Biello D R, Levitt R G, Melson G L
Semin Nucl Med. 1979 Jan;9(1):58-65. doi: 10.1016/s0001-2998(79)80008-2.
The evaluation of patients with suspected abdominal abscesses begins with a history and careful physical examination. Gallium-67 (67Ga) scintigraphy, ultrasonography (US), and computed tomography (CT) are utilized only after other routine investigations have failed to localize the abscess. All three modalities are reliable for the detection of abdominal abscesses. The decision regarding which of these three diagnostic tests to use in a particular patient rests upon clinical considerations. If the patient has acute localizing signs and symptoms, 67Ga should not be used initially. In this type of patient, rapid diagnosis is best provided by either US or CT. Further radiologic investigation may be terminated if the CT or US findings are characteristic of an abscess. A 67Ga scan should be performed in a patient with acute localizing signs and symptoms if the initial CT or US is negative. In a patient with nonlocalizing signs and symptoms, 67Ga imaging should be employed as the first procedure since the entire body is easily surveyed. If the 67Ga images are abnormal, then CT or US should be utilized for further lesion characterization. This diagnostic approach will optimize the rapidity of patient evaluation and will minimize diagnostic errors.
对疑似腹部脓肿患者的评估始于病史采集和仔细的体格检查。只有在其他常规检查未能定位脓肿后，才会使用镓-67（67Ga）闪烁扫描、超声检查（US）和计算机断层扫描（CT）。这三种检查方法对腹部脓肿的检测都是可靠的。对于特定患者使用这三种诊断测试中的哪一种，取决于临床考虑因素。如果患者有急性定位体征和症状，最初不应使用67Ga。对于这类患者，超声或CT能最好地实现快速诊断。如果CT或超声检查结果具有脓肿特征，则可终止进一步的影像学检查。如果最初的CT或超声检查结果为阴性，对于有急性定位体征和症状的患者应进行67Ga扫描。对于无定位体征和症状的患者，应首先采用67Ga成像，因为可以轻松对全身进行检查。如果67Ga图像异常，则应使用CT或超声对病变进行进一步特征描述。这种诊断方法将优化患者评估的速度，并将诊断错误降至最低。
