99mTc—RBC显像对小肠出血的诊断价值  

Diagnostic Value of 99mTc-RBC Scintigraphy in Small Bowel Bleeding

作　　者：高树兴[1] 桂文来[1] 将灵军[1] 王玲珑[1] 张志刚[1] 刘晓杰[1] 丁育松[1] 

机构地区：[1]浙江省嘉兴市第一医院/嘉兴学院附属第一医院,浙江嘉兴314000

出　　处：《中国肛肠病杂志》2012年第11期12-13,共2页Chinese Journal of Coloproctology

摘　　要：为探讨99mTc-RBC显像对小肠出血定性及定位诊断的意义，对27例临床高度怀疑小肠出血患者，常规行放射、超声等检查未能明确诊断，后行99mTc-RBC显像检查，阳性者以铅块遮挡法进行体表定位，据此进行手术治疗，阴性者常规行剖腹探查。结果显示，25例99mTc-RBC显像呈阳性，阳性率为92．6％，其中有19例显像提示出血部位与病灶部位相符，有6例显像提示出血部位与病灶部位不符，2例呈阴性。手术结果提示，25例阳性病例中，平滑肌瘤16例，血管畸形6例，小肠炎2例，血管瘤1例；6例显像提示出血部位与病灶部位不符，均为平滑肌瘤。2例阴性，1例为空肠平滑肌瘤，1例为空肠炎症。结果表明，99mTc-RBC显像具有敏感性高、安全无创、操作简单、可重复检查等优点，对小肠出血的定位诊断以及指导临床手术治疗具有较大的临床意义和应用价值。This study aimed to discuss the diagnostic value of 99mTc-RBC scintigraphy in confirming the na- ture and site of small bowel bleeding. Twenty-seven clinical highly suspected cases underwent 99mTc-RBC scintigraphy who failed to confirm the diagnosis after receiving routine X-ray and ultrasound examination. The positive cases were located with lead shield on the body surface then underwent operations, while the negative cases received conventional laparotomy for exploration. The results showed that 99mTc-RBC seinti- gram was positive in 25 cases,and the positive rate was 92. 6~,of which 19 cases were found that the bleeding sites were consistent with those of lesions, 6 cases were not, and 2 negative cases. The operative findings showed that of 25 positive cases, 16 developed leiomyoma, 6 vascular malformations, 2 enteritis and 1 hemangioma. That bleeding sites supported by imaging were inconsistent with the site of lesions occurred in 6 cases, all of which were leiomyoma. There were 2 cases of false negative, 1 case of jejunal leiomyoma, and 1 jejuneum inflammation. It is concluded that 99mTc-RBC scintigraphy owns the merits of being highly sensitive, safe, non-invasive, simple to operate, and can be used repeatedly,which is of highly clinical signifi- cance and applicable value to the location diagnosis and surgical treatment of small bowel bleeding.

关 键 词：小肠出血 99mTc-标记红细胞显像 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]