The Present Status of Spleen Scintigraphy: Clinical Results Obtained in 4500 Cases

As compared with scintigraphic studies of other parenchymatous organs, such as the thyroid, the liver and the kidneys, study of the spleen has until recently been somewhat neglected. This is all the more surprising since, apart from angiographic techniques, there is no simple radiographic method of obtaining the true image of this organ. The biological principle of spleen scanning - for which various methods are available at present - is based on the spleen's biological property of eliminating from the blood those red blood corpuscles which have lost their plasticity. This loss of plasticity can be brought about artificially by physical or chemical alteration of the corpuscles, which after injection are rapidly removed from the blood and accumulate in the spleen. The rate of blood clearance and selectivity of the accumulation process in the spleen differ from one method to the next. The paper lists techniques for the labelling and alteration of red corpuscles for the purposes of scanning, some of these methods giving a very exact image of the spleen. By using planimetry, one can easily estimate the area of the scintigram and determine the volume of the organ. One can thus, for the first time, make an exact and quantitive estimate of the degree of any splenomegaly present, thereby obtaining information of great value in general medicine. Comparison of clinical and scanning diagnoses in more than 3 000 cases showed that only 26% of the cases of splenomegaly could be detected clinically. The paper presents some examples, illustrated by figures, of results obtained by means of spleen scanning in connection with haematological and hepatic diseases. (author)