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Nuclear Medicine in Gastrointestinal System

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.

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Nuclear Medicine in Gastrointestinal System

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  1. Nuclear Medicine in Gastrointestinal System

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

  3. GI Motility Studies • Radionuclide Esophagram • Gastroesophageal Reflux • Gastric Emptying

  4. 胃食道反流显像

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

  6. GI Bleeding Scintigraphy

  7. 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.

  8. Pertechnetate Imaging • Meckel's Diverticulum • Barrett's Esophagus

  9. 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.

  10. 肝 胶 体 显 像 显像剂

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

  12. POST ANT LLA RLA Colloid Liver Imaging Normal Image

  13. Colloid Liver Imaging POST ANT LLA RLA

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

  15. Liver Blood Pool Imaging Radiopharmaceutical 99mTc-RBC

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

  17. 肝胶体显像 肝血池显像

  18. 肝动脉血供增强

  19. 部分疾病肝胶体显像与肝血池显像表现

  20. Hepatobiliary Imaging

  21. 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 二.显像剂 肝胆动态显像

  22. 5 min 10 min 15 min 20 min 25 min 30 min 35 min 40 min 45 min Normal Hepatobiliary Imaging

  23. Normal Pattern Hepatobiliary Imaging

  24. 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 .

  25. 急 性 胆 囊 炎

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

  27. 完全性梗阻 1 hour 24hour

  28. DelayedHepatobiliaryImaging HCC (+) 5 mins 2 hours RLA 5 hours

  29. 肝肿瘤阳性显像 肝胶体显像 67Ga显像

  30. 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.

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