99Tcm-HMPAO-labelled white blood cell scans to detect acute appendicitis in older patients with an atypical clinical presentation

Wy, Lin; Ch, Kao; Ht, Lin; Yl, Wang; Sj, Wang; Tj, Liu

doi:10.1097/00006231-199701000-00015

Cited by 7 publications

(3 citation statements)

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“…In this study there was a false-negative rate of 10% and a false-positive rate of 6.6% [16]. Lin et al reported similar findings in older patients (>50 years) with clinical findings equivocal for appendicitis and concluded that 99m Tc-HMPAO WBC scan provides a rapid and highly accurate method for the diagnosis of appendicitis in older patients with equivocal clinical findings [31]. Rypins et al reported 99m Tc-HMPAO WBC scan to have a sensitivity of 98% and a specificity of 85% in appendicitis patients with equivocal clinical findings [17].…”

Section: Discussionsupporting

confidence: 63%

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The value of 99mTc-HMPAO labelled white blood cell scintigraphy in acute appendicitis patients with an equivocal clinical presentation

et al. 2001

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Various imaging studies can be performed in the evaluation of patients with a clinical presentation equivocal for acute appendicitis. One of these studies is technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled white blood cell (WBC) scintigraphy. The aim of this study was to evaluate the accuracy and clinical value of 99mTc-HMPAO WBC scintigraphy in the aforementioned group of patients. Forty-one patients who had acute right lower quadrant abdominal pain with a clinical presentation equivocal for acute appendicitis were included in the study. The anterior abdomen and pelvis were imaged up to 4 h after the injection of 125-300 MBq 99mTc-HMPAO WBCs and the results were immediately reported to the surgeon before a decision was taken on whether to perform laparotomy. Diagnostic accuracy was established by the intra-operative findings and the histopathology in operated patients. In non-operated patients, absence of abdominal symptoms 1 month after scintigraphy and/or identification of another cause of abdominal pain was used to rule out acute appendicitis. There were 16 patients with positive scintigraphy and 81% of these patients were positive within 2 h post injection. There were no false-positive or false-negative results. We operated on 17 (41.4%) patients, and only one patient (5.9%) underwent unnecessary laparotomy. We conclude that 99mTc-HMPAO WBC scintigraphy is a rapid, highly accurate method for the exclusion of acute appendicitis and that its use can lower the unnecessarily high laparotomy rate in patients with an equivocal clinical presentation.

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Section: Discussionsupporting

confidence: 63%

“…Lin et al and Rypins et al also imaged their patients up to 3 and 4 h after the injection of HMPAO WBCs [17,31]. Physiological bowel activity can be present 2 h after the injection of HMPAO WBCs, but this kind of activity shows a typical bowel shape and low-grade intensity.…”

Section: Discussionmentioning

confidence: 99%

The value of 99mTc-HMPAO labelled white blood cell scintigraphy in acute appendicitis patients with an equivocal clinical presentation

et al. 2001

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“…The use of nuclear imaging with tagged WBCs has been well studied as a diagnostic tool for acute appendicitis. 36,38 The reported sensitivities of nuclear scans depend on the tag used and range from 88 to 98%. The overall usefulness of these scans is limited owing to poor specificity; any process causing inflammatory changes in the lower abdomen can lead to a falsepositive scan.…”

Section: Nuclear Medicine Scansmentioning

confidence: 99%

Acute Appendicitis

2013

FRCR 2B Viva: A Case-Based Approach

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Appendicitis is a common condition requiring emergency surgery. About 7% of people will develop appendicitis sometime during their lifetime. Most cases occur in adolescents and young adults, with the incidence in men being slightly higher than in women. 1,2 Although the diagnosis is clinically clear in classic presentations, it still remains elusive in atypical presentations; after missed myocardial infarction and fractures, missed appendicitis represents the largest number of malpractice claims for practicing emergency physicians. 3

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Acute Appendicitis

Wolfe¹,

Henneman²

2010

Rosen's Emergency Medicine – Concepts and Clinical Practice

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99Tcm-HMPAO-labelled white blood cell scans to detect acute appendicitis in older patients with an atypical clinical presentation

Cited by 7 publications

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The value of 99mTc-HMPAO labelled white blood cell scintigraphy in acute appendicitis patients with an equivocal clinical presentation

The value of 99mTc-HMPAO labelled white blood cell scintigraphy in acute appendicitis patients with an equivocal clinical presentation

Acute Appendicitis

Acute Appendicitis

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