[Current possibilities in radiology for the diagnosis and therapy of gastrointestinal hemorrhage (roentgen diagnosis, nuclear medicine and interventional radiology)]. / Die heutigen Möglichkeiten der Radiologie zur Diagnostik und Therapie gastrointestinaler Blutungen. (Röntgendiagnostik, Nuklearmedizin und interventionelle Radiologie).

Especially in acute gastrointestinal bleeding, conventional x-ray examinations with barium sulfate contrast are obsolete. On the other hand, blood pool scintigraphy and selective angiography are efficient methods to localize bleeding sources that have not been identified by prior endoscopy. In the interval between acute bleeding episodes, only vascular or highly vascularised lesions--as aneurysms, angiomas and leiomyomas--can be demonstrated. In all other lesions, active bleeding during the examination is a prerequisite. Angiography has not only a diagnostic, but also a therapeutic potential. By preoperative hemostasis, the circulatory conditions of the patient can be stabilized and surgery can be performed with a lower mortality risk. In "poor risk" patients, transarterial therapy can replace surgical interventions.

Immunoscintigraphic localization of inflammatory lesions: clinical experience.

This clinical study was based on the experimental results reported in the two preceding papers, showing that the highly selective affinity of the 123I-anti-CEA monoclonal antibody 47 (123I-Mabgc) for human granulocytes makes this compound suitable for the immunoscintigraphic detection of inflammatory lesions. Forty five patients with suspected infections have been studied after infusion of 4 mCi (148 MBq) 123I-Mabgc corresponding to 120 micrograms labeled protein. No adverse reactions have been seen. Because of the high number of labeled cells, the quality of the images was excellent. SPECT was performed in 15 cases in order to define the extent of the lesion. Infectious foci were usually seen 3-5 h postinjection, but the unimpaired function of the granulocytes guarantees diagnostically relevant examinations over a much longer period of time. Scans were read as being negative if no pathological accumulation of activity was detected after 24 h. The new scanning method is technically easy to perform and provides distinct advantages over other techniques necessitating in vitro labeling of the white blood cells. Therefore, recommended indications are acute infections of unknown origin or extent, especially recurrent episodes of osteomyelitis and infections of joint prostheses.