technetium-tc-99m-sulfur-colloid and Heart-Defects--Congenital

For the evaluation of a variety of hepatosplenic disorders, SPECT complements planar 99mTc-sulfur colloid liver/spleen imaging. By isolating small, ectopic or poorly functioning spleen(s) from overlying or adjacent liver, SPECT imaging should facilitate identification of splenic tissue in infants with suspected heterotaxy syndrome.. During a 10-yr period, 10 planar-only and 9 planar-plus-SPECT liver/spleen scans were obtained from 15 infants, 13 of whom were less than 1 mo of age at first examination. Four of the planar-only group had follow-up planar-plus-SPECT imaging. Scintigraphic diagnosis regarding presence of splenic tissue was correlated with clinical diagnosis.. Thirteen infants had splenic tissue; two were asplenic. Planar-only imaging provided correct diagnoses in six [four with, two without spleen(s)] but was negative or equivocal in four infants. Planar-plus-SPECT imaging was positive in all in whom it was performed; moreover, in 4/13 infants (31%), splenic tissue was documented only by SPECT imaging.. Particularly when planar views are inconclusive, SPECT imaging is invaluable for identification and localization of functioning splenic tissue in infants with suspected heterotaxy syndrome.

Topics: Abnormalities, Multiple; Female; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Liver; Male; Retrospective Studies; Sensitivity and Specificity; Situs Inversus; Spleen; Syndrome; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon

Topics: Colloids; Female; Heart Defects, Congenital; Humans; Infant, Newborn; Radionuclide Imaging; Spleen; Splenic Diseases; Sulfur; Syndrome; Technetium; Technetium Tc 99m Sulfur Colloid

Asplenia was suspected in one patient with combined immunodeficiency syndrome and 5 with congenital cardiac anomalies who had Howell-Jolly bodies on peripheral blood smears. 99mTc-sulfur colloid scans were equivocal for absence of the spleen. When they were compared with the 99mTc-PIPIDA hepatobiliary images, a discrepancy in organ morphology between the two scans indicated that the spleen was present, whereas similarity of the two images suggested asplenia. This procedure was useful in establishing asplenia in 4 patients and confirming the presence of a rudimentary or ectopic spleen in 2 others. Unequivocal demonstration of the spleen on the sulfur colloid scans makes the hepatobiliary study unnecessary, while unequivocal demonstration of a normal-appearing liver without splenic activity may warrant a tagged red-cell study for a more complete evaluation.

Topics: Erythrocyte Inclusions; Female; Heart Defects, Congenital; Humans; Imino Acids; Immunologic Deficiency Syndromes; Infant; Infant, Newborn; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Spleen; Sulfur; Syndrome; Technetium; Technetium Tc 99m Sulfur Colloid