Strobl-Jäger E, Kolbe H, Ludwig H, Sinzinger H
Nuklearmedizinische Abteilung, Ludwig Boltzmann-Institut für Nuklearmedizin, Wien.
Wien Klin Wochenschr. 1988 Feb 5;100(3):72-8.
Gamma-camera imaging after injection of radiolabelled autologous leucocytes can be very helpful in the diagnosis, localization and further clinical treatment of inflammatory diseases. We present a technique allowing sterile separation of white blood cells and labelling with 99mTc-phytate or -oxine and with 111In-oxine, -oxine sulphate or -tropolone. The method is non-invasive and the radiation dose amounts to less than 80 mrad using 100 microCi 111Indium. The use of radiolabelled granulocytes is of particular diagnostic value in patients with septicaemia of unknown origin. Whole body scanning allows not only visualization of enhanced splenic uptake in septicaemia, but also localization of an inflammatory process. Preferential indications for a diagnostic approach using radiolabelled granulocytes are inflammatory abdominal processes which cannot easily be documented by means of other non-invasive techniques, such as inflammatory bowel disease (Crohn's diseases and ulcerative colitis), arthritic processes and abscesses of the liver and spleen, as well as subphrenic and retroperitoneal abscesses. Untreated osteomyelitis can be located with the help of labelled granulocytes, but in patients treated with antibiotics a false negative result is obtained in approximately 50% of cases for as yet unknown reasons, even in the presence of a still active osteomyelitic process.
注射放射性标记的自体白细胞后进行γ相机成像,对炎症性疾病的诊断、定位及进一步临床治疗非常有帮助。我们介绍一种技术,可无菌分离白细胞,并用99mTc-植酸盐或-奥克辛以及111In-奥克辛、-硫酸奥克辛或-托品酮进行标记。该方法是非侵入性的,使用100微居里的111铟时,辐射剂量小于80毫拉德。对于不明原因败血症患者,使用放射性标记的粒细胞具有特殊的诊断价值。全身扫描不仅能显示败血症时脾脏摄取增强,还能定位炎症过程。使用放射性标记粒细胞进行诊断的优先适应证是其他非侵入性技术难以记录的炎性腹部病变,如炎症性肠病(克罗恩病和溃疡性结肠炎)、关节炎病变以及肝脾脓肿,还有膈下和腹膜后脓肿。未经治疗的骨髓炎可借助标记的粒细胞定位,但在使用抗生素治疗的患者中,约50%的病例会出现假阴性结果,原因尚不明,即使存在仍活跃的骨髓炎病变。