Campeau R J, Ingram C
Department of Radiology, Tulane University Medical Center, New Orleans, Louisiana 70112, USA.
Clin Nucl Med. 1998 Sep;23(9):582-4. doi: 10.1097/00003072-199809000-00003.
A 49-year-old black man with hypertension-induced chronic renal failure requiring hemodialysis and a history of arteriovenous access graft infection was admitted with Staphylococcus aureus sepsis, dyspnea, and peri-incisional erythema over his arteriovenous graft fistula. Results of a transthoracic echo demonstrated aortic sclerosis and concentric left ventricular hypertrophy. Results of a whole-body In-111 white cell (WBC) scan were negative over the arteriovenous graft site; however, an intense abnormal focus of labeled WBCs was evident to the left of the sternum. A subsequent transesophageal echocardiogram showed a mixed cystic-solid calcified mass adjacent the left aortic cusp. Surgery confirmed a perivalvular abscess. As a whole-body imaging modality, the In-111 WBC scintigram indicated the true location of the infectious process responsible for the patient's sepsis. The combination of echocardiography and radiolabeled WBC imaging increases sensitivity for detection of endocarditis/perivalvular abscess. Radiolabeled WBC imaging is more efficacious for monitoring therapy because the echocardiogram often does not change with treatment of endocarditis/perivalvular abscess.
一名49岁的黑人男性，患有高血压所致的慢性肾衰竭，需要进行血液透析，并有动静脉通路移植物感染史，因金黄色葡萄球菌败血症、呼吸困难以及动静脉移植物瘘周围切口处红斑入院。经胸超声心动图结果显示主动脉硬化和左心室向心性肥厚。全身铟-111白细胞（WBC）扫描结果显示动静脉移植物部位无异常；然而，在胸骨左侧可见一个明显的标记白细胞异常浓聚灶。随后的经食管超声心动图显示左主动脉瓣尖旁有一个混合性囊实性钙化肿块。手术证实为瓣周脓肿。作为一种全身成像方式，铟-111白细胞闪烁扫描显示了导致患者败血症的感染过程的真实位置。超声心动图和放射性标记白细胞成像相结合可提高心内膜炎/瓣周脓肿检测的敏感性。放射性标记白细胞成像在监测治疗方面更有效，因为超声心动图在治疗心内膜炎/瓣周脓肿时通常不会发生变化。
