Kotani Kohei, Kawabe Joji, Higashiyama Shigeaki, Yoshida Atsushi, Kawamura Etsushi, Kawahata Hideki, Yamanaga Takashi, Katayama Yutaka, Shiomi Susumu
Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan,
Abdom Imaging. 2014 Aug;39(4):677-84. doi: 10.1007/s00261-014-0111-3.
Gastrointestinal (GI) bleeding scintigraphy in combination with single-photon emission computed tomography/computed tomography (SPECT/CT) remains to be studied in detail. This study aimed to examine the diagnostic ability of this tool.
GI bleeding scintigraphy using (99m)Tc-human serum albumin-diethylenetriaminepentaacetic acid was performed for 38 patients with suspected GI bleeding. Twenty-four patients were diagnosed using planar images alone (planar group) and 14 patients were diagnosed using planar images and additional SPECT/CT images (planar + SPECT/CT group). The diagnostic ability of each method was analyzed.
GI bleeding was observed in 20 of the 38 patients. For the existence of GI bleeding, planar images alone showed a sensitivity of 70%, specificity of 93%, positive predictive value (PPV) of 88%, negative predictive value (NPV) of 81%, and an overall accuracy of 83%, whereas planar images + SPECT/CT showed a sensitivity of 100%, specificity of 75%, PPV of 91%, NPV of 100%, and an overall accuracy of 93%. The source of bleeding was accurately diagnosed in 50% in the planar group and 78% in the planar + SPECT/CT group. In the planar + SPECT/CT group, 44% of the evaluable patients showed correct localization of the source of GI bleeding by additional SPECT/CT images, although planar images only showed incorrect localization.
GI bleeding scintigraphy in combination with SPECT/CT is a noninvasive and useful tool for the examination of GI bleeding.
胃肠道（GI）出血闪烁扫描术联合单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）仍有待详细研究。本研究旨在检验该工具的诊断能力。
对38例疑似胃肠道出血患者进行了使用（99m）Tc-人血清白蛋白-二乙三胺五乙酸的胃肠道出血闪烁扫描术。24例患者仅使用平面图像进行诊断（平面组），14例患者使用平面图像及额外的SPECT/CT图像进行诊断（平面+SPECT/CT组）。分析了每种方法的诊断能力。
38例患者中有20例观察到胃肠道出血。对于胃肠道出血的存在，仅平面图像显示灵敏度为70%，特异性为93%，阳性预测值（PPV）为88%，阴性预测值（NPV）为81%，总体准确率为83%，而平面图像+SPECT/CT显示灵敏度为100%，特异性为75%，PPV为91%，NPV为100%，总体准确率为93%。平面组中50%的患者出血源被准确诊断，平面+SPECT/CT组中这一比例为78%。在平面+SPECT/CT组中，44%的可评估患者通过额外的SPECT/CT图像显示胃肠道出血源定位正确，尽管平面图像仅显示定位错误。
胃肠道出血闪烁扫描术联合SPECT/CT是一种用于检查胃肠道出血的无创且有用的工具。
