背景：脾臟是腹腔中最易受創傷的器官，脾臟破裂在腹部外傷中的發病率高過40~50%。由於脾臟組織脆弱，破裂後不易止血、縫合或修補，以前臨床常採用脾臟切除術，但隨著對脾臟切除後凶險感染(OPSI)的認識增加以及對脾臟免疫功能的研究日益深入，單純性脾臟切除手術已被臨床棄用，代之以脾臟切除後自體脾移植術。本研究探討放射性同位素脾臟顯像監測自體移植脾是否存活及其功能狀態的臨床價值。
方法：16例因外傷性脾臟破裂接受脾切除及自體脾移植的患者，於術後早期(7~14天，平均10天)進行了鎝-99m標幟熱變性紅血球脾臟顯像，其中12例患者術後3~5月(平均104天)再次接受同樣的顯像，對兩次檢查結果進行比較。同時，患者於顯像同期測定外周血中T細胞亞群CD3、CD4、CD8、百分比和CD4/CD8比值，並對照結果進行對比分析。
結果：術後早期移植脾片影像模糊，放射性聚集程度低於肝臟水平；術後3~5個月再次顯像時，移植脾片聚集放射性明顯增多，影像清晰可辨。術後1週外周血中CD3、CD4、CD8百分比和CD4/CD8、比值均明顯低於對照組，至術後3個月恢復正常，這與移植脾在術後經歷「壞死、再生、血管再生長」的組織學變化過程相吻合。
結論：鎝-99m標幟熱變性紅血球脾臟顯像是監測自體移植脾是否存活及其功能狀態的直接而有效的方法。

Objective: The purpose of this study was to evatuate the survival and function of splenic autotransplants using spleen imaging with 99mTc-heat damaged erythrocytes.
Methods: Sixteen patients with splenic rupture under-went spleen imaging with 99mTc-heat damaged erythrocytes in 1 to 2 weeks after splenic autotransplantation (early scans). Twelve of them underwent the same imaging 3 to 5 months after operation (follow-up scans).
Meanwhile, CD3, CD4, CD8 and CD4/CD8, in peripheral blood were measured and compared to those of controls.
Results: Splenic autotransplants were faintly showed on early scans, and the intensity of radioactivity in auto- transplants was lower than that in liver. The increase of intensity of tracer accumulation in autotransplants was significant on follow-up scans. The levels of CD3, CD4, CD8 and CD4/CD8 ratio were significantly lower than those of controls 1 week after operation, and returned to normal 3 months later. These findings were accordant with the histological sequences of splenic autotransplants (i.e. necrosis, regeneration, vascular re-growth).
Conclusion: The spleen imaging with 99mTc-heat dam-aged erythrocytes is a valuable and effective method for evaluation of the survival and function of splenic auto-transplants.