Three-phase Tc-99m labeled RBC scintigraphy of a splenic hemangioma.

A 46-year-old man presented with right upper quadrant pain with a clinical suspicion of cholelithiasis and was referred for an abdominal ultrasound (US). On US evaluation, the liver and gallbladder were normal. Incidentally noted a homogeneous, well demarcated, hyperechoic, 5-cm mass in the inferior portion of the spleen. A subsequent Tc-99m labeled RBC scan showed a 5-cm photopenic area in the inferior portion of the spleen on perfusion and early blood pool images. Subsequent filling in on delayed images with slightly increased uptake relative to surrounding splenic tissue was seen on the final images (85 min). Splenic hemangiomas are rare neoplasms, although they still represent the most common primary neoplasm of the spleen. The incidence of splenic hemangiomas ranges from 0.03-14% in autopsy studies.

Skeletal scintigraphy with technetium-99m-tetraphenyl porphyrin sulfonate for the detection and determination of osteomyelitis in an animal model.

UNLABELLED: This article explores the accumulation of 99mTc-tetraphenyl porphyrin sulfonate (TPPS4) at inflammatory sites, especially osteomyelitis, and compares the results with 111In Cl3 and 111In-WBC in an animal model. METHODS: Osteomyelitis was induced in 12 New Zealand white rabbits by injecting staphylococcus aureus in the left tibia. Three weeks later, radiographs confirmed the disease. Two hours later, after injection of 74 MBq 99mTc-TPPS4, scintiphotos of the lower extremities were acquired and repeat scintiphotos were obtained 24 hr after injection of 5.55 MBq 111In Cl3. After these studies, 24- and 48-hr scintiphotos of the lower extremities were acquired after injecting 5.55 MBq 111In-labeled WBC. RESULTS: The left tibia averaged three times the uptake with 99mTc-TPPS4 compared with right tibia; with 111In Cl3 and 111In WBC the ratios are two times. These three radiopharmaceuticals reveal positive images, but the image quality using 99mTc-TPPS4 is better, as would be expected from the more favorable physical characteristics of 99mTc and the higher uptake. CONCLUSION: The traditional combination of three-phase bone and 67Ga-citrate scintigraphy can be replaced by a single injection of 99mTc-TPPS4 with imaging as early as 2 hr. Finally, the use 99mTc-TPPS4 should result in a substantial reduction in radiopharmaceutical cost.

Peritoneoscintigraphy using Tc-99m MAA for diagnosis of diaphragmatic disruptions in trauma patients.

The diagnosis of diaphragmatic disruptions secondary to blunt trauma is difficult because the patients are usually asymptomatic. Delay in recognition of this injury can be life threatening. The presence of previous pulmonary pathology makes the diagnosis even more difficult to establish. In this report, a diaphragmatic tear was diagnosed using intraperitoneal instillation of Tc-99m MAA.