ISCHEMIC COLITIS - TC-99M HMPAO LEUKOCYTE SCINTIGRAPHY AND CORRELATIVE IMAGING

A 62-year-old woman became progressively ill after aorto-bifemoral gra ft surgery. A Tc-99m hexamethylpropyleneamine oxime (HMPAO) leukocyte scan was performed because of fever and suspected graft infection. The anterior abdominal and pelvic views demonstrated marked uptake within the sigmoid colon. Follow-up studies, including CT scan and contrast intestinal x-rays, confirmed the presence of an abnormal sigmoid loop. Subsequent surgical resection and pathological examination of the sig moid colon revealed ischemic changes. To our knowledge, detection of i schemic colitis using Tc-99m HMPAC labeled leukocytes has not been rep orted. Clinical and routine radiological findings of ischemic colitis are typically nonspecific and may result in delayed diagnosis that can lead to high mortality. Tc-99m HMPAC leukocyte scintigraphy may be he lpful in the noninvasive diagnosis of ischemic injury to the colon, es pecially after aortic graft surgery.