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DOI: 10.1055/s-2007-960530
Seltene und spezielle Indikationen für eine nuklearmedizinische Entzündungsdiagnostik
Rare and Special Indications for Nuclear Medicine Evaluation of Infective DiseasePublication History
Publication Date:
04 June 2007 (online)
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Zusammenfassung
Dieser Artikel gibt einen evidenzgeleiteten Überblick über entzündungsszintigrafische Verfahren bei einigen seltenen Indikationen. Bei der Diagnostik und bei der Beurteilung der Aktivität einer chronisch-entzündlichen Darmerkrankung bleibt die Szintigrafie mit 99mTc-HMPAO-markierten autologen Leukozyten die nuklearmedizinische Standarduntersuchung. Eine Appendizitis kann sowohl mittels in vitro markierter Leukozyten als auch immunentzündungs-szintigrafisch mit hoher Sicherheit nachgewiesen und ausgeschlossen werden. Die späte SPECT (20-24 h p. i.) mit 99mTc-markierten monoklonalen Anti-CD-66-Antikörpern ist eine sinnvolle Zusatzuntersuchung zur transösophagealen Echokardiografie bei der Endokarditisdiagnostik. Infizierte Gefäßprothesen sollten mittels 99mTc-HMPAO-markierter autologer Leukozyten untersucht werden. Es muss diskutiert werden, ob die [18F]FDG-PET oder [18F]FDG-PET / CT bei dieser Fragestellung eine höhere diagnostische Genauigkeit aufweist.
Abstract
This article gives an evidence-based overview about several special indications for scintigraphy in imaging infection and inflammation. In diagnosing and evaluating the extent of inflammatory bowel disease, the scintigraphy with 99mTc-HMPAO labelled leucocytes remains the standard evaluation in Nuclear Medicine. Appendicitis can be proven or excluded with a high grade of certainty both by 99mTc-labelled monoclonal antigranulocytic antibodies and FAb′-fragments and by in-vitro labelled leucocytes. In endocarditis a late SPECT (20-24 h p. i.) with a 99mTc-labeled anti-CD66 monoclonal antibody is a useful adjunct to echocardiographic techniques. In infected vascular prostheses, 99mTc-HMPAO-labelled autologous leucocytes remain the standard of Nuclear Medicine although [18F]FDG-PET or [18F]FDG-PET / CT may exhibit a higher diagnostic accuracy.
Schlüsselwörter
entzündliche Darmerkrankungen - Appendizitis - infizierte Gefäßprothese - Endokarditis - Szintigrafie - radioaktiv markierte Leukozyten - [18F]FDG
Key words
inflammatory bowel disease - appendicitis - infection of vascular prostheses - endocarditis - scintigraphy - labelled white blood cells - [18F]FDG
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PD Dr. J. Meller
Abteilung Nuklearmedizin
Robert-Koch-Str. 130
37075 Göttingen
Phone: +49 / 5 51 / 39 85 12
Fax: +49 / 5 51 / 39 85 26
Email: jmeller@med.uni-goettingen.de