Gao Z R, Kornblum C, Flacke S, Logvinski T, Yüksel M, An R, Klockgether T, Biersack H J, Ezziddin S
Department of Nuclear Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Neurol Sci. 2007 Aug;28(4):175-80. doi: 10.1007/s10072-007-0816-y. Epub 2007 Aug 10.
To evaluate the potential value of somatostatin receptor scintigraphy (SRS) using 111In-DTPA (diethylenetriaminepenta acetic acid)-D-Phe1-octreotide (111In-pentetreotide) in patients with recurring or persisting symptoms of myasthenia gravis (MG), 14 consecutive cases with such supplemental receptor imaging during neurological routine follow-up were retrospectively evaluated in this study. All 14 patients underwent SRS in addition to chest computed tomography (CT). Mean follow-up after imaging was 34 months. Eight patients had previous thymectomy, and three patients were referred to surgery after scintigraphy and chest CT. SRS was positive in one of the 14 patients with local recurrence of thymoma and pleural invasion, and negative in the remaining 13 patients. CT was positive for thymoma in three patients, inconclusive in four patients and negative in seven patients. In conclusion, while SRS may be able to detect thymoma lesions including metastases, it seems of limited value in patients with inconspicuous CT findings. Our initial experience fails to point out a benefit of SRS in the management of persisting or recurring MG (with regard to detection of thymic disorders) compared to CT. Whether SRS is useful for differentiating thymoma from non-neoplastic thymic disease may be investigated by larger series. A predominant proportion of patients with unsatisfactory treatment response, however, continue to suffer an unfavourable clinical course despite absent evidence for thymic pathology.
为评估使用111铟-二乙三胺五乙酸（DTPA）-D-苯丙氨酸1-奥曲肽（111铟-喷曲肽）的生长抑素受体闪烁显像（SRS）在重症肌无力（MG）复发或持续有症状患者中的潜在价值，本研究回顾性评估了14例在神经科常规随访期间进行此类补充受体显像的连续病例。所有14例患者除接受胸部计算机断层扫描（CT）外，均接受了SRS检查。显像后的平均随访时间为34个月。8例患者曾接受胸腺切除术，3例患者在闪烁显像和胸部CT检查后被转诊进行手术。14例胸腺瘤局部复发并伴有胸膜侵犯的患者中，1例SRS检查呈阳性，其余13例呈阴性。3例患者CT检查显示胸腺瘤阳性，4例不确定，7例阴性。总之，虽然SRS可能能够检测包括转移灶在内的胸腺瘤病变，但在CT表现不明显的患者中其价值似乎有限。与CT相比，我们的初步经验未能指出SRS在持续性或复发性MG管理（关于胸腺疾病的检测）中的益处。SRS是否有助于区分胸腺瘤与非肿瘤性胸腺疾病可能需要更大规模的系列研究来探讨。然而，尽管没有胸腺病变的证据，但相当一部分治疗反应不佳的患者仍继续经历不利的临床病程。
