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[我们在肺部结节病病例中进行镓闪烁扫描的经验(作者译)]

[Our experiences with the gallium-scintigraphy in case of sarcoidosis of the lungs (author's transl)].

作者信息

Schermuly W, Behrend H, Helmke F R, Worch R

出版信息

Z Erkr Atmungsorgane. 1977 Jul;149(1):112-21.

PMID:607612
Abstract

The comparing examinations of patients suffering from a sarcoidosis of the lungs by the help of roentgenograms, scintigraphies of lung perfusion of 67-gallium and bioptic examinations admit to conclude as follows: In the stages I and II the activity-accumulation of radioactive gallium corresponds nearly to the alterations becoming visible in the X-ray-graph. Consequently, increases of lymph nodes and active granulomatous interstitial or centriform infiltrations may be presented. In case of a successful treatment the activity-incorporation is not to be proved anymore. As to time the alterations also coincide with the radiogram. In single cases the epithelioid nodule may be proved bioptically and microscopically when the active process already has stabilized spontaneously or by a treatment. In these cases the radioactive gallium is incorporated no more. The proof of 67-Ga-activity has a special signification in case fibrotic alterations have already appeared. The examinations prove that a granulomatosis may continue to exist when already distinct X-ray-symptoms of a fibrosis are present. Consequently, the granulomas may appositionally develop and cause an additional fibrosis. Therefore, in case of an existing infiltration of the lungs the combination of a definite lesion in the form of a fibrosis and a persisting formation of granulomas rather means a rule than an exception. A perfusion scintigram may be altered pathologically by a granuloma as well as by a fibrosis. Disorders in perfusion caused by granulomas are reversible.

摘要

通过X线片、67镓肺灌注闪烁扫描及活检检查对肺部结节病患者进行对比检查后可得出以下结论:在I期和II期,放射性镓的活性聚集与X线片中可见的改变几乎一致。因此,可能出现淋巴结增大及活动性肉芽肿性间质或中央型浸润。如果治疗成功,将不再显示活性摄取。在时间上,这些改变也与X线片相符。在个别情况下,当活动过程已经自发稳定或经治疗稳定后,可通过活检和显微镜检查证实上皮样结节。在这些情况下,放射性镓不再摄取。当已经出现纤维化改变时,67镓活性的证实具有特殊意义。检查证明,当已经出现明显的纤维化X线症状时,肉芽肿病可能继续存在。因此,肉芽肿可能会附加性发展并导致额外的纤维化。所以,在存在肺部浸润的情况下,以纤维化形式存在的明确病变与持续存在的肉芽肿形成相结合,这是常见情况而非例外。肉芽肿和纤维化均可使灌注闪烁扫描出现病理性改变。由肉芽肿引起的灌注障碍是可逆的。

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