Taylor K J, Sullivan D C, Wasson J F, Rosenfield A T
Gastrointest Radiol. 1978 Aug 31;3(3):281-6. doi: 10.1007/BF01887080.
Two hundred and twenty-two patients presented with clinical suspicion of an abdominal or pelvic abscess. Abscesses tend to locate in the perihepatic spaces or the pelvis, and these areas can easily be examined by ultrasound, using the liver or the urinary bladder as acoustic windows. Thirty-eight of 42 abdominal abscesses, and 32 of 33 pelvic abscesses were correctly diagnosed and located by ultrasound, giving a sensitivity of 93.3%. Of the 145 patients without abscesses, 143 were correctly excluded, giving a specificity of 98.6%. Thirty of these patients also underwent gallium 67 examination. This detected all 7 true negatives and all 10 abscesses, 1 of which was missed by ultrasound. Of the remaining 13 patients with positive gallium results, 10 had nonspecific uptake in diffuse inflammatory conditions, and 3 were false positives with uptake in bowel or in a surgical wound. In those patients with nonspecific gallium uptake, ultrasound was valuable in documenting the absence of an abscess cavity. Conversely, gallium detected a left subphrenic abscess missed by ultrasound. For reasons of economy, speed, and high sensitivity, we believe that ultrasound should be the initial screening procedure for patients with clinical suspicion of abdominal or pelvic abscess. Gallium should be reserved for patients with equivocal ultrasound results of those with septic foci not revealed by ultrasound.
222例患者临床上怀疑有腹部或盆腔脓肿。脓肿往往位于肝周间隙或盆腔，这些区域可通过超声以肝脏或膀胱作为声窗进行轻松检查。42例腹部脓肿中的38例以及33例盆腔脓肿中的32例通过超声得到了正确诊断和定位，敏感性为93.3%。145例无脓肿的患者中，143例被正确排除，特异性为98.6%。其中30例患者还接受了镓67检查。该检查检测出了所有7例真阴性以及所有10例脓肿，其中1例脓肿超声检查漏诊。其余13例镓检查结果阳性的患者中，10例在弥漫性炎症情况下有非特异性摄取，3例在肠道或手术伤口处摄取为假阳性。在那些镓摄取非特异性的患者中，超声对于记录无脓肿腔很有价值。相反，镓检测出了1例超声漏诊的左膈下脓肿。出于经济、速度和高敏感性的考虑，我们认为超声应作为临床怀疑有腹部或盆腔脓肿患者的初始筛查程序。镓检查应保留给超声结果不明确的患者或超声未发现感染灶的患者。
