Ardjomand N, Esche G, Fellner P, Lindner S, Panzitt M, Aigner R, Langmann A
Universitäts-Augenklinik, Karl Franzens Universität Graz.
Ophthalmologe. 2003 Dec;100(12):1049-53. doi: 10.1007/s00347-003-0807-1.
In this study the diagnostic accuracy of orbital octreotide uptake in patients with presumed active Grave's ophthalmopathy (GO) was evaluated.
A prospective study of 23 patients suffering from GO was carried out. Single photon emission computed tomography (SPECT) images were obtained 4 h after iv injection of 3 mCi 111 indium octreotide. The results were correlated with the patients clinical state during a follow-up of 17.5+/-6 months.
Octreotide scintigraphy was positive in 15 and negative in 8 cases, 12 patients with positive octreotide scintigraphy underwent immunosuppressive treatment and showed a clinically positive response with regression of symptoms. In three cases the patients refused immunosuppressive treatment. Patients with negative pathologic orbital octreotide uptake did not undergo any treatment.
Octreotide scintigraphy is a useful tool to determine the activity state of Graves' ophthalmopathy. Since Graves' ophthalmopathy must be treated in the active phase, octreotide scintigraphy should be performed in subacute cases to facilitate the indications for immunosuppressive treatment.
本研究评估了眼眶奥曲肽摄取对疑似活动性格雷夫斯眼病(GO)患者的诊断准确性。
对23例GO患者进行了一项前瞻性研究。静脉注射3 mCi 111铟奥曲肽4小时后获得单光子发射计算机断层扫描(SPECT)图像。结果与患者在17.5±6个月随访期间的临床状态相关。
奥曲肽闪烁扫描阳性15例,阴性8例。12例奥曲肽闪烁扫描阳性的患者接受了免疫抑制治疗,症状消退,临床反应呈阳性。3例患者拒绝免疫抑制治疗。眼眶奥曲肽摄取病理阴性的患者未接受任何治疗。
奥曲肽闪烁扫描是确定格雷夫斯眼病活动状态的有用工具。由于格雷夫斯眼病必须在活动期进行治疗,因此在亚急性病例中应进行奥曲肽闪烁扫描,以促进免疫抑制治疗的指征判断。