technetium-tc-99m-sulfur-colloid and Abscess

Despite the fact that the spleen has multiple functions, only one has been widely used for evaluation of the organ by imaging techniques (phagocytosis of 99mTc sulfur colloid). The usual splenic uptake of this radiocolloid can by used to determine the size, location, and integrity of the organ. A major use of splenic radiocolloid imaging has been in the study of congenital defects. Thus, eventration of the diaphragm, accessory spleens, splenogonadal fusion, the asplenia and polysplenia syndromes, and the wandering spleen are amenable to study by means of intravenously administered radiocolloid. Interference with the splenic uptake of radiocolloid can be either focal or generalized (as in functional asplenia). Imaging of the spleen has a major role in evaluating suspected trauma of the organ and in following its clinical course. The return of splenic function after splenectomy (splenosis or accessory spleens) can be documented by radionuclide imaging, and likely by hematologic techniques when the volume of tissue is sufficiently large. The detection of intrasplenic lesions is important in tumor staging and as an alerting sign to an ongoing process.

Topics: Abscess; Adult; Child; Child, Preschool; Cysts; Diaphragmatic Eventration; Humans; Hypersplenism; Phagocytosis; Postoperative Complications; Radiation Dosage; Radionuclide Imaging; Spleen; Splenic Diseases; Splenic Neoplasms; Splenic Rupture; Splenomegaly; Technetium Tc 99m Sulfur Colloid

Topics: Abscess; Animals; Dogs; Gallium Radioisotopes; Humans; Indium; Inflammation; Leukocytes; Methods; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Abscess; Extravasation of Diagnostic and Therapeutic Materials; Humans; Male; Middle Aged; Pelvis; Peritoneal Dialysis; Peritoneal Diseases; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Rectum; Technetium Tc 99m Sulfur Colloid; Urinary Bladder; Urinary Bladder Fistula

A case of 65-year-old man with tuberculous splenic abscess is presented. The Ga-67 citrate scan revealed three focal areas of increased uptake in the left upper quadrant of the abdomen. The combined Tc-99m SC/Ga-67 scans revealed that these Ga-67 avid lesions localized in the splenic photon-deficit areas found in the Tc-99m SC scan. This case demonstrated the usefulness of Ga-67 imaging in a survey of fever of unknown origin in unsuspected tuberculous splenic abscess.

Topics: Abscess; Aged; Gallium Radioisotopes; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Tuberculosis, Splenic

Topics: Abscess; Adolescent; Citrates; Citric Acid; Fusobacterium Infections; Gallium Radioisotopes; Hematoma; Humans; Laparotomy; Male; Radionuclide Imaging; Splenic Diseases; Subtraction Technique; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

During a prolonged hospital stay, left hip pain developed in a woman with sickle cell disease and bilateral hip prostheses. In-111 labeled WBC scintigraphy supplemented by Tc-99m SC bone marrow imaging demonstrated abnormal WBC accumulation surrounding the left greater trochanter. Results of surgical exploration showed an abscess involving the pseudocapsule, trochanteric bursa, and periprosthetic cement column. Cultures grew Clostridium difficile, an unusual pathogen in this site.

Topics: Abscess; Adult; Anemia, Sickle Cell; Bone Marrow; Clostridioides difficile; Clostridium Infections; Female; Hip Prosthesis; Humans; Indium Radioisotopes; Leukocytes; Prosthesis-Related Infections; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Abscess; Adult; Female; Humans; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach Diseases; Subphrenic Abscess; Technetium Tc 99m Sulfur Colloid

A patient with fungal splenic abscesses is presented in whom multiple noninvasive diagnostic imaging modalities were available for correlation. Of the five imaging modalities, three (Gallium-67, ultrasound and computed tomography) were diagnostically useful, while two (liver-spleen scan and In-111 white blood cell scan) were not as useful. This case also stresses the use of repeated studies correlating with clinical impressions to obtain an accurate diagnosis in a potentially life-threatening condition such as splenic abscess.

Topics: Abscess; Adolescent; Candidiasis; Gallium Radioisotopes; Humans; Immune Tolerance; Indium; Leukemia, Monocytic, Acute; Liver; Male; Radioisotopes; Radionuclide Imaging; Spleen; Splenic Diseases; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

A case of a 23-year-old man with an encapsulated, anaerobic splenic abscess is reported. Both the In-111 leukocyte and Tc-99m sulfur colloid scans demonstrated an intrasplenic defect. The Ga-67 citrate scan revealed uptake in the rim of the abscess only where the abscess cavity was relatively photon-deficient. The combined Tc-99m sulfur colloid/In-111 leukocyte/Ga-67 scan appearance of a subacute splenic abscess has not been described previously. In cases suspected to be splenic abscesses the combined In-111 leukocyte/Tc-99m sulfur colloid imaging is the most useful.

