Altiay G, Cermik T F
Department of Chest Disease, Trakya University Hospital, Edirne, Turkey.
Rev Esp Med Nucl Imagen Mol. 2012 Jan-Feb;31(1):9-14. doi: 10.1016/j.remn.2011.03.012. Epub 2011 May 6.
The aim of this study was to assess the role of labelled leukocyte scintigraphy in the diagnosis and monitorization of response to therapy of patients with active bronchiectasis.
Twenty patients underwent (99m)Technetium hexamethylpropyleneamine oxime ((99m)Tc-HMPAO) labelled white blood cell (WBC) scintigraphy. A second scintigraphy was performed in 13 patients at 10 day of the treatment. Regional (99m)Tc-HMPAO WBC uptake and radiologic imaging findings (high resolution computed tomography or Chest X-Ray) in the lungs were classified into 3 categories in 6 lung areas. scintigraphic, radiological and clinical disease scores were calculated for all patients.
An abnormal accumulation was visually observed in 19 of 20 patients on the pre-treatment scans, the scintigraphy showing 95% sensitivity. A significant difference was found between early and late ratios (P=0.001) in the pre-treatment scans. The infected areas revealed a significant decrease in uptake ratios on the post-treatment scans compared to the pre-treatment scans (P=0.001). However, no significant correlation was determined between clinical and radiological scores, clinical and scintigraphic scores and also between scintigraphic and radiological scores (P ≥ 0.05).
(99m)Tc-HMPAO WBC scintigraphy may be a useful tool to evaluate response to therapy in patients with active bronchiectasis.
本研究旨在评估标记白细胞闪烁扫描术在活动性支气管扩张症患者的诊断及治疗反应监测中的作用。
20例患者接受了锝-99m(99mTc)六甲基丙烯胺肟(99mTc-HMPAO)标记的白细胞(WBC)闪烁扫描术。13例患者在治疗第10天时进行了第二次闪烁扫描术。肺部区域99mTc-HMPAO白细胞摄取及影像学表现(高分辨率计算机断层扫描或胸部X线)在6个肺区分为3类。计算所有患者的闪烁扫描、放射学及临床疾病评分。
20例患者中,19例在治疗前扫描中可见异常聚集,闪烁扫描术显示出95%的敏感性。治疗前扫描中早期与晚期比值之间存在显著差异(P = 0.001)。与治疗前扫描相比,治疗后扫描中感染区域的摄取比值显著降低(P = 0.001)。然而,临床与放射学评分、临床与闪烁扫描评分以及闪烁扫描与放射学评分之间均未发现显著相关性(P≥0.05)。
99mTc-HMPAO白细胞闪烁扫描术可能是评估活动性支气管扩张症患者治疗反应的有用工具。