Reitblat T, Ben-Horin C L, Reitblat A
Rheumatology Outpatient Clinic, Barzilai Medical Centre, affliated with Faculty of Health Sciences, Ben-Gurion University, Ashkelon 78306, Israel.
Rheumatol Int. 2006 Sep;26(11):1010-3. doi: 10.1007/s00296-006-0124-5. Epub 2006 Apr 5.
Giant cell arteritis/temporal arteritis (GCA/TA) and polymyalgia rheumatica (PMR) are closely related conditions that affect middle age and older patients and frequently occur together. Many authorities consider them to be different phases of the same disease. A study was undertaken of the possible contribution of gallium-67 ((67)Ga) single photon emission tomography (SPECT) scintigraphy to the diagnosis of GCA/TA and PMR, and to support the possible hypothesis of vasculitic nature of PMR. Nine consecutive patients with PMR, and nine consecutive patients with GCA/TA were included in the study. All patients fulfilled the American College of Rheumatology criteria for GCA/TA and Healey's criteria for PMR. The control patients group consisted of those who underwent (67)Ga scintigraphy for febrile illness. All patients and controls underwent (67)Ga SPECT scan of the skull on a dual-head Helix gamma camera 2 days after I.V. injection of 8-10 mCi of (67)Ga citrate. (67)Ga uptake ratio of temporal bone region to bone out of temporal area (TR/Bone) was estimated on transaxial and coronary slices after SPECT scan reconstruction. For each patient and control the calculations of both temporal areas were done. All GCA/TA and PMR patients showed increased uptake in both temporal areas of the skull, while (67)Ga uptake among GCA/TA was the highest, 1.31+/-0.14 in tranaxial view and 1.47+/-0.16 in coronary view. (67)Ga uptake among PMR patients was lower, 1.19+/-0.11 and 1.28+/-0.13, respectively. In comparison, the control patients showed the lowest (67)Ga uptake, 1.04+/-0.09 in transaxial view and 1.11+/-0.06 in coronary view. The results differ significantly between the three groups. It seems that (67)Ga SPECT scan may become a useful tool in the investigation of patients with suspicion of GCA/TA and PMR. Our findings of the increased (67)Ga uptake in the temporal areas among PMR patients add new arguments for vasculitic nature of this disorder.
巨细胞动脉炎/颞动脉炎（GCA/TA）和风湿性多肌痛（PMR）是密切相关的病症，影响中年及老年患者，且常同时发生。许多权威人士认为它们是同一种疾病的不同阶段。开展了一项关于镓-67（⁶⁷Ga）单光子发射断层扫描（SPECT）闪烁显像对GCA/TA和PMR诊断的可能贡献的研究，并支持PMR血管炎性质的可能假说。该研究纳入了9例连续的PMR患者和9例连续的GCA/TA患者。所有患者均符合美国风湿病学会的GCA/TA标准和希利的PMR标准。对照患者组由因发热性疾病接受⁶⁷Ga闪烁显像的患者组成。所有患者和对照在静脉注射8 - 10毫居里的枸橼酸⁶⁷Ga后2天，使用双头螺旋γ相机对头骨进行⁶⁷Ga SPECT扫描。在SPECT扫描重建后的横断面和冠状面上估计颞骨区域与颞外骨的⁶⁷Ga摄取率（TR/Bone）。对每位患者和对照都进行了两个颞区的计算。所有GCA/TA和PMR患者的颅骨两个颞区摄取均增加，而GCA/TA患者的⁶⁷Ga摄取最高，横断面视图为1.31±0.14，冠状面视图为1.47±0.16。PMR患者的⁶⁷Ga摄取较低，分别为1.19±0.11和1.28±0.13。相比之下，对照患者的⁶⁷Ga摄取最低，横断面视图为1.04±0.09，冠状面视图为1.11±0.06。三组结果差异显著。似乎⁶⁷Ga SPECT扫描可能成为怀疑患有GCA/TA和PMR患者检查中的一种有用工具。我们关于PMR患者颞区⁶⁷Ga摄取增加的发现为该病症的血管炎性质增添了新的论据。
