胃肠出血^(99m)Tc-RBC显像的诊断价值

THE CLINICAL VALUE OF ^(99m)Tc-RBC SCINTIGRAPHY IN DIAGNOSIS OF GASTROINTESTINAL BLEEDING

目的 探讨胃肠出血99mTc RBC显像的诊断价值。方法 比较消化道出血患者放射核素显像与纤维胃镜、纤维结肠镜、血管造影 (DSA)、气钡双重造影、上消化道钡餐、全消化道钡餐、钡灌肠造影、隐血试验的结果。结果 核素显像的灵敏度为 96 3 % ,显著高于纤维胃镜、纤维结肠镜、DSA、气钡双重造影、上消化道钡餐、全消化道钡餐、钡灌肠造影 ;与隐血试验无显著差别。核素显像的准确率为 97 4% ,较纤维胃镜、纤维结肠镜、DSA、气钡双重造影、上消化道钡餐、全消化道钡餐显著性高 ;与钡灌肠造影、隐血试验比较无差别。结论 核素显像用于胃肠道出血定位诊断有较高的灵敏度和准确率 ,是一种无创、安全、简便而有效的诊断胃肠道出血的检查方法 ,尤其对慢性间隙性出血、慢性渗血。

Objective: To evaluate the clinical value of ^(99m)Technetium labelled red cell (^(99m)Tc、RBC) scintigraphy in diagnosis of gastrointestinal (GI) tract bleeding. Methods: The results of ^(99m)Tc、RBC scintigraphy performed in 82 patients presenting with gastrointestinal tract bleeding were compared with the results of fiber gastroscope,fiber colonscope ,digital subtraction angiography(DSA), barium、air double contrast radiography of gastrointestin、al(DC), gastroduodenal barium meal radiography, barium meal examination of digestive tract, barium enema radiography of colon (BE), and occult blood test (OBT). Resultes: The sensitivity of ^(99m)Tc、RBC scintigraphy was 96.3% which is higher than gastroscope, colonscope, DSA, DC, gastroduodenal barium meal radiography, barium meal examination of digestive tract, and BE significantly. The accuracy of red cell nuclide scanning was 97.4% which is higher than gastroscope,colonscope, DSA, DC, gastroduodenal barium meal rad、iography, barium meal examination of digestive tract obviously. Conclusions: There are significantly high sensitivity and accuracy of ^(99m)Tc、RBC scin、tigraphy in diagnosis of gastrointestinal bleeding, which is a noninvasi、ve, secure, simple, and userful examination, which can be used in diagnosis of gastrointestinal chronic, intermittent or minimal bleeding in addition to penetrative bleeding, especially serious cases being fit not for invasive examination.