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Anorectal bleeding vs penile activity. A potential diagnostic problem.

L A Gilbert, E B Silberstein, G C Rauf

    Clinical Nuclear Medicine
    |April 1, 1984
    PubMed
    Summary
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    Tc-99m sulfur colloid or erythrocyte gastrointestinal bleeding studies can show false positives due to penile blood pool activity. Correct patient positioning during imaging is crucial to prevent misinterpreting this as rectal bleeding.

    Area of Science:

    • Nuclear medicine
    • Gastroenterology
    • Radiology

    Background:

    • Gastrointestinal (GI) bleeding studies are vital for diagnosing lower GI bleeds.
    • Radiopharmaceuticals like Technetium-99m (Tc-99m) sulfur colloid and Tc-99m labeled erythrocytes are commonly used.
    • Artefacts can complicate the interpretation of these studies.

    Purpose of the Study:

    • To identify potential sources of artefact in Tc-99m labeled GI bleeding studies.
    • To highlight the significance of intrapenile blood pool activity as a confounding factor.
    • To emphasize the importance of proper patient positioning to ensure accurate study interpretation.

    Main Methods:

    • Review of nuclear medicine imaging principles for GI bleeding detection.
    • Analysis of potential artefact sources in Tc-99m based imaging.

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  • Evaluation of anatomical considerations influencing imaging results.

    • Main Results:

    • Intrapenile blood pool activity can mimic rectal bleeding on scintigraphy.
    • This artefact is particularly relevant when using Tc-99m sulfur colloid or Tc-99m labeled erythrocytes.
    • Incorrect patient positioning can lead to mislocalization of activity.

    Conclusions:

    • Penile blood pool activity is a significant potential artefact in Tc-99m GI bleeding studies.
    • Proper patient positioning is essential to differentiate true rectal bleeding from this artefact.
    • Accurate interpretation relies on recognizing and avoiding this common imaging pitfall.