Saïle R, Deveaux M, Hachulla E, Descamps J, Duquesnoy B, Marchandise X
Service Associé de Médecine Nucléaire, Hôpital Claude Huriez, Centre Hospitalier Universitaire, Lille, France.
Eur J Nucl Med. 1993 Feb;20(2):130-7. doi: 10.1007/BF00168873.
This study describes the results of scintigraphy with iodine-123-labelled serum amyloid P component (SAP) as a means of establishing the distribution of organ involvement in amyloidosis. The significance of 123I-SAP scans obtained in 15 patients with biopsy-proven AA or AL amyloidosis is discussed. Biopsy-proven amyloidosis was typically confirmed by scintigraphy, though such confirmation was not obtained in the kidneys in six patients with histological proof of extensive renal amyloid deposition. This lack of uptake may have been due to the accumulation of a major part of the 123I-SAP in the spleen and/or liver. Twenty-four hour whole-body retention of 123I-SAP was higher in patients with amyloidosis than in controls. Twenty-four hour tracer accumulation of the radioactivity in the extravascular compartment was notably greater in patients than in controls and appeared to be a good diagnostic criterion. We conclude that 123I-SAP scintigraphy may be helpful for the evaluation of organ involvement not only in patients with biopsy-proven amyloidosis but also when a biopsy cannot be performed or when a strong suspicion of amyloidosis exists in spite of repeated negative biopsies.
本研究描述了用碘-123标记的血清淀粉样蛋白P成分（SAP）进行闪烁扫描的结果，以此作为确定淀粉样变性中器官受累分布的一种方法。讨论了在15例经活检证实为AA型或AL型淀粉样变性患者中获得的123I-SAP扫描的意义。经活检证实的淀粉样变性通常通过闪烁扫描得以确认，不过在6例有广泛肾淀粉样沉积组织学证据的患者中，肾脏未得到这样的确认。这种摄取缺乏可能是由于123I-SAP的大部分积聚在脾脏和/或肝脏中。淀粉样变性患者中123I-SAP的24小时全身滞留量高于对照组。患者血管外间隙中放射性示踪剂的24小时积聚明显高于对照组，似乎是一个良好的诊断标准。我们得出结论，123I-SAP闪烁扫描不仅对经活检证实的淀粉样变性患者评估器官受累情况可能有帮助，而且在无法进行活检时，或尽管多次活检阴性但仍高度怀疑淀粉样变性时也可能有帮助。
