Kim D G, Lee J I, Lee D S, Lee M C, Choi K S, Han D H
Department of Neurosurgery, Seoul National University College of Medicine, Korea.
Surg Neurol. 1995 Oct;44(4):338-45. doi: 10.1016/0090-3019(95)00221-9.
Scintigraphy with 111In (indium-111)-oxine or 99mTechnetium-hexamethylpropyleneamine oxime (99mTc-HMPAO) labeled leukocytes has been used to differentiate brain abscess from brain tumor. However, there are false positive or false negative results from planar scintigraphic images. So a more specific and sensitive scintigraphic technique needs to be developed.
Planar and single photon emission computed tomography (SPECT) images were obtained and reviewed in 14 patients with intracerebral ring-enhancing lesions on computed tomography (CT) or magnetic resonance imaging (MRI). In all patients, diagnosis was confirmed by histopathologic examination. The effect of steroids or antibiotics on scintigraphic finding was examined.
Abscess was confirmed in six patients, tumor in six, tuberculoma and cysticercosis in one each, respectively. In all the patients with abscess, SPECT showed increased focal activity irrespective of steroid or antibiotic therapy. Increased radioactivity, which could not be detected on planar images, could be identified in two patients with abscess. In three of the six patients with tumor, radiolabeled leukocytes did not accumulate in the tumor. In the other three patients with tumor, SPECT showed focally increased activity that was less intense than the activity shown in the patients with abscess.
99mTc-HMPAO labeled leukocyte SPECT is useful for the differential diagnosis of intracerebral ring-enhancing lesions, and the use of steroids or antibiotics does not influence the sensitivity of SPECT. Diagnostic sensitivity of scintigraphy with labeled leukocytes could be improved by SPECT in addition to planar image.
使用铟 - 111（111In）- 奥克辛或锝 - 99m（99mTc）- 六甲基丙烯胺肟（99mTc - HMPAO）标记白细胞的闪烁扫描术已被用于鉴别脑脓肿和脑肿瘤。然而，平面闪烁扫描图像存在假阳性或假阴性结果。因此，需要开发一种更特异、更敏感的闪烁扫描技术。
对14例计算机断层扫描（CT）或磁共振成像（MRI）显示脑内环形强化病变的患者进行了平面和单光子发射计算机断层扫描（SPECT）图像采集及分析。所有患者均经组织病理学检查确诊。研究了类固醇或抗生素对闪烁扫描结果的影响。
6例确诊为脓肿，6例为肿瘤，1例为结核瘤，1例为囊尾蚴病。所有脓肿患者，无论是否接受类固醇或抗生素治疗，SPECT均显示局灶性活性增加。在2例脓肿患者中，平面图像上未检测到的放射性增加可在SPECT图像上识别出来。6例肿瘤患者中有3例，放射性标记的白细胞未在肿瘤中聚集。在另外3例肿瘤患者中，SPECT显示局灶性活性增加，但强度低于脓肿患者。
99mTc - HMPAO标记白细胞SPECT对脑内环形强化病变的鉴别诊断有用，类固醇或抗生素的使用不影响SPECT的敏感性。除平面图像外，SPECT可提高标记白细胞闪烁扫描术的诊断敏感性。
