CASE 153 A 43-year-old man presented 8 years previously with thrombocytopenia, and idiopathic thrombocytopenic purpura (ITP) was diagnosed. The disease initially responded to therapy with steroids but eventually became refractory, and the patient underwent splenectomy 5 years after diagnosis. At first, his platelet levels increased dramatically, but ultimately he relapsed, leading to the study presented below (Figs. 153.1 and 153.2). Fig. 153.1 Fig. 153.2 • Heat-damaged red blood cells (RBCs) labeled with 1 to 3 mCi of technetium 99mTc • Planar and SPECT images of the abdomen beginning 30 to 120 minutes after injection Anterior maximum-intensity projection (MIP) view from the SPECT study (Fig. 153.1
Clinical Presentation
Technique
Autologous RBCs labeled in vitro
Heated at 49°C for 15 to 20 minutes
Cooled at room temperature for 15 minutes
Image Interpretation
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