el-Shirbiny A, Fernandez R, Zuckier L S
Department of Nuclear Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Clin Nucl Med. 1995 Aug;20(8):691-4.
Tc-99m RBC scintigraphy is favored by many investigators because it provides the ability to image the abdomen over a prolonged period of time, thereby allowing identification of delayed bleeding sites that are frequently encountered due to the intermittent nature of gastrointestinal bleeding. The authors describe a case of bleeding scintigraphy with labeled red blood cells in which the bleeding site was identifiable only on the dynamic blood-flow and first static images. On later images, the labeled blood cells had spread throughout the colon, rendering localization of the actual bleeding site impossible. Two previous red blood cell scintigraphies and a subsequent contrast angiogram did not reveal sites of active bleeding. As illustrated by this unusual case, factors governing timing and visualization of abnormal bleeding sites are discussed, as is a differential diagnosis of abnormal foci of activity seen on the dynamic phase of bleeding scintigraphy.
锝-99m红细胞闪烁扫描术受到许多研究者的青睐，因为它能够在较长时间内对腹部进行成像，从而能够识别出由于胃肠道出血的间歇性而经常遇到的延迟出血部位。作者描述了一例标记红细胞出血闪烁扫描的病例，其中出血部位仅在动态血流和首次静态图像上可识别。在随后的图像上，标记的血细胞已扩散至整个结肠，无法定位实际出血部位。之前的两次红细胞闪烁扫描及随后的血管造影均未发现活动性出血部位。通过这个不寻常的病例，讨论了决定异常出血部位显影时间的因素，以及对出血闪烁扫描动态期所见异常活性灶的鉴别诊断。
