Nuclear Medicine in Gastrointestinal System

Contents GI Motility Studies GI Bleeding Scintigraphy Pertechnetate Imaging Salivary Gland Imaging Hepatobiliary Imaging Urea Breath Testing

GI Motility Studies Radionuclide Esophagram Gastroesophageal Reflux Gastric Emptying

胃食道反流显像

Gastroesophageal Reflux Imaging Sensitivity is 90% The sensitivity of X ray and endoscope is only about 40%

GI Bleeding Scintigraphy

GI Bleeding Scintigraphy can detect bleeding rates as low as 0.1-0.5ml/min. Sensitivity is 90%，specificity is 95%. Incorrect localizations can be seen in 3 to 60% of cases. It is probably prudent not to base surgery solely on the results of RBC scanning.

Pertechnetate Imaging Meckel's Diverticulum Barrett's Esophagus

Colloid Liver Imaging Particles between 0.3 and 1.0 microns are predominantly phagocytized by the Kupffer cells of the liver and fixed intracellularly for an indefinite period of time.

肝 胶 体 显 像 显像剂

Colloid Liver Imaging Imaging method Patient preparation: No Injected dose： 74~185MBq（2~5mCi） Imaging time： after 15 min Acquisition method：static or tomography

ANT POST LLA RLA Colloid Liver Imaging Normal Image

Colloid Liver Imaging POST ANT LLA RLA

Cold area in colloid liver imaging metastatic tumor cyst hepatocellular carcinoma hematoma hemangioma abscess pseudoplasm

Liver Blood Pool Imaging Radiopharmaceutical 99mTc-RBC

Method Patient preparation: none Injected dose： 555~740MBq（15~20mCi） Imaging time：immediately after injection and 30min, 2h. Acquisition: dynamic, static or tomographic.

肝胶体显像 肝血池显像

肝动脉血供增强

部分疾病肝胶体显像与肝血池显像表现

Hepatobiliary Imaging

肝胆动态显像 二.显像剂 99mTc-HIDA 140 8.10 X10-6 2.70 X10-6 20 药物名称 γ射线能量 吸收剂量（Gy） 尿中排泄率（%） （KeV） 肝脏 全身 （3h） 99mTc-HIDA 140 8.10 X10-6 2.70 X10-6 20 99mTc-EHIDA 140 8.10 X10-6 2.70 X10-6 5 99mTc-DISIDA 140 2.70 X10-6 5.40 X10-6 4.5 99mTc-PAPADA 140 2.43 X10-6 4.50 X10-6 10 99mTc-BIDA 140 1.35 X10-6 5.40 X10-6 2 99mTc-Mebrofenin 140 2 99mTc-PG 140 1.08 X10-5 2.70 X10-6 28 99mTc-PI 140 8.10 X10-6 2.70 X10-6 10 99mTc-PMT 140 1.35 X10-5 5.40 X10-6 2

Normal Hepatobiliary Imaging 5 min 10 min 15 min 20 min 25 min 30 min 35 min 40 min 45 min

Normal Pattern Hepatobiliary Imaging

Clinical Applications Diagnosis of acute cholecystitis. Differentiation of obstruction outside liver and siltation of bile inside liver. Differentiation of congenital bile tract obstruction and neonate hepatitis. Diagnosis of common bile duct cyst. Follow-up of therapeutic effect of liver and bile system. Differentiation diagnosis of liver cancer, adenoma and FNHEctopic gallbladder .

急 性 胆 囊 炎

梗阻性黄疸 5min 10min 20min 30min 45min 60min 90min 120min 24hour

完全性梗阻 1 hour 24 hour

Delayed Hepatobiliary Imaging HCC (+) 5 mins 2 hours RLA 5 hours

肝肿瘤阳性显像 肝胶体显像 67Ga显像

Urea Breath Testing The test is useful for initial diagnosis of H. pylori but more commonly used to document eradication or failure of initial therapy.