99mTcRBC动态显像定位诊断下消化道出血临床评价.docVIP

99mTcRBC动态显像定位诊断下消化道出血临床评价 　　[摘要] 目的：评价99mTc-RBC动态显像(DI)定位诊断下消化道出血(GIH)的临床价值。方法：①对21例GIH患者行DI(1 F/1 min×10 +1 F/5 min×10)。腹部出现异常放射性浓聚即用核素在体表标记。若60 min结果为阴性，则行3、6 h或24 h延迟显像。②异常放射性浓聚位于左上腹者选择纤维胃镜检查，腹周边者行结肠镜检，中腹部且内科治疗无效者予以手术探查。③经手术或纤维镜检证实后，评价DI定位诊断GIH的临床价值。结果：5 min出现异常放射性浓聚者8例(42.1%)，10 min者5例(26.3%)，30 min者5例(26.3%)，3 h者1例(5.3%)；DI诊断GIH的灵敏度为90.5%(19/21)，定位符合率为94.7% (18/19)。结论：DI能提高定位诊断GIH的符合率，对进一步选择检查和治疗方案具有重要的临床意义。 　　[关键词] 胃肠出血；锝；放射性核素显像 　　[中图分类号]R737.9[文献标识码]B [文章编号]1673-7210（2007）11（a）-104-02 　　 　　Clinical evaluation on localization of gastrointestinal hemorrhage with 99mTc-RBC dynamic imaging 　　XIE Chang-hui, MA Zhi-hai, ZHU Lin,YAO Guo-xian 　　(Department of Nuclear Medicine,the Affiliated Shenzhen Baoan Hospital of the South Medical University, Shenzhen 518101,China) 　　[Abstract] Objective: To evluate the clinical value on localization of gastrointestinal hemorrhage(GIH) with 99mTc-RBC dynamic imaging(DI). Methods:①21 GIH patients were performed on DI(1 F/1 min×10+1 F/5 min×10).When an abnormal radioactive area was found within the abdomen, the skin surface of abdomen was marked with radionuclide. If the 60 min result was negative,imaging would be delayed up to 3, 6 h or 24 h. ②The fibro-optic gastroscope examination was performed on patients with abnormal radioactive areas within the left upper abdomen,the fibro-optic conlonic-scope within the peripheral abdomen,the explorative operation for no effect after physic treatment within the middle abdomen. ③The clinical value of localization of GIH was evaluated after being confirmed with operation and/or fibro-optic scope. Results: The abnormal radioactive areas within the abdomen were found in 8 patients(42.1%)at 5 min, 5 patients(26.3%)at 10 min, 5 patients(26.3%) at 30 min,1 patient(5.3%) at 3 h. The sensitivity in diagnosing GIH was 90.5% by DI. The concordant rate of localization of GIH was 94.7% by DI. Conclusion: DI can increase the concordant rate of localization diagnosticating for GIH. It can play