Palestro C J, Swyer A J, Kim C K, Muzinic M, Goldsmith S J
Department of Physics-Nuclear Medicine, Mt. Sinai School of Medicine, Mt. Sinai Medical Center, New York, New York 10029.
Clin Nucl Med. 1991 May;16(5):305-8. doi: 10.1097/00003072-199105000-00001.
The differential diagnosis of intracerebral enhancing lesions on contrast computed tomography includes tumors, abscesses, and cerebrovascular accidents. Particularly important is the differentiation between tumor and abscess. While In-111 labeled leukocyte imaging is an accurate test for identification of foci of infection in general, the role of this procedure in the evaluation of the intracranial lesion is not well established. We undertook a retrospective review of 16 patients with contrast enhancing intracerebral lesions identified on computed tomography, who were also studied with labeled leukocyte imaging. Final diagnoses were: abscess (n = 2), primary brain tumor (n = 6), metastasis (n = 4), dermoid cyst (n = 1), and cerebral infarct (n = 3). There were two positive labeled leukocyte studies; both were cerebral abscesses. No labeled leukocyte activity was identified in any of the tumors or infarcts. We conclude that In-111 labeled leukocyte imaging is an accurate method of differentiating infectious from noninfectious causes of intracerebral lesions identified on computed tomography.
在对比增强计算机断层扫描上，脑内强化病变的鉴别诊断包括肿瘤、脓肿和脑血管意外。肿瘤与脓肿的鉴别尤为重要。虽然铟 - 111标记的白细胞显像总体上是识别感染灶的准确检查方法，但该检查在颅内病变评估中的作用尚未明确确立。我们对16例在计算机断层扫描上发现有对比增强脑内病变且也接受了标记白细胞显像检查的患者进行了回顾性研究。最终诊断结果为：脓肿（2例）、原发性脑肿瘤（6例）、转移瘤（4例）、皮样囊肿（1例）和脑梗死（3例）。有两项标记白细胞检查呈阳性；均为脑脓肿。在任何肿瘤或梗死灶中均未发现标记白细胞活性。我们得出结论，铟 - 111标记的白细胞显像对于鉴别计算机断层扫描所发现的脑内病变的感染性与非感染性病因是一种准确的方法。
