Fernandez-Ulloa M, Vasavada P J, Black R R
Eugene L. Saenger Radioisotope Laboratory, University of Cincinnati Medical Center, Ohio 45267-0577.
Clin Nucl Med. 1989 Feb;14(2):97-100. doi: 10.1097/00003072-198902000-00005.
A young patient with sickle cell disease (SCD) and multiple hospitalizations for crisis was admitted because of suspected osteomyelitis. Initial laboratory work, radiographs, and bone images were not contributory. An In-111 white blood cell (WBC) study demonstrated two areas of increased radionuclide uptake consistent with osteomyelitis. One of these had associated soft tissue infection. No other areas of active osteomyelitis were visualized, in spite of the presence of several additional infection sites. Imaging with In-111 WBC is probably not justified for routine diagnosis of acute osteomyelitis in areas free of previous disease, where conventional bone images are highly efficient. In-111 WBC imaging, however, may be helpful in detecting osteomyelitis in selected patients with SCD in whom Tc-99m bone images and radiographs are usually abnormal and difficult to interpret due to previous bone infarcts. Localization of the infection focus is very important in choosing the aspiration site for bacteriologic studies. A negative study, however, should be interpreted cautiously.
一名患有镰状细胞病（SCD）且因危象多次住院的年轻患者因疑似骨髓炎入院。初始实验室检查、X线片和骨影像均无诊断价值。铟 - 111白细胞（WBC）扫描显示有两个放射性核素摄取增加的区域，符合骨髓炎表现。其中一处伴有软组织感染。尽管存在其他几个感染部位，但未发现其他活动性骨髓炎区域。对于既往无疾病区域的急性骨髓炎常规诊断，使用铟 - 111白细胞成像可能不合理，因为传统骨影像在此类情况下效率很高。然而，铟 - 111白细胞成像可能有助于在部分患有SCD的患者中检测骨髓炎，对于这些患者，由于既往存在骨梗死，锝 - 99m骨影像和X线片通常异常且难以解读。在选择细菌学研究的穿刺部位时，感染灶的定位非常重要。然而，对于阴性检查结果应谨慎解读。
