Abstract
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Objectives: Protein-losing enteropathy (PLE) is characterised by excessive loss of plasma proteins into the gastrointestinal tract. Tc-99m HSA-D scintigraphy is an important diagnostic modality for diagnosis of PLE since its introduction in 1986. This method is simple and sensitive not only to diagnose PLE, but also to localize the site of protein loss in the gastrointestinal tract that is almost impossible in certain cases with other imaging modalities. The purpose of this educational exhibit is to investigate the diagnostic utility of Tc-99m HSA-D scintigraphy in a group of patients suspected of having PLE and discuss the adaptation of Tc-99m HSA-D scintigraphy.
Methods: We retrospectively reviewed 63 Tc-99m HSA-D scans in the past 10 years (between December 2006 and April 2016), presenting consecutively with PLE. We evaluated all the images with respect to visualization and initial appearance time of abnormal radioactivity. After intravenous injection of 740 MBq of freshly prepared Tc-99m HSA-D, static images were obtained at 5 minutes -3 h (early phase) and at 6-24 h (delayed phase).
Results: 17 patients had a negative, and 46 patients had a positive Tc-99m HSA-D scintigraphy. 29 of 46 positive cases had demonstrable positive tracking in the early phase. Compared with the negative group, patients in the positive group had a lower serum albumin level. In positive groups, their underlying causes included collagenous colitis (n=8), SLE (n=6) and enteritis (n=3).
Conclusion: Tc-99m HSA-D scintigraphy is reliable and useful for imaging PLE. We recommend the continuing use of Tc-99m HSA-D scintigraphy in the diagnosis of PLE. In our experience, major reason for positive finding was autoimmune dis and collagenous colitis.