- 期刊
99mtc-Labeled Heat-Denatured Red Blood Cell Scintigraphy for Differential Diagnosis of Splenosis Vs.Gastric Tumor in A Case of Upper Gastrointestinal Bleeding
以鎝-99m標幟熱破壞紅血球核醫造影鑒別診斷脾官能過旺及胃腫瘤在上消化道出血病人-病例報告
摘要
上消化道出血合併先前脾臟破裂及脾臟切除病史時，脾官能過旺須列入鑑別診斷。鎝-99m標幟熱破壞紅血球核醫造影對於脾臟組織偵測有很高的敏感度及專一性。本文提出一四十歲男性病人，二十年前因運動傷害脾臟破裂，接受脾臟切除，病人因輕年型中風，在本院接受追踪治療，最近因急性大量吐血，入院診斷治療，初期的胃鏡及腹部電腦斷層診斷為一胃基底處胃腫瘤，但進一步磁振掃描造影懷疑在原脾床脾官能過旺，經鎝-99m標幟熱破壞紅血球核醫造影診斷，於相對應解剖位置，有明顯放射活性累積，經診斷為脾官能過旺，最後病人於門診追踪。
並列摘要
We report a 40-year-old male who suffered from sudden onset of upper gastrointestinal bleeding with previous history of splenectomy and stroke. A large protruding submucosal mass was found in the gastric fundus during the gastroendoscopic examination. The contrast enhanced abdominal CT also revealed a large lobular soft tissue mass with extraluminal protrusion and diaphragmatic invasion in the gastric fundus. Based on this observation, gastric stromal tumor was considered. However, the identified intact gastric wall, with external compression from a solid retroperitoneal tumor was noted in MRI image. Under the suspicion of splenosis with extensive invasion, we suggested 99mTc-labeledheat-denatured red blood cell scintigraphy for differential diagnosis. In addition, the 99mTc-labeled heat-denatured red blood cell scintigraphy demonstrated a focal radioactive accumulation in the left upper retroperi-toneum which was compatible with the low portion one of soft tissue masses in the MRI finding.99mTc-labeledheat-denatured red blood cell scintigraphy is a useful, high sensitive and specific imaging procedure to identify splenic tissue of splenosis in a gastrointestinal bleeding case with history of splenectomy.
延伸閱讀
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