Klett R, Lange U, Haas H, Voth M, Pinkert J
Department of Nuclear Medicine, University Hospital Giessen and Marburg, Giessen, Germany.
Rheumatology (Oxford). 2007 Oct;46(10):1531-7. doi: 10.1093/rheumatology/kem155. Epub 2007 Jun 27.
Hypertrophy and inflammation of the synovium with various underlying pathologies - such as rheumatoid arthritis, osteoarthritis, haemophilia and spondyloarthropathy - can be treated successfully by radiosynoviorthesis (RSO). For medium-sized joints (shoulder, elbow, wrist, hip and ankle), the radionuclide of choice is rhenium-186. We review the evidence for the efficacy of this local, relatively non-invasive therapy and evaluate its benefits and risks. We conclude good evidence of rhenium-186 RSO in rheumatoid arthritis and haemophilic arthropathy. In the remaining pathologies, up to now, the therapeutic efficacy has not been confirmed by today's most stringent criteria for clinical studies. The available data support rhenium-186 RSO as a suitable second-line treatment for patients in whom other therapies (including locally injected corticoids) have failed, as long as proper attention is paid to correct administration - including post-treatment immobilization and the co-administration of corticoids.
伴有各种潜在病理状况（如类风湿性关节炎、骨关节炎、血友病和脊柱关节病）的滑膜肥大和炎症，可通过放射性滑膜切除术（RSO）成功治疗。对于中型关节（肩、肘、腕、髋和踝关节），首选的放射性核素是铼-186。我们回顾了这种局部、相对非侵入性治疗方法有效性的证据，并评估了其益处和风险。我们得出结论，铼-186放射性滑膜切除术治疗类风湿性关节炎和血友病性关节病有充分证据。在其余病理状况中，截至目前，按照当今最严格的临床研究标准，其治疗效果尚未得到证实。现有数据支持铼-186放射性滑膜切除术作为其他治疗方法（包括局部注射皮质类固醇）失败的患者的合适二线治疗方法，只要适当注意正确给药——包括治疗后固定和皮质类固醇的联合使用。
