Kao P F, Tzen K Y, Tsui K H, Tsai M F, Yen T C
Department of Nuclear Medicine, Chang Gung Memorial Hospital, Tauyuan, Taiwan, R.O.C.
Eur J Nucl Med. 1998 Oct;25(10):1442-7. doi: 10.1007/s002590050321.
A psoas abscess is a rare clinical entity that presents diagnostic and therapeutic challenges. In this retrospective study, we reviewed gallium-67 scan findings in cases of psoas abscess to determine the specific uptake pattern and the usefulness of 67Ga scans in diagnosis and management. Fifteen psoas abscess lesions in 13 patients who had undergone a 67Ga scan during an 8-year period were found in the hospital computer. All but two of the patients had been diagnosed as having fever of unknown origin, urinary tract infection or another irrelevant disease prior to the 67Ga scan. Of the 15 psoas abscess lesions, 12 (80%) could be clearly diagnosed on the basis of the specific 67Ga uptake pattern, in which: (1) the oblique direction of the 67Ga-avid lesion correlates with the orientation of the psoas muscle from the lumbar region to the hip joint region; (2) the lesion does not cross the abdominal midline; (3) the lesion goes through the inguinal region; and (4) the lesion involves at least two-thirds of the whole length of the psoas muscle. The specific features may help in the differentiation of psoas abscess from other intra-abdominal lesions or normal bowel distribution, especially with single-photon emission tomographic images. In 7 of 13 patients (53.8%) the 67Ga scan findings contributed to the clinical management of the patients by first detecting the focus of the infection. Multiple concomitant 67Ga-avid lesions were found in ten patients. In conclusion, the specific features as well as the whole-body survey with 67Ga scan are useful and important in the diagnosis of psoas abscesses and the detection of unexpected concomitant multiple infectious foci in clinically suspicious infectious disease patients.
腰大肌脓肿是一种罕见的临床病症，在诊断和治疗方面均具有挑战性。在这项回顾性研究中，我们回顾了腰大肌脓肿病例的镓-67扫描结果，以确定其特异性摄取模式以及67Ga扫描在诊断和管理中的作用。在医院计算机中发现了13例患者的15个腰大肌脓肿病灶，这些患者在8年期间接受了67Ga扫描。除两名患者外，所有患者在进行67Ga扫描之前均被诊断为不明原因发热、尿路感染或其他无关疾病。在15个腰大肌脓肿病灶中，有12个（80%）可根据67Ga的特异性摄取模式明确诊断，其特征如下：（1）67Ga摄取病灶的斜向与腰大肌从腰椎区域到髋关节区域的走向相关；（2）病灶不越过腹部中线；（3）病灶穿过腹股沟区；（4）病灶累及腰大肌全长的至少三分之二。这些特异性特征可能有助于将腰大肌脓肿与其他腹腔内病变或正常肠管分布区分开来，尤其是在单光子发射断层扫描图像中。在13例患者中的7例（53.8%）中，67Ga扫描结果通过首先检测到感染灶，有助于患者的临床管理。10例患者发现有多个伴随的67Ga摄取病灶。总之，67Ga扫描的特异性特征以及全身检查在腰大肌脓肿的诊断以及临床可疑感染性疾病患者中意外伴随的多个感染灶的检测方面均有用且重要。