Topics: Abscess; Adult; Gallium Radioisotopes; Humans; Indium; Leukocytes; Male; Radioisotopes; Radionuclide Imaging; Splenic Diseases; Technetium Tc 99m Sulfur Colloid

Indium-111-labeled leukocyte scanning is an excellent technique for detecting abdominal abscesses. However, since labeled leukocytes are normally taken up by the liver and spleen, diagnosing upper abdominal abscesses can be difficult. A prospective study was undertaken to see if having a technetium-99m sulfur colloid liver-spleen scan to compare with the 111In leukocyte scan would improve the reader's ability to diagnose or exclude upper abdominal abscesses. Ninety patients with suspected upper abdominal abscesses were examined with 111In leukocyte scans followed immediately by conventional 99mTc sulfur colloid liver-spleen scans in the same projections. In 57% of patients with upper abdominal abscesses and 26% of all patients studied, the 99mTc sulfur colloid scan was essential to diagnose or exclude an upper abdominal abscess. The liver-spleen scan was considered helpful in another 13%. The addition of a 99mTc sulfur colloid liver-spleen scan to the 111In leukocyte study is useful when evaluating patients with suspected upper abdominal abscesses.

Topics: Abdomen; Abscess; Adult; Aged; Female; Humans; Indium; Leukocytes; Liver; Male; Middle Aged; Prospective Studies; Radioisotopes; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid

After undergoing therapeutic transcatheter embolization of the splenic artery for treatment of portal hypertension, 11 consecutive patients were evaluated with sulfur colloid scintigraphy and real-time sonography of the left upper quadrant to determine which method was better for follow-up evaluation of the spleen. Six splenic infarcts were documented by both imaging methods; sonography, however, demonstrated the characteristic wedge shape of the infarct in four of the six cases. There were no cases of splenic abscess formation. Sonography should be the primary method for evaluation of the spleen after transcatheter embolization and can help in planning treatment to avoid abscess formation.

Topics: Abscess; Acute Disease; Diagnosis, Differential; Embolization, Therapeutic; Follow-Up Studies; Humans; Hypertension, Portal; Radionuclide Imaging; Splenic Infarction; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Topics: Abscess; Aged; Diagnosis, Differential; Female; Gallium Radioisotopes; Humans; Pentetic Acid; Radionuclide Imaging; Retroperitoneal Space; Sepsis; Sulfur; Technetium; Technetium Tc 99m Pentetate; Technetium Tc 99m Sulfur Colloid

A 43-year-old man with acute undifferentiated leukemia developed high fever and stomatitis followed by severe abdominal pain after completion of a first course of chemotherapy. A 99mTc-sulfur colloid (SC) scan showed multiple, irregular defects in an enlarged spleen. A 67Ga-citrate scan showed uniform tracer distribution except for a large defect in the upper portion of the spleen. The size of the spleen in the 67Ga-scan was much larger than in the SC scan. At surgery an abscess cavity was found between the spleen and the greater gastric curvature with multiple smaller abscesses on the splenic capsule and throughout the splenic parenchyma. A hematoma was present in the upper pole of the spleen. The disparate splenic size and seemingly discordant distribution patterns of tracer in the 99mTc- and 67Ga-scans were fully explained by histopathological study of the surgically resected spleen.

Topics: Abscess; Acute Disease; Adult; Aspergillosis; Gallium Radioisotopes; Humans; Leukemia; Male; Radionuclide Imaging; Splenic Diseases; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

A case of portal vein obstruction with cavernous transformation is presented, in which findings on both Tc-99m-sulfur colloid and HIDA liver scintigrams suggested the diagnosis. These findings included a focal hyperconcentration of colloid on the former and notching of the common bile duct as well as "draping" of the right hepatic duct on the latter. All of these findings were shown at angiography and surgery to be secondary to extensive venous collateral vessels related to portal vein obstruction.

Topics: Abscess; Adult; Bile Ducts, Intrahepatic; Collateral Circulation; Common Bile Duct; Humans; Imino Acids; Liver; Male; Portal Vein; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid; Thrombosis

Topics: Abscess; Adult; Aeromonas; Antineoplastic Agents; Escherichia coli Infections; Female; Gallium Radioisotopes; Humans; Immunosuppression Therapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Splenic Diseases; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Ultrasonography