technetium-tc-99m-sulfur-colloid and Varicose-Veins

Angiography has become an integral tool in the management of patients with gastrointestinal bleeding. It is used for localizing the site of bleeding and then for controlling the bleeding when more conservative methods of treatment are unsuccessful.

Topics: Angiography; Blood Vessels; Endoscopy; Erythrocytes; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Hemostatic Techniques; Humans; Intestine, Small; Mesenteric Veins; Peptic Ulcer Hemorrhage; Postoperative Complications; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Varicose Veins; Vasopressins

Lymphoscintigraphy, using technetium-99m-labeled sulphur microcolloid, was employed to study the flow and transport of lymph in the lower extremities of 39 consecutive patients in whom lymphedema of one or both legs was suspected clinically. Time-activity curves of four segments of each leg were evaluated for lymph capacity, flow and soft-tissue uptake, and compared with the results from film scintigraphy. Curve analysis provided quantitative evaluation of the extent of hypoplasia or aplasia in primary lymphedema and of lymphatic obstruction in secondary lymphedema, and is particularly suited to assess the involvement of lymphatics in chronic venous disease. Film scintigraphy, on the other hand, is preferable in cases in which the pattern of activity distribution in the affected extremity is diagnostic, such as in dermal back flow, traumatic lymphocele, or megalymphatics. Venography is most informative in cases of suspected underlying venous disease, but the role of lymphangiography, which shows only part of the lymphatic system and requires incision of the edematous tissues, is considered questionable.

Topics: Adult; Aged; Female; Humans; Leg; Lymphatic System; Lymphedema; Lymphoscintigraphy; Male; Middle Aged; Technetium Tc 99m Sulfur Colloid; Thrombophlebitis; Tin; Tin Compounds; Varicose Veins

We have developed a single scintigraphic technique to detect and localize the site of bleeding in the gastrointestinal tract. This examination requires only intravenous administration of 99m-Technetium sulfur colloid and imaging of the abdomen. Very shortly after the introduction of the radiopharmaceutical, a fraction of the injected activity extravasates at the bleeding site and is eliminated from the circulation. This phenomenon is repeated each time the blood recirculates adding another, but smaller fraction to the extravasated activity at the site of hemorrhage. Because of continued clearance of the radiopharmaceutical from the vascular pool by the reticuloendothelial system, a contrast is eventually reached between the site of bleeding and surrounding background. Based on animal experiments bleeding rates as low as .05-0.1 cc/min can be detected with this technique. The sensitivity of the approach in the detection of the site of hemorrhage is significantly higher than arteriography or other techniques which utilize radioactive blood pool indicators. We have mainly used this technique in the evaluation of patients with GI bleeding. In more than 25 patients with negative scintigrams for hemorrhage, arteriography showed no evidence of bleeding. In 38 patients with scintigraphic evidence of bleeding. In 38 patients with scintigraphic evidence of hemorrhage, arteriograms were positive for bleeding in les than 50% of the cases. No false positive results have been noted in the latter group. This technique appears to offer a simple, practical and reliable approach to the evaluation of patients with gastrointestinal bleeding.

Topics: Angiography; Colloids; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Humans; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Varicose Veins