Lutzker L G
Semin Nucl Med. 1983 Jul;13(3):184-98. doi: 10.1016/s0001-2998(83)80015-4.
After the introduction of Tc-99m sulfur colloid and the gamma camera, radiocolloid liver-spleen imaging displaced angiography as the primary modality for diagnosing injury because of its sensitivity and non-invasiveness. A splenic defect may be nonspecific since it can be caused by a congenital variant. Specificity can be increased by awareness of common morphologic variations and judicious use of detector angulation to separate an overlapping left lobe. An increased incidence of overwhelming sepsis in postsplenectomy patients led to a more conservative approach to splenic injury, aided by sequential scintigraphy to demonstrate healing of traumatic defects. This decreased the significance of an initial false-positive scan that was caused by congenital variation, since the clinical "bottom line" was failure of a defect to enlarge or cause delayed rupture. Computed tomography (CT) is also a sensitive method of diagnosing injury or spleen and liver as well as other intraabdominal organs such as the kidneys. Its performance has not been compared to simultaneous multiorgan scintigraphy, an underutilized but very useful approach.
随着锝-99m硫胶体和γ相机的引入，放射性胶体肝脾显像因其敏感性和非侵入性，取代血管造影成为诊断损伤的主要方式。脾缺损可能是非特异性的，因为它可能由先天性变异引起。通过了解常见的形态学变异并明智地使用探测器角度来分离重叠的左叶，可以提高特异性。脾切除术后患者暴发性败血症的发生率增加，导致对脾损伤采取更保守的方法，连续闪烁显像有助于证明创伤性缺损的愈合。这降低了由先天性变异引起的初始假阳性扫描的重要性，因为临床“底线”是缺损没有扩大或导致延迟破裂。计算机断层扫描（CT）也是诊断脾、肝以及其他腹内器官如肾脏损伤的敏感方法。其性能尚未与同步多器官闪烁显像进行比较，同步多器官闪烁显像虽未得到充分利用，但却是一种非常有用的方法。
