
J Radiol Case Rep. 2012 Feb;6(2):23-8. doi: 10.3941/jrcr.v6i2.844. Epub 2012 Feb 1.
Tc-99m labeled RBC scintigraphy is commonly employed in the evaluation of acute gastrointestinal bleeding. On Tc-99m RBC studies gastrointestinal bleeding is seen as an initial focus of increased radiotracer activity that on subsequent images increases in intensity and changes position in a pattern that conforms to segments of bowel. We report a case of a patient with multiple episodes of hematochezia that presented with lower gastrointestinal hemorrhage. A Tc-99m labeled RBC scan was performed and the findings suggested a GI bleed. However, subsequent angiography revealed prominent ileal varices simulating an acute bleed. Although most varices fill promptly and should not be misinterpreted as a focus of hemorrhage, slow filling varices can simulate an acute bleed and lead to a false positive interpretation.
锝-99m标记的红细胞闪烁扫描术常用于评估急性胃肠道出血。在锝-99m红细胞研究中，胃肠道出血表现为放射性示踪剂活性增加的初始灶，在后续图像中强度增加并按符合肠段的模式改变位置。我们报告一例有多次便血发作的患者，表现为下消化道出血。进行了锝-99m标记的红细胞扫描，结果提示胃肠道出血。然而，随后的血管造影显示明显的回肠静脉曲张，类似急性出血。虽然大多数静脉曲张迅速充盈，不应被误判为出血灶，但缓慢充盈的静脉曲张可类似急性出血并导致假阳性判读。
