Braude A C, Cohen R, Rahmani R, Hornstein A, Klein M, Meindok H O, Chamberlain D W, Rebuck A S
Am Rev Respir Dis. 1984 Nov;130(5):783-5. doi: 10.1164/arrd.1984.130.5.783.
In the evaluation of the active alveolitis of pulmonary sarcoidosis, both the proportional lymphocyte count obtained by bronchoalveolar lavage and state of activation of the alveolar macrophage by gallium scanning are required. We injected 6 mCi (200 MBq) of 67Ga intravenously on 24 occasions in 13 patients with biopsy-proved sarcoidosis. Forty-eight hours later, patients were scanned with a rectilinear scanner and the generated scintigrams were evaluated using the NIH index. Seventy-two hours after injection, bronchoalveolar lavage was performed, and venous blood was sampled. The harvested lavage fluid was analyzed for absolute and proportional cell counts, and radioactivity was measured in blood and BAL fluid. An in vitro 67Ga index was generated and expressed as counts/100,000 alveolar macrophages/ml blood (mean, 0.0146 +/- 0.0087 SD). There was a significant relationship between the in vitro index and proportional lymphocyte BAL counts (r = 0.79; p less than 0.002) that was comparable to that obtained using the NIH index (r = 0.74; p less than 0.005). These data suggest that the in vitro index might offer a more objective assessment of 67Ga uptake by the lung, but this would require validation against clinical parameters in a prospective study.
在评估肺结节病的活动性肺泡炎时，既需要通过支气管肺泡灌洗获得的淋巴细胞比例计数，也需要通过镓扫描评估肺泡巨噬细胞的活化状态。我们对13例经活检证实为结节病的患者进行了24次静脉注射6mCi（200MBq）的67Ga。48小时后，用直线扫描仪对患者进行扫描，并使用美国国立卫生研究院（NIH）指数评估所生成的闪烁图。注射72小时后，进行支气管肺泡灌洗，并采集静脉血。对采集的灌洗液进行绝对细胞计数和比例细胞计数分析，并测量血液和支气管肺泡灌洗液中的放射性。生成体外67Ga指数，并表示为每毫升血液中每100,000个肺泡巨噬细胞的计数（平均值，0.0146±0.0087标准差）。体外指数与支气管肺泡灌洗淋巴细胞比例计数之间存在显著相关性（r = 0.79；p < 0.002），这与使用NIH指数获得的相关性（r = 0.74；p < 0.005）相当。这些数据表明，体外指数可能为肺对67Ga摄取提供更客观的评估，但这需要在前瞻性研究中根据临床参数进行验证。
