Corstens F H, van der Meer J W
Department of Nuclear Medicine, University Hospital, Nijmegen, The Netherlands.
Lancet. 1999 Aug 28;354(9180):765-70. doi: 10.1016/S0140-6736(99)06070-5.
Nuclear medicine imaging techniques can help in patient evaluation where infectious and non-infectious inflammatory disorders are suspected. When selected and tailored to the clinical situation, most techniques already in use or available soon provide information with high sensitivity. However, almost all currently available techniques lack the specificity to discriminate between infectious and non-infectious inflammation. In undiagnosed fever, this non-specificity may be an advantage since fever of unknown origin is caused by infection in only about 25% of cases, but in the postoperative patient the reliable differentiation between infection and sterile inflammation is highly relevant to clinical management. The range of radiopharmceuticals to investigate infectious and non-microbial inflammatory disorders is expanding and developments in protein/peptide chemistry and in labelling technology should lead to agents with very high specific activities. Nuclear medicine has to add specificity to its already high sensitivity if it is to distinguish both categories of inflammatory disorder.
在怀疑存在感染性和非感染性炎症性疾病的患者评估中，核医学成像技术能提供帮助。当根据临床情况进行选择和调整时，大多数现有或即将可用的技术都能以高灵敏度提供信息。然而，几乎所有当前可用的技术都缺乏区分感染性和非感染性炎症的特异性。在不明原因发热中，这种非特异性可能是一个优势，因为不明原因发热仅约25%的病例由感染引起，但在术后患者中，感染与无菌性炎症的可靠区分对临床管理至关重要。用于研究感染性和非微生物性炎症性疾病的放射性药物范围正在扩大，蛋白质/肽化学和标记技术的发展应能带来具有非常高比活度的药物。如果核医学要区分这两类炎症性疾病，就必须在其已有的高灵敏度基础上增加特异性。
