Tubo-ovarian abscess: Tc-99m hexamethylpropylene amineoxime leukocyte scintigraphy and correlative imaging

Tc-99m hexamethylpropylene amineoxime (HMPAO) leukocytes are used widely to localize inflammatory foci and abscesses. However, the use of radiolabeled leukocytes to detect a tubo-ovarian abscess has not been reported. The authors describe two cases of tubo-ovarian abscess successfully imaged using this technique in obese women with a clinical history of prolonged fever and abdominal pain. Labeled leukocyte scintigraphy with Tc-99m HMPAO is a noninvasive, physiologic procedure with excellent imaging quality that is complementary but not competitive with anatomic imaging techniques such as US and CT. This scan is recommended as one of the steps for rapid accurate diagnosis of gynecologic pyogenic infection.