Abdel-Dayem H M, Mahajan K K, Ericsson S, Nawaz K, Owunwanne A, Kouris K, Higazy E, Awdeh M
Clin Nucl Med. 1986 Nov;11(11):788-91. doi: 10.1097/00003072-198611000-00015.
Intravenous Tc-99m DTPA was evaluated in 34 patients with active upper gastrointestinal bleeding. Active bleeding was detected in 25 patients: nine in the stomach, 12 in the duodenum, and four from esophageal varices. No active bleeding was seen in nine patients (two gastric ulcers and seven duodenal ulcers). Results were correlated with endoscopic and/or surgical findings. All completely correlated except: 1) one case of esophageal varices in which there was disagreement on the site, 2) three cases of duodenal ulcers that were not bleeding on endoscopy but showed mild oozing on delayed images and 3) one case of gastric ulcer, in which no bleeding was detected in the Tc-99m DTPA study, but was found to be bleeding at surgery 24 hours later. The Tc-99m DTPA study is a reliable method for localization of upper gastrointestinal bleeding with an agreement ratio of 85%. This method also can be used safely for follow-up of patients with intermittent bleeding. It is less invasive than endoscopy, is easily repeatable, and has the same accuracy.
对34例活动性上消化道出血患者进行了静脉注射锝-99m二乙三胺五乙酸（Tc-99m DTPA）检查。在25例患者中检测到活动性出血：9例位于胃，12例位于十二指肠，4例来自食管静脉曲张。9例患者（2例胃溃疡和7例十二指肠溃疡）未见活动性出血。将结果与内镜和/或手术结果进行了对比。除以下情况外，所有结果完全相符：1）1例食管静脉曲张患者，在内镜检查和Tc-99m DTPA检查中，对出血部位的判断存在分歧；2）3例十二指肠溃疡患者，内镜检查未见出血，但延迟显像显示有轻度渗血；3）1例胃溃疡患者，Tc-99m DTPA检查未发现出血，但在24小时后的手术中发现有出血。Tc-99m DTPA检查是定位上消化道出血的可靠方法，符合率为85%。该方法也可安全地用于间歇性出血患者的随访。它比内镜检查侵入性小，易于重复，且准确性相同。
