首页> 外文OA文献 >Comparison of 99m technetium hexamethylpropylene-amine oxime labelled leucocyte with 111-indium tropolonate labelled granulocyte scanning and ultrasound in the diagnosis of intra-abdominal abscess.
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Comparison of 99m technetium hexamethylpropylene-amine oxime labelled leucocyte with 111-indium tropolonate labelled granulocyte scanning and ultrasound in the diagnosis of intra-abdominal abscess.

机译:99m六甲基丙烯胺肟肟标记的白细胞与111-对羟基苯甲酸铟标记的粒细胞的扫描和超声检查在腹腔内脓肿诊断中的比较。

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摘要

Fifty patients with suspected intra-abdominal abscess were investigated prospectively with ultrasound and with 99mTc-hexamethylpropylene-amine oxime (HMPAO) isotope labelled mixed leucocytes, using 111-In tropolonate granulocyte scanning as the reference standard. Twenty five patients had inflammatory bowel disease (three were postoperative): 21 of these had Crohn's disease and four had ulcerative colitis. The remainder comprised nine with postoperative fever and 16 with fever and abdominal pain. An abscess was diagnosed when focal activity on serial 111-In tropolonate and 99m-Tc-HMPOA images at one, three, and 24 hours resulted in activity at least equal to liver activity at 24 hours. Thirteen abscesses were diagnosed using each type of white cell scanning, resulting in 100% sensitivity for 99m-Tc-HMPAO compared with 111-In tropolonate. Bowel inflammation was easily distinguished from abscess on serial images. Eight of these 13 abscesses were detected by ultrasound. Altogether 17 abscesses were found. Ultrasound detected 12, including four liver abscesses which were not purulent and had not been detected by white cell scanning. Ultrasound had a sensitivity of 71% (12 of 17) and a specificity of 87% (33 of 38) using all confirmed abscesses as the reference standard. White cell scanning showed a sensitivity of 76% (13 of 17: as a result of the four non-purulent liver abscesses) and a specificity of 100%. 99m-Tc-HMPAO scanning is as accurate as 111-In tropolonate scanning, and has several advantages including simplicity, availability, superior image quality, and reduced radiation dose. Both methods are more sensitive and specific than ultrasound for intra-abdominal abscess detection but ultrasound is advisable if a neutrophil infiltrate is not suspected.
机译:使用111-In对光玻璃酸盐粒细胞扫描作为参考标准,对50例怀疑有腹腔内脓肿的患者进行了超声检查,并用99mTc-六甲基丙烯胺肟(HMPAO)同位素标记的混合白细胞进行了调查。 25例炎症性肠病(3例术后):其中21例患有克罗恩病,4例患有溃疡性结肠炎。其余包括9例术后发烧,16例发烧和腹痛。当连续1、3和24小时在111-In对羟基苯甲酸和99m-Tc-HMPOA系列图像上的聚焦活动导致活动至少等于24小时肝脏活动时,诊断为脓肿。每种类型的白细胞扫描可诊断出13个脓肿,与111-In对羟基苯甲酸相比,对99m-Tc-HMPAO的敏感性为100%。在连续图像上很容易将肠炎与脓肿区分开。这13个脓肿中有8个是通过超声检查发现的。共发现脓肿17处。超声检测到12个,包括四个肝脓肿,这些脓肿不是化脓性的,也没有通过白细胞扫描检测到。使用所有已确认的脓肿作为参考标准,超声的灵敏度为71%(17个中的12个),特异性为87%(38个中的33个)。白细胞扫描显示灵敏度为76%(17个中的13个:由于四个非脓性肝脓肿的结果),特异性为100%。 99m-Tc-HMPAO扫描与111-In对羟基苯甲酸扫描一样精确,并且具有多个优点,包括简单,实用,图像质量高和辐射剂量低。对于腹部内脓肿的检测,这两种方法都比超声更灵敏,更特异性,但如果不怀疑中性粒细胞浸润,建议使用超声。

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