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Der Nuklearmediziner 2007; 30(2): 154-167
DOI: 10.1055/s-2007-960530
© Georg Thieme Verlag Stuttgart · New York

Seltene und spezielle Indikationen für eine nuklearmedizinische Entzündungsdiagnostik

Rare and Special Indications for Nuclear Medicine Evaluation of Infective DiseaseS. Tesche1 , B. Meller2 , U. Siefker1 , A. Hamann1 , C. O. Sahlmann1 , J. Meller1
  • 1Abteilung Nuklearmedizin, Georg August Universität Göttingen
  • 2Abteilung Nuklearmedizin, Universität zu Lübeck
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Publication 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

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