Soyluoğlu Selin, Korkmaz Ülkü, Özdemir Büşra, Durmuş Altun Gülay
Trakya University Faculty of Medicine, Department of Nuclear Medicine, Edirne, Turkey.
Mol Imaging Radionucl Ther. 2021 Feb 9;30(1):8-17. doi: 10.4274/mirt.galenos.2020.24392.
Gastrointestinal bleeding (GIB) is a life-threatening problem that requires a multidisciplinary approach for successful treatment. This study aims to emphasize the clinical contribution of single photon emission computed tomography/computed tomography (SPECT/CT) for the diagnosis of acute bleeding.
All 14 patients referred to the nuclear medicine department in 3 years with suspicion of acute GIB were evaluated retrospectively. Clinical records were analyzed to assess the scintigraphic findings, emphasizing the correlative contribution of the CT portion on SPECT/CT studies.
Five patients were negative on dynamic and static planar images. SPECT/CT was performed in 9 patients who had positive findings on planar imaging. SPECT/CT could identify the same bleeding site originating from the anastomosis in four patients with a history of abdominal surgery. SPECT/CT confirmed bleeding from the cecum in a patient with cervical cancer. SPECT/CT showed the bleeding focus in the bladder neck of a patient with bladder cancer and the bleeding from peritoneal metastases of a patient with gastric cancer. In 1 patient, the right upper quadrant activity accumulation, which may cause false positives, was found to be the gallbladder on SPECT/CT. Delayed images showed the true bleeding focus in the cecum. In 1 patient, suspicious activity accumulation in the midline of the abdomen was found to be due to a previously unknown aortic aneurysm on SPECT/CT.
SPECT/CT imaging is a feasible technique to facilitate image interpretation in patients with GIB. SPECT/CT imaging can guide the surgeon through more accurate localization. Therefore, for proper patient management, SPECT/CT should be applied to detect the bleeding focus, if present, especially in patients who had undergone a previous operation.
胃肠道出血（GIB）是一个危及生命的问题，需要多学科方法才能成功治疗。本研究旨在强调单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）对急性出血诊断的临床贡献。
回顾性评估3年内转诊至核医学科的14例疑似急性GIB患者。分析临床记录以评估闪烁显像结果，重点强调SPECT/CT研究中CT部分的相关贡献。
5例患者的动态和静态平面图像为阴性。9例平面成像有阳性结果的患者进行了SPECT/CT检查。SPECT/CT能够识别4例有腹部手术史患者吻合口处的同一出血部位。SPECT/CT证实1例宫颈癌患者盲肠出血。SPECT/CT显示1例膀胱癌患者膀胱颈部的出血灶以及1例胃癌患者腹膜转移灶的出血。在1例患者中，SPECT/CT发现右上腹的活性积聚可能导致假阳性，实际为胆囊。延迟图像显示盲肠为真正的出血灶。在1例患者中，SPECT/CT发现腹部中线可疑的活性积聚是由先前未知的主动脉瘤引起的。
SPECT/CT成像是一种可行的技术，有助于GIB患者的图像解读。SPECT/CT成像可通过更准确的定位为外科医生提供指导。因此，为了对患者进行恰当的管理，如果存在出血灶，尤其是既往接受过手术的患者，应应用SPECT/CT来检测出血灶。
