Szumowski Piotr, Abdelrazek Saeid, Żukowski Łukasz, Mojsak Małgorzata, Sykała Monika, Siewko Katarzyna, Maliszewska Katarzyna, Popławska-Kita Anna, Myśliwiec Janusz
Department of Nuclear Medicine, Medical University of Bialystok, M. Skłodowskiej-Curie St. 24A, 15-276, Bialystok, Poland.
Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, M. Skłodowskiej-Curie St. 24A, 15-276, Bialystok, Poland.
BMC Endocr Disord. 2019 Jan 18;19(1):10. doi: 10.1186/s12902-019-0340-0.
The most frequently used methods of assessing Graves' orbithopathy (GO) include: Clinical Activity Score (CAS), ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI). There exists another, slightly forgotten, imaging method: single-photon emission computed tomography (SPECT) with the use of diethylenetriaminepentaacetic acid tagged with Tc (Tc-DTPA). These days it is possible to conduct a SPECT examination fused with a CT scan (SPECT/CT), which increases the diagnostic value of the investigation. The aim of this paper is to evaluate the usefulness of Tc-DTPA SPECT/CT in diagnosing Graves orbitopathy, as compared with other methods.
Twenty-three patients with suspected active (infiltrative-edematous) Graves' orbithopathy were included in the study. Each patient underwent a CAS, an MRI, and a SPECT/CT. The obtained results were analysed statistically, with the assumed statistical significance of p < 0.05.
The SPECT/CT and MRI were found to have the highest sensitivity: 0.93 each. The SPECT/CT had the highest specificity: 0.89. MRI and CAS had lower values: 0.78 and 0.56, respectively. The occurrence of an active form of GO had no impact on the exacerbation of exophthalmos or the thickness of the oculomotor muscles.
The Tc-DTPA SPECT/CT method provides a very good tool for assessing the active form of GO and can, alongside the MRI scan, be used as a referential diagnostic procedure in GO.
评估格雷夫斯眼眶病（GO）最常用的方法包括：临床活动评分（CAS）、超声检查（USG）、计算机断层扫描（CT）和磁共振成像（MRI）。还存在另一种有点被遗忘的成像方法：使用锝标记的二乙三胺五乙酸（Tc-DTPA）的单光子发射计算机断层扫描（SPECT）。如今，可以进行与CT扫描融合的SPECT检查（SPECT/CT），这提高了检查的诊断价值。本文的目的是评估与其他方法相比，Tc-DTPA SPECT/CT在诊断格雷夫斯眼眶病中的实用性。
23例疑似活动性（浸润性水肿型）格雷夫斯眼眶病患者纳入研究。每位患者均接受了CAS、MRI和SPECT/CT检查。对获得的结果进行统计学分析，假定统计学显著性为p < 0.05。
发现SPECT/CT和MRI的灵敏度最高：均为0.93。SPECT/CT的特异性最高：为0.89。MRI和CAS的值较低，分别为0.78和0.56。活动性GO的发生对外凸眼或动眼肌厚度的加重没有影响。
Tc-DTPA SPECT/CT方法为评估活动性GO提供了一个很好的工具，并且可以与MRI扫描一起用作GO的参考诊断程序。
