technetium-tc-99m-pyrophosphate and Colonic-Diseases

Gastrointestinal complications are more common in children than in adults and present a serious problem with dermatomyositis. We report on a 66-yr-old man with dermatomyositis who suffered from intestinal perforation. The abdominal plain radiograph revealed only dilatation of the intestinal loops; increased radioactivity, however, was clearly demonstrated in the early 5-min and delayed 3-hr 99mTc-pyrophosphate images.

Topics: Aged; Colonic Diseases; Dermatomyositis; Diverticulitis, Colonic; Humans; Intestinal Perforation; Male; Radiography; Radionuclide Imaging; Technetium Tc 99m Pyrophosphate

Radionuclide scintigraphy is commonly utilized as a screening examination before performing more invasive procedures in the work-up of patients with lower gastrointestinal (GI) bleeding. We reviewed our institutional experience with technetium-labelled red blood cell scintigraphy (TRCS) in detecting and localising acute lower GI bleeding. The study group included 72 patients who had 80 red cells scans over a five year period. Thirty-eight scans were positive (47.5%), and 42 were negative (52.5%). Sites of lower GI bleeding were confirmed by endoscopy, arteriography, surgery and/or pathology in 22 of the 38 positive scans. There were four false-negative scans (9.5%). The overall sensitivity and specificity of TRCS in detecting lower GI bleeding was 84.6% (22/26) and 70.4% (38/54), respectively. The accuracy of localization of bleeding sites in the patients with confirmed positive scans was 72.7% (16/22). Thirty mesenteric arteriograms were performed on patients in this series. Eleven arteriograms were performed after negative TRCS; one was positive. Technetium-labelled red blood cell scintigraphy appears to be a useful screening examination for patients with lower GI bleeding who are hemodynamically stable. This may avoid the potential morbidity of arteriography in patients who are not actively bleeding.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Colonic Diseases; Erythrocytes; False Negative Reactions; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Radionuclide Imaging; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Pyrophosphate; Time Factors; Tin Polyphosphates

Topics: Adult; Colonic Diseases; Diphosphates; Erythrocytes; Factitious Disorders; Female; Gastrointestinal Hemorrhage; Humans; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate