Protein-losing enteropathy: Diagnosis with Tc-99m-labeled human serum albumin scintigraphy

PURPOSE: To investigate the diagnostic value of technetium 99m-labeled huma n serum albumin (HSA) scintigraphy in a group of patients suspected of havi ng protein-losing enteropathy (PLE). MATERIALS AND METHODS: After intravenous injection of 740 MBq of freshly pr epared Te-99m HSA, serial images of the abdomen were obtained from 10 minut es until 24 hours after injection. A Tc-99m HSA scan was considered positiv e for PLE if there was visible tracer exudation in the gut. The diagnosis w as established on the basis of standard clinical and biopsy findings. RESULTS: Thirty-nine scans were obtained: 27 scans in 26 suspected cases of PLE and 12 scans in control subjects with no known gastrointestinal diseas e. Twenty-five of the 26 studies in patients suspected of having PLE showed Tc-99m HSA activity in the bowel. Among the 25 studies with positive findi ngs, seven demonstrated PLE only on images obtained 24 hours after injectio n. In the control subjects, no activity war seen in the bower. CONCLUSION: Tc-99m HSA With Serial scanning for up to 24 hours is reliable and useful for imaging PLE. Sites of protein loss may also be demonstrated. This imaging method is convenient, easy to perform, and yields results wit hin 24 hours.