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

A prospective study of 16 patients with hemoptysis was conducted over a 2 1/2-year period. Technetium-99m sulfur colloid (Tc-SC) and technetium-99m-labeled red blood cells (Tc-RBC) were sequentially used to identify the general area of bleeding. Tc-SC accurately located the bleeding area in 3 patients and Tc-RBC identified the bleeding area in 8; there were no false-positive studies. Tc-SC scans were positive at 6-10 minutes and all patients had positive Tc-RBC studies. In general, the scans accurately located the source of bleeding as determined by bronchoscopy and/or surgery. Because of the small sample, statistically significant differences between both techniques were not ascertained. Both Tc-SC and Tc-RBC may prove to be helpful, minimally invasive imaging procedures for determining the general area of hemorrhage in patients with clinically significant hemoptysis. Although a trend suggests that Tc-RBC is a more sensitive method, further comparison is needed for corroboration.

Topics: Adult; Aged; Bronchoscopy; Erythrocytes; Female; Hemoptysis; Humans; Male; Middle Aged; Prospective Studies; Radiography; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Lung scans with technetium sulfur colloid were performed in ten patients with life-threatening hemoptysis and nondiagnostic chest roentgenograms. Localized deposition of radionuclide was demonstrated in five of the six patients who were studied during active bleeding. These abnormalities were confirmed bronchoscopically in four patients, and lung scans provided clinically useful information regarding the bleeding site that had not been available from the medical history, physical examination, or chest roentgenogram. Evaluation with radionuclide scanning may complement bronchoscopic and roentgenographic studies in selected patients with massive pulmonary hemorrhage.

Topics: Adult; Colloids; Hemoptysis; Humans; Lung; Male; Middle Aged; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Topics: Adolescent; Adult; Aged; Carcinoma, Bronchogenic; Female; Hemoptysis; Humans; Lung; Lung Diseases, Obstructive; Lung Neoplasms; Male; Middle Aged; Radiography; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tuberculosis, Pulmonary

Radionuclide imaging has been successfully used clinically to determine sites of gastrointestinal hemorrhage, but its use in hemoptysis has not been studied. A dog model of intrapulmonary hemorrhage was devised. Utilizing technetium sulfur colloid, at doses of 4 and 15 mCi, bleeding rates of 0.1--0.2 cc/min were detected. In some dogs, however, significantly higher bleeding into a large bronchus, which causes a diffuse distribution of the radionuclide.

Topics: Animals; Colloids; Dogs; Hemoptysis; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Time Factors

Pulmonary hemorrhage, whether in the form of hemoptysis or bleeding into the pleural space, may be a life threatening problem. While fiberoptic bronchoscopy and selective bronchial and intercostal angiography are the major diagnostic modalities, these techniques are not without risks. Two patients are described-one with massive hemoptysis from a bronchogenic carcinoma; another with pleural bleeding from a torn intercostal artery-in whom Tc-99m-sulfur colloid scintigraphy accurately located the source of hemorrhage. We conclude that Tc-99m-sulfur colloid scintigraphy may be a helpful noninvasive method to increase the sensitivity and specificity of fiberoptic bronchoscopy and bronchial angiography in patients with massive pulmonary bleeding.

Topics: Adult; Angiography; Bronchoscopy; Carcinoma, Bronchogenic; Diagnosis, Differential; Fiber Optic Technology; Hemoptysis; Hemorrhage; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Pleura; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid