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

PURPOSE: To investigate the diagnostic value of technetium 99m-labeled human serum albumin (HSA) scintigraphy in a group of patients suspected of having protein-losing enteropathy (PLE). MATERIALS AND METHODS: After intravenous injection of 740 MBq of freshly prepared Te-99m HSA, serial images of the abdomen were obtained from 10 minutes until 24 hours after injection. A Tc-99m HSA scan was considered positive for PLE if there was visible tracer exudation in the gut. The diagnosis was 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 disease. 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 findings, seven demonstrated PLE only on images obtained 24 hours after injection. 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 within 24 hours.