Lin WY, Hung GU, Chao TH. The value of Tc-99m (V) dimercaptosuccinic acid in detecting intra-abdominal infection: compared with gallium scan.
Ann Nucl Med 2007;
21:285-91. [PMID:
17634846 DOI:
10.1007/s12149-007-0021-3]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Accepted: 03/07/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE
Gallium-67 (Ga-67) and labeled leukocytes are useful in the detection of an unknown infectious source. However, the delay in the diagnosis of a Ga-67 citrate scan (gallium scan) and the complicated labeling technique of a leukocyte scan are major drawbacks to their clinical use. Recently, Tc-99m (V) dimercaptosuccinic acid (DMSA) has been found to be very useful in the detection of infection. Tc-99m (V) DMSA is inexpensive, easy to prepare, and provides a result within hours. In this study, we evaluated the potential of Tc-99m (V) DMSA scan (DMSA scan) in the detection of intra-abdominal infection.
METHODS
A total of 33 patients who suffered from an unknown cause of fever after colorectal surgery were enrolled in this study. All patients received both a gallium scan and a DMSA scan. DMSA scintigraphy was performed 3-4 h after an injection of 740 MBq (20 mCi) of Tc-99m DMSA. After completion of the DMSA image, 111 MBq (3 mCi) of Ga-67 citrate was injected intravenously. Gallium scintigraphy was performed after 24 h and later as needed.
RESULTS
Of the 33 patients, 17 (51.5%) were diagnosed with intra-abdominal abscesses. For DMSA scans, the sensitivity, specificity, and overall accuracy were 88.2%, 93.7%, and 90.9%, respectively. For gallium scans, the diagnostic sensitivity, specificity, and accuracy were 100%, 87.5%, and 93.9%, respectively. No statistical difference was found in the diagnostic accuracy between these two diagnostic modalities using Fisher's exact test.
CONCLUSIONS
DMSA scan is a useful alternative to gallium scan in the detection of intra-abdominal infection in patients with colorectal surgery because Tc-99m DMSA is inexpensive, easy to prepare, and most importantly the result can be obtained within hours.
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