^(99m)TcO_4^-联合^(99m)Tc-RBC对小儿下消化道出血的诊断

^(99m)TcO_4^- Combined ^(99m)Tc-RBC for the Diagnosis of Lower Gastrointestinal Bleeding in Children

目的:评价99mTcO4-联合99mTc-RBC显像对小儿下消化道出血的诊断价值。方法:94例下消化道出血患者先进行99mTcO4-显像,阴性者再进行99mTc-RBC,显像资料均参照临床最终结果进行评价。结果:94例患者中99mTcO4-显像阳性者32例,其中29例证实为Meckel憩室,2例为小肠重复畸形,1例为空肠黏膜下血管畸形9。9mTcO4-显像阴性62例,进行99mTc-RBC显像阳性28例,经手术及胃、肠镜证实胃溃疡或肠息肉18例,空肠黏膜下血管畸形5例,其余5例及阴性病例治疗好转出院9。9mTcO4-联合99mTc-RBC显像诊断下消化道出血的灵敏度为82.1%,特异度为100%,准确度为91.9%。结论:99mTcO4-联合99mTc-RBC显像对小儿下消化道出血具有较高的定位诊断及鉴别诊断价值,且无创、简单易行、快速可靠。

Objective：To evaluate the 99mTcO4-combined 99mTc-RBC scintigraphy in children with the diagnosis of lower gastrointestinal bleeding.Methods：94 patients with lower gastrointestinal bleeding in patients with first conduct 99mTcO4-imaging,further negative 99mTc-RBC,with reference to the clinical imaging data to evaluate the final result.Results：94 patients with imaging-positive patients were 32 cases,including 29 cases confirmed to Meckel diverticulum,2 cases of intestinal duplication,1 case of intestinal vascular malformations is empty.62 cases with negative imaging,99mTc-RBC scintigraphy were positive in 28 cases,by surgery and stomach,colonoscopy confirmed 18 cases of gastric ulcer or intestinal polyps,jejunal mucosal vascular malformation in 5 cases,the remaining 5 cases improved hospital treatment and negative cases.99mTcO4-combined 99mTc-RBC imaging in the diagnosis of lower gastrointestinal bleeding was 82.1% sensitivity and specificity of 100% and accuracy 91.9%.Conclusion：99mTcO4-combined 99mTc-RBC scintigraphy in children with lower gastrointestinal bleeding has a high value in diagnosis and differential diagnosis,and non-invasive,simple,fast and reliable.