Gotthardt M, Bröker S, Schlieck A, Bauhofer A, Herbst B, Béhé M, Corstens F H, Behr T M, Görg C
Department of Nuclear Medicine, Radboud University Nijmegen Medical Center, Postbus 9101, 6500 HB Nijmegen, The Netherlands.
Nuklearmedizin. 2007;46(4):135-40.
Ultrasound may be a cheap alternative to scintigraphic determination of splenic function. We directly compared nanocolloid scintigraphy (NS), scintigraphy with heat-altered erythrocytes (ES), and colour-coded Doppler sonography (DS) in patients with chronic inflammatory bowel disease (CIBD).
PATIENTS, METHODS: 35 patients were included into the study. Clearance rates were determined in ES, spleen/liver ratios (SLR) were measured scintigraphically in ES/NS. In DS, spleen size, echogenicity, and vascular resistance indices (RI) were determined. The results were compared to each other, to the clinical activity scores for CIBD, and to the course of the disease.
Based on the blood erythrocyte clearance serving as standard, patients had a good (19 patients), impaired (5), or missing splenic function (11). There was a good correlation of the clearance to SLR in ES (0.63, p < 0.01). The 10 min / 45 min ES clearance showed a high correlation (Spearman-Rho 0.87, p < 0.01). The SLR in ES at 2, 5, 10 and 45 min also correlated well with each other (Spearman-Rho > 0.9, p < 0.01; SLR > 3.45 normal splenic function, SLR < 1.22 indicated hyposplenia). There were no correlations between the results of NS, DS, Howell-Jolly-bodies, or clinical parameters. Only ES and the erythrocyte clearance correlated well. Howell-Jolly-Bodies detected 1 of 11 patients with hyposplenia while false-positive in 4.
Ultrasound and colloid scintigraphy show a low correlation with clearance of heat-altered erythrocytes. Only ES shows a good correlation in patients with CIBD. The clearance at 10 min already reliably determines splenic function. SLR may be determined after 10 minutes and is predictive of normal function if above 3.45 while SLR < 1.2 indicated hyposplenia.
超声检查可能是一种比闪烁扫描法测定脾功能更便宜的替代方法。我们对慢性炎症性肠病（CIBD）患者直接比较了纳米胶体闪烁扫描法（NS）、热变性红细胞闪烁扫描法（ES）和彩色编码多普勒超声检查（DS）。
患者、方法：35例患者纳入本研究。在ES中测定清除率，在ES/NS中闪烁扫描测量脾/肝比值（SLR）。在DS中，测定脾脏大小、回声性和血管阻力指数（RI）。将结果相互比较，与CIBD的临床活动评分以及疾病进程进行比较。
以血红细胞清除率为标准，患者脾功能良好（19例）、受损（5例）或缺失（11例）。ES中清除率与SLR具有良好的相关性（0.63，p<0.01）。10分钟/45分钟的ES清除率显示出高度相关性（Spearman等级相关系数0.87，p<0.01）。ES在2分钟、5分钟、10分钟和45分钟时的SLR也相互之间具有良好的相关性（Spearman等级相关系数>0.9，p<0.01；SLR>3.45提示脾功能正常，SLR<1.22提示脾功能减退）。NS、DS、豪-乔小体或临床参数的结果之间无相关性。只有ES与红细胞清除率具有良好的相关性。豪-乔小体检测出11例脾功能减退患者中的1例，同时有4例假阳性。
超声检查和胶体闪烁扫描法与热变性红细胞清除率的相关性较低。只有ES在CIBD患者中显示出良好的相关性。10分钟时的清除率已能可靠地确定脾功能。10分钟后可测定SLR，SLR>3.45提示功能正常，而SLR<1.2提示脾功能减退。
