Gaál János, Varga József, Szabados Lajos, Garai Ildikó, Galuska László, Surányi Péter, Szegedi Andrea, Zeher Margit, Bodolay Edit
Department of Rheumatology, Kenézy Gyula Hospital, University Medical School of Debrecen, Debrecen, Hungary.
Nucl Med Commun. 2005 Dec;26(12):1113-7. doi: 10.1097/00006231-200512000-00011.
To look for the frequency of oesophageal dysfunction using radionuclide oesophageal transit scintigraphy in 145 patients with undifferentiated connective tissue disease (UCTD); to seek the correlation between the clinical/laboratory data and scintigraphic alterations; and to determine predictive value of radionuclide oesophageal transit scintigraphy for evolution to established connective tissue disease (CTD).
One hundred and forty-five patients with UCTD were examined by 99mTc-DTPA oesophageal transit scintigraphy. The intraoesophageal transport of the radiopharmaceutical was followed and imaged by a gamma camera, a series of 128 x 128 images were stored and evaluated. The correlation between the scintigraphic data and clinical and laboratory parameters was analysed statistically.
Unequivocally positive scintigraphy, indicative of motor abnormality was found in 46% of patients (66), 71% (47) of whom were totally asymptomatic. Significant correlation was found between the presence and severity of scintigraphic alterations and antinuclear antibodies, the anti-beta2GPI, IgM, IgG, the aCL antibody positivity, and the skin symptoms. Scintigraphic positivity was significantly more frequent in patients evolving to definitive CTD (P = 0.0178), and abnormal scan predisposed to transition into the definitive CTD (odds ratio, 2.292; CI, 1.610-4.525). Its cumulative positive predictive value was found to be 43% and cumulative negative predictive value 73% with regard to the development of a definitive CTD.
Our results show that scintigraphic alterations together with clinical and laboratory alterations can help the clinician in the prediction of final outcome.
利用放射性核素食管通过闪烁扫描术，探寻145例未分化结缔组织病（UCTD）患者食管功能障碍的发生率；寻找临床/实验室数据与闪烁扫描改变之间的相关性；并确定放射性核素食管通过闪烁扫描术对发展为确诊结缔组织病（CTD）的预测价值。
对145例UCTD患者进行99mTc-DTPA食管通过闪烁扫描术检查。通过γ相机跟踪放射性药物在食管内的转运并成像，存储并评估一系列128×128图像。对闪烁扫描数据与临床和实验室参数之间的相关性进行统计学分析。
46%（66例）患者闪烁扫描明确阳性，提示运动异常，其中71%（47例）完全无症状。闪烁扫描改变的存在和严重程度与抗核抗体、抗β2糖蛋白I、IgM、IgG、抗心磷脂抗体阳性以及皮肤症状之间存在显著相关性。发展为确诊CTD的患者闪烁扫描阳性率显著更高（P = 0.0178），扫描异常易发展为确诊CTD（优势比，2.292；可信区间，1.610 - 4.525）。就确诊CTD的发生而言，其累积阳性预测值为43%，累积阴性预测值为73%。
我们的结果表明，闪烁扫描改变以及临床和实验室改变可帮助临床医生预测最终结果。
