Nijhof M W, Oyen W J, van Kampen A, Claessens R A, van der Meer J W, Corstens F H
University Hospital Nijmegen, Department of Nuclear Medicine, The Netherlands.
J Nucl Med. 1997 Aug;38(8):1300-5.
Indium-111-labeled human nonspecific immunoglobin G (111In-IgG) is one of the newer agents suggested for scintigraphic evaluation of infection and inflammation. In this study, the utility of this agent was studied in routine clinical practice.
A dose of 75 MBq 111In labeled to 2 mg IgG (MacroScint) was administered intravenously in 226 patients with 232 possible foci of infection or inflammation. Imaging was performed 4, 24 and 48 hr postinjection. The results were verified by culture, obtained either surgically (42%) or via puncture (19%) and long-term clinical and roentgenological follow-up (39%). Follow-up data were used in patients of whom the vast majority had a negative work-up, including negative 111In-IgG scintigraphy.
All infected total hip (THA) and total knee arthroplasties, focal osteomyelitis, diabetic foot infections, septic arthritis and soft-tissue infections were detected (61 foci). Only one patient with early, low-grade spondylodiscitis was false negative with 111In-IgG. Since 111In-IgG scintigraphy does not discriminate between infectious and sterile inflammation, careful interpretation is necessary in cementless THA up to 1 yr after insertion, uptake only around the neck of the femoral component of a THA, recent fractures and pseudarthrosis, in which uptake may be caused by sterile inflammation and not by infection (specificity for inflammation 100%, specificity for infection of 77%).
Indium-111-IgG scintigraphy is a very sensitive tool for detection of infectious bone and joint disease. Moreover, when uptake patterns of 111In-IgG, which are characteristic for sterile inflammation, are excluded, infection can be ruled out with a high degree of certainty.
铟 - 111标记的人非特异性免疫球蛋白G（111In - IgG）是用于感染和炎症闪烁显像评估的较新试剂之一。在本研究中，该试剂在常规临床实践中的效用进行了研究。
将75 MBq铟 - 111标记到2 mg IgG（MacroScint）中，静脉注射给226例有232个可能感染或炎症病灶的患者。在注射后4、24和48小时进行显像。结果通过培养进行验证，培养标本通过手术获取（42%）或穿刺获取（19%），以及长期临床和放射学随访（39%）。随访数据用于绝大多数检查结果为阴性的患者，包括111In - IgG闪烁显像阴性的患者。
所有感染的全髋关节置换术（THA）和全膝关节置换术、局灶性骨髓炎、糖尿病足感染、化脓性关节炎和软组织感染均被检测到（61个病灶）。只有1例早期轻度脊椎椎间盘炎患者的111In - IgG检查结果为假阴性。由于111In - IgG闪烁显像不能区分感染性炎症和无菌性炎症，因此在非骨水泥型THA植入后1年内、仅THA股骨部件颈部周围有摄取、近期骨折和假关节的情况下，需要仔细解读，其中摄取可能由无菌性炎症而非感染引起（炎症特异性为10%，感染特异性为77%）。
铟 - 111 - IgG闪烁显像对于检测感染性骨和关节疾病是一种非常敏感的工具。此外，当排除111In - IgG摄取模式（无菌性炎症的特征性模式）时，可以高度确定地排除感染。
