The clinical evaluation of gastrointestinal bleeding scintigraphy

Objective: To assess the clinical utility of 99mTc-labeled red blood cells (RBCs) and 99mTc-pertechnetate in the diagnosis of gastrointestinal (GI) bleeding and suspected Meckel's diverticulum respectively. Methods: A total of 65 patients suspected of having active gastrointestinal bleeding undertook GI bleeding scintigraphy using 99mTc-labeled RBCs during the period from Feb. 1994 to Apr. 2000. Meckel's diverticulum scintigraphy was performed additionally in 14 patients under the age of 20. Results: The authors found a sensitivity of 60% on red cell scintigraphy in the detection of gastrointestinal (GI) bleeding and 35.9% of the positive results (14 cases) were found on delayed imaging. Only 18.2% of patients who had been administered haemostatics showed positive results, which is much less than that (68.5%) of those who hadn't. The accuracy of Meckel's diverticulum scintigraphy is 92.9%. Conclusion: scintigraphy with labeled RBCs is a necessary complement to endoscopy and angiography because it provides a convenient, economic, non-invasive and sensitive method to locate gastrointestinal bleeding site and permits continuous monitoring over hours. Sodium pertechnetate scintigraphy in Meckel's diverticulum as a method to diagnose and locate ectopic gastric mucosa may be the procedure of choice at present