Galuska L, Leovey A, Szucs-Farkas Z, Garai I, Szabo J, Varga J, Nagy E V
Department of Nuclear Medicine, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
Nucl Med Commun. 2002 Dec;23(12):1211-6. doi: 10.1097/00006231-200212000-00010.
Currently available methods for the estimation of disease activity in the orbits of patients with Graves' ophthalmopathy (GO) have the disadvantages of being either expensive or time consuming. The aim of this study was to develop a quick, reliable method using Tc labelled diethylenetriaminepentaacetic acid (DTPA) and four-headed single photon emission computed tomography (SPECT) for this purpose. The theoretical basis of the method is that the high capillarization and oedema in the orbit may be reflected on Tc-DTPA images in GO. SPECT data of 28 orbits of 14 patients with GO were compared with magnetic resonance imaging (MRI) T2 relaxation time scores. Based on the number of 'active' muscles with T2 relaxation times of more than 70 ms in a given orbit, an MRI score of 0 (no active muscle) to 4 (all rectus muscles active) was assigned to the orbit. With MRI, 18 orbits were inactive, and 10 were active. Thirty minutes after the intravenous administration of 7 MBq.kg Tc-DTPA, 128 projections were acquired by a four-headed SPECT. On the sum of six transaxial slices containing the entire bulbar region of the skull, a triangle-like region of interest (ROI) was drawn (OR ROI). This ROI was 'slipped' to the right temporal region of the brain as reference site (B ROI). The count ratios of OR/B were calculated and compared to MRI score values. In the group of 18 inactive orbits (an MRI score of zero on both sides), in the transaxial plane, the mean OR/B value was 6.4+/-1.17, and in the group of 10 active orbits (an MRI score of 1-3) 8.30+/-2.08, the difference being significant (P <0.05). Tc-DTPA orbital SPECT is a promising method for the estimation of disease activity in the orbits of patients with Graves' ophthalmopathy.
目前用于评估格雷夫斯眼病（GO）患者眼眶疾病活动度的方法存在昂贵或耗时的缺点。本研究的目的是为此开发一种使用锝标记的二乙三胺五乙酸（DTPA）和四头单光子发射计算机断层扫描（SPECT）的快速、可靠方法。该方法的理论基础是眼眶中的高毛细血管化和水肿可能在GO的锝-二乙三胺五乙酸图像上得到反映。将14例GO患者28个眼眶的SPECT数据与磁共振成像（MRI）T2弛豫时间评分进行比较。根据给定眼眶中T2弛豫时间超过70毫秒的“活跃”肌肉数量，为该眼眶分配0（无活跃肌肉）至4（所有直肌活跃）的MRI评分。通过MRI检查，18个眼眶无活动，10个眼眶有活动。静脉注射7MBq.kg锝-二乙三胺五乙酸30分钟后，通过四头SPECT采集128个投影。在包含颅骨整个眼球区域的六个横断面切片的总和上，绘制一个三角形感兴趣区域（ROI）（OR ROI）。将该ROI“滑动”到脑的右颞区作为参考部位（B ROI）。计算OR/B的计数比并与MRI评分值进行比较。在18个无活动眼眶组（两侧MRI评分为零）中，在横断面平面上，平均OR/B值为6.4±1.17，在10个有活动眼眶组（MRI评分为1 - 3）中为8.30±2.08，差异具有统计学意义（P<0.05）。锝-二乙三胺五乙酸眼眶SPECT是评估格雷夫斯眼病患者眼眶疾病活动度的一种有前景的方法。
