Sy W M, Seo I S, Homs C J, Gulrajani R, Sze P, Smith K F, McBride J
Department of Nuclear Medicine, The Brooklyn Hospital Center, New York 11201, USA.
Ann Nucl Med. 1998 Apr;12(2):77-82. doi: 10.1007/BF03164833.
Gallium-67 scintigraphy has been proven as the imaging modality of choice in monitoring the presence of active disease in sarcoidosis. The purpose of this study is to analyze the patterns of evolutional stage changes of sarcoidosis while on steroid therapy by Ga-67 scintigraphy.
Eighty-six consecutive patients with biopsy-proved sarcoidosis are evaluated by Ga-67 scintigraphy. Thirty-six of 86 patients have had a baseline and one to eight follow-up Ga-67 scintigraphs (total 136 studies). The initial follow-up scintigraphs are obtained on average about 4-12 months after the baseline study.
Seventeen of 36 patients (47.2%) are in stage IV at the time of the baseline study. Following their first course of corticosteroid therapy, 13 patients remained in the same stage and activity distribution pattern while 13 patients have shown reversion to other stages, eight patients showed complete remission while two patients became active from inactive stage.
Evolutional stage changes are seen in 23 patients (63.9%), including eight patients (22.2%) who showed complete scintigraphic remission. The evolutionary stage changes remain quite variable and unpredictable. This, however, should not detract from the usefulness of Ga-67 scintigraphy in the diagnosis and prognostic evaluation of sarcoidosis, particularly when extrapulmonary involvement (Stage IV disease) is present.
镓 - 67闪烁扫描已被证明是监测结节病活动性疾病存在的首选成像方式。本研究的目的是通过镓 - 67闪烁扫描分析结节病在接受类固醇治疗时的演变阶段变化模式。
对86例经活检证实为结节病的连续患者进行镓 - 67闪烁扫描评估。86例患者中有36例进行了基线检查以及1至8次随访镓 - 67闪烁扫描（共136项研究）。初始随访闪烁扫描平均在基线研究后4 - 12个月进行。
36例患者中有17例（47.2%）在基线研究时处于IV期。在接受第一个疗程的皮质类固醇治疗后，13例患者仍处于同一阶段且活动分布模式不变，而13例患者显示转变为其他阶段，8例患者完全缓解，2例患者从不活动阶段变为活动阶段。
23例患者（63.9%）出现了演变阶段变化，其中8例患者（22.2%）闪烁扫描完全缓解。演变阶段变化仍然相当多变且不可预测。然而，这并不影响镓 - 67闪烁扫描在结节病诊断和预后评估中的有用性，特别是当存在肺外受累（IV期疾病）时。
