Plewe G, Beyer J, Krause U, Cordes U, Eissner D, Hahn K
Klin Wochenschr. 1985 Jul 15;63(14):627-30. doi: 10.1007/BF01732857.
In a retrospective study of 31 patients with suspected pheochromocytoma we examined the preoperative results of 131I-metaiodobenzylguanidine (131-I-MIBG) scintigraphy and a fluorimetric urine catecholamine determination test. An additional radioenzymatic plasma catecholamine determination test was performed in 25 patients. In 14 of the 31 patients the diagnosis of pheochromocytoma was later histologically confirmed. In the remaining 17 patients the suspected diagnosis was finally rejected after a clinical decision had been made on the basis of clinical history, symptoms, laboratory and imaging tests. 131-I-MIBG scintigraphy apparently had a very high specificity (no false-positive results among the patients with rejected diagnosis), but showed the least sensitivity (3 of 14 tumours were not detected). Urine catecholamines showed two false-negative and three false-positive results. Plasma catecholamines had the highest sensitivity and gave only one false-positive result. Because of its high pathognomonic value 131-MIBG scintigraphy can be helpful not only for localization, but also for confirmation of diagnosis when catecholamine determination tests are contradictory. On the basis of our experience with false-positive results after interfering medication therapy, urine and plasma catecholamine determination tests should only be carried out after purification with thin layer chromatography or high performance liquid chromatography.
在一项对31例疑似嗜铬细胞瘤患者的回顾性研究中，我们检查了131I-间碘苄胍（131-I-MIBG）闪烁扫描术的术前结果以及荧光法尿儿茶酚胺测定试验。另外对25例患者进行了放射酶法血浆儿茶酚胺测定试验。31例患者中有14例后来经组织学证实为嗜铬细胞瘤。其余17例患者，在根据临床病史、症状、实验室检查和影像学检查做出临床诊断后，最终排除了疑似诊断。131-I-MIBG闪烁扫描术显然具有很高的特异性（排除诊断的患者中无假阳性结果），但灵敏度最低（14个肿瘤中有3个未被检测到）。尿儿茶酚胺出现了2例假阴性和3例假阳性结果。血浆儿茶酚胺的灵敏度最高，仅出现1例假阳性结果。由于131-MIBG闪烁扫描术具有很高的确诊价值，当儿茶酚胺测定试验结果相互矛盾时，它不仅有助于定位，还有助于确诊。根据我们在干扰性药物治疗后出现假阳性结果的经验，尿和血浆儿茶酚胺测定试验应仅在采用薄层色谱法或高效液相色谱法纯化后进行。
