Wong D W, Vasinrapee P, Spieth M E, Cook R E, Ansari A N, Jones M, Mandal A
Department of Radiology, Los Angeles County-Martin Luther King Hospital, CA 90059, USA.
J Am Coll Surg. 1997 Dec;185(6):534-43. doi: 10.1016/s1072-7515(97)00105-1.
Acute appendicitis remains problematic for emergency clinicians. A rapid and definitive test is needed for detecting acute appendicitis before surgical intervention. The purpose of this clinical trial was to determine the efficacy of Tc-99m-labeled intact polyvalent human immune globulin (Tc-99m IgG) in the evaluation of acute appendicitis.
Thirty-five patients with clinically suspected acute appendicitis were evaluated with Tc-99m IgG. After the intravenous injection of 25 mCi (92.5 MBq) of Tc-99m IgG, anterior flow, single photon emission computerized tomography (SPECT) and planar delayed images of the abdomen were obtained. Any abnormal focal uptake of Tc-99m IgG in the right lower quadrant was considered to be a positive scan.
Twenty-one patients with a positive Tc-99m IgG scan underwent laparotomy and were found to have acute appendicitis. Of the 14 patients who had negative scans, 7 underwent surgery. In this series, Tc-99m IgG study yielded 21 true-positive, 12 true-negative, and 2 false-negative results with a sensitivity, specificity, and accuracy of 91%, 100%, and 94%, respectively. The positive and negative predictive values were 100% and 86%, respectively. There were no false-positive results.
Tc-99m IgG scintigraphy can provide the clinicians a simple, rapid, and definitive test for the diagnosis of acute appendicitis.
急性阑尾炎对于急诊临床医生来说仍然是个难题。在进行手术干预之前，需要一种快速且明确的检测方法来诊断急性阑尾炎。本临床试验的目的是确定锝-99m标记的完整多价人免疫球蛋白（Tc-99m IgG）在评估急性阑尾炎中的疗效。
对35例临床怀疑为急性阑尾炎的患者进行了Tc-99m IgG评估。静脉注射25毫居里（92.5兆贝可）的Tc-99m IgG后，获取腹部的前位血流、单光子发射计算机断层扫描（SPECT）和平面延迟图像。右下腹任何异常的Tc-99m IgG局灶性摄取被视为扫描阳性。
21例Tc-99m IgG扫描阳性的患者接受了剖腹手术，发现患有急性阑尾炎。14例扫描阴性的患者中，7例接受了手术。在本系列研究中，Tc-99m IgG检查产生了21例假阳性、12例假阴性和2例假阴性结果，敏感性、特异性和准确性分别为91%、100%和94%。阳性和阴性预测值分别为100%和86%。没有假阳性结果。
Tc-99m IgG闪烁扫描可为临床医生提供一种简单、快速且明确的急性阑尾炎诊断检测方法。
