Dupont J, Fleury-Goyon M C, Lahnèche B, Mornex R
Service de Médecine Interne, Hôpital Nord, Saint-Etienne.
Ann Med Interne (Paris). 1991;142(3):171-6.
Scintigraphy using 131I-labeled meta-iodobenzylguanidine was performed in 89 patients. A diagnosis of pheochromocytoma was indicated by urinalysis in 28 cases and confirmed histologically in the 27 patients who underwent surgery. The tumor was located using scintigraphy and computed tomography. Fourteen isolated and 6 malignant metastatic pheochromocytomas were found as well as 8 pheochromocytomas associated with genetic disease. Scintigraphy located the tumors in 22 out of 28 cases; however, 3 adrenal pheochromocytomas and 3 malignant pheochromocytomas were not detected. Radioisotope perfusion scanning was more sensitive than computed tomography for the detection of bilateral adrenal pheochromocytoma. In the only case of a multifocal tumor, a combination of scintigraphy and computed tomography located all pheochromocytomas which were later resected. The high number of patients without elevated urine catecholamines and in whom scintigraphy did not alter the diagnosis shows that his technique should be applied only after demonstration of catecholamine hypersection.
对89例患者进行了使用131I标记的间碘苄胍的闪烁扫描。28例经尿液分析提示嗜铬细胞瘤诊断,27例接受手术的患者经组织学证实。通过闪烁扫描和计算机断层扫描定位肿瘤。发现14例孤立性和6例恶性转移性嗜铬细胞瘤以及8例与遗传疾病相关的嗜铬细胞瘤。闪烁扫描在28例中的22例定位了肿瘤;然而,3例肾上腺嗜铬细胞瘤和3例恶性嗜铬细胞瘤未被检测到。放射性同位素灌注扫描对双侧肾上腺嗜铬细胞瘤的检测比计算机断层扫描更敏感。在唯一一例多灶性肿瘤中,闪烁扫描和计算机断层扫描相结合定位了所有后来被切除的嗜铬细胞瘤。大量尿儿茶酚胺未升高且闪烁扫描未改变诊断的患者表明,该技术仅应在证实儿茶酚胺分泌过多后应用。