Sundram F X, Wong W Y, Ang E S, Goh A S, Ng D C, Yu S
Department of Nuclear Medicine, Block 2 Basement 1, Singapore General Hospital, 1 Hospital Drive, Singapore 169608.
Ann Acad Med Singap. 2000 Nov;29(6):699-703.
The aim of this study was to evaluate the usefulness of technetium-99m (Tc-99m) ciprofloxacin in imaging inflammation/infection. The ciprofloxacin for labelling, as a kit, was obtained from St Bartholomew's Hospital in London.
Patients were injected intravenously with Tc-99m ciprofloxacin and imaging was done at 10 minutes, 4 hours and 24 hours if necessary. Tomographic images (SPECT) were obtained in a few patients. Ninety-six patients were studied using Tc-99m ciprofloxacin. Forty-eight patients had bone scans and 22 had Tc-99m IgG scans. Eight patients were imaged using Tc-99m HMPAO labelled white blood cell, and bacteriological culture results were available in 24 patients. Organisms cultured included Acinetobacter baumanii, Streptococcus, Staphylococcus aureus, Pseudomonas, Klebsiella, Blastococidia, Methicillin-resistant S. aureus, Salmonella and Candida.
Findings were evaluated against microbiology, alternative imaging modalities and clinical outcome. There were 47 true positives, 33 true negatives, 5 false positives and 11 false negatives, giving a sensitivity of 81% and specificity of 87%. The positive and negative predictive values were 90% and 75%, respectively. There were no side effects and the scan was particularly useful in the evaluation of painful joint prosthesis to exclude infection. Repeat studies on 8 patients given antibiotics over a long period were very useful in deciding on termination of the antibiotic treatment.
本研究的目的是评估锝-99m（Tc-99m）环丙沙星在炎症/感染成像中的效用。用于标记的环丙沙星试剂盒购自伦敦的圣巴塞洛缪医院。
患者静脉注射Tc-99m环丙沙星，必要时在10分钟、4小时和24小时进行成像。少数患者获得了断层图像（SPECT）。96例患者使用Tc-99m环丙沙星进行研究。48例患者进行了骨扫描，22例患者进行了Tc-99m IgG扫描。8例患者使用Tc-99m HMPAO标记的白细胞进行成像，24例患者有细菌培养结果。培养出的微生物包括鲍曼不动杆菌、链球菌、金黄色葡萄球菌、铜绿假单胞菌、克雷伯菌、芽生菌、耐甲氧西林金黄色葡萄球菌、沙门氏菌和念珠菌。
根据微生物学、其他成像方式和临床结果对结果进行评估。有47例假阳性、33例假阴性、5例假阳性和11例假阴性，灵敏度为81%，特异性为87%。阳性预测值和阴性预测值分别为90%和75%。没有副作用，该扫描在评估疼痛的关节假体以排除感染方面特别有用。对8例长期使用抗生素的患者进行的重复研究在决定抗生素治疗的终止方面非常有用。
