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结节病静息状态下铊-201心肌单光子发射计算机断层扫描结果

Thallium-201 myocardial SPECT findings at rest in sarcoidosis.

作者信息

Yamamoto N, Gotoh K, Yagi Y, Terashima Y, Nagashima K, Sawa T, Deguchi F, Nawada M, Tanaka H, Tsukamoto T

机构信息

Second Department of Internal Medicine, Gifu University School of Medicine, Japan.

出版信息

Ann Nucl Med. 1993 May;7(2):97-103. doi: 10.1007/BF03164574.

Abstract

In 41 patients with sarcoidosis (diagnosed according to criteria recommended by the Committee on Diffuse Pulmonary Disease, Ministry of Health and Welfare, Japan 1988), thallium-201 (201Tl) myocardial SPECT was performed to investigate: (1) the ability of 201Tl SPECT to detect cardiac involvement of sarcoidosis with images recorded at rest and 2 hours later, and (2) the relationships between 201Tl myocardial SPECT findings and the activity of sarcoidosis or endomyocardial biopsy findings. As to the abnormal findings in 201Tl myocardial SPECT, (1) a low density area was seen in 13 of 41 cases (31.7%) and non-uniform uptake was found in 17 cases (41.5%), (2) the mean washout ratio (n = 39) was 16.5 +/- 7.4%, which is significantly (p < 0.05) lower than that found in normal subjects, 23.9 +/- 7.5% (n = 10). Of the 19 patients judged visually to be normal, 5 patients had a reduced mean washout ratio less than 12%. Thus, the incidence of abnormal findings including all types of abnormality, on 201Tl myocardial SPECT in sarcoidosis was 63.4% (26/41 cases). In studying the relationship between 201Tl myocardial SPECT findings and the activity of sarcoidosis (as measured by the serum ACE (angiotensin converting enzyme) or lysozyme level, or the presence of more than 30% symphocyte fraction in BALF (broncho-alveolar lavage fluid)), 20 (80%) of 25 cases with 201Tl abnormality were judged to be active sarcoidosis, while only 6 (37.5%) of 16 cases with normal findings on 201TI SPECT were judged to be active.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对41例结节病患者(根据日本厚生省弥漫性肺疾病委员会1988年推荐的标准诊断)进行了铊-201(201Tl)心肌单光子发射计算机断层扫描(SPECT),以研究:(1)201Tl SPECT在静息及2小时后成像检测结节病心脏受累情况的能力;(2)201Tl心肌SPECT检查结果与结节病活动度或心内膜活检结果之间的关系。关于201Tl心肌SPECT的异常表现:(1)41例中有13例(31.7%)可见低密度区,17例(41.5%)摄取不均匀;(2)平均洗脱率(n = 39)为16.5±7.4%,显著低于正常受试者(p < 0.05)的23.9±7.5%(n = 10)。在19例视觉判断为正常的患者中,5例平均洗脱率降低至12%以下。因此,结节病患者201Tl心肌SPECT包括所有类型异常的异常表现发生率为63.4%(26/41例)。在研究201Tl心肌SPECT检查结果与结节病活动度(通过血清血管紧张素转换酶(ACE)或溶菌酶水平,或支气管肺泡灌洗液(BALF)中淋巴细胞比例超过30%来衡量)之间的关系时,25例201Tl异常的患者中有20例(80%)被判定为结节病活动期,而201Tl SPECT检查结果正常的16例患者中只有6例(37.5%)被判定为活动期。(摘要截短至250字)

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