Lung scintigraphy with nonspecific human immunoglobulin G (99mTc-HIG) in the evaluation of pulmonary involvement in connective tissue diseases:: correlation with pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT)
Lung scintigraphy with nonspecific human immunoglobulin G (99mTc-HIG) in the evaluation of pulmonary involvement in connective tissue diseases:: correlation with pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT)
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DOI：
10.1007/s00259-007-0599-7
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发表时间：
2008-02-01
影响因子：
9.1
通讯作者：
Leondi, A.
中科院分区：
文献类型：
--
作者：
Kostopoulos, Ch.;Koutsikos, J.;Leondi, A.
目的在结缔组织疾病（CTD）患者中，早期发现和评估肺部受累的严重程度是必须的。高分辨率计算机断层扫描（HRCT）和肺功能测试（PFTs）被认为是有价值的非侵入性诊断方式。放射性药物也被用于这一目的。我们的目的是评估技术标记的人多克隆免疫球蛋白G （HIG）肺显像在早期发现和评估CTD患者肺部病变严重程度中的作用。方法对52例非吸烟CTD患者进行PFTs、HRCT和HIG检查。根据pft分为A组（pft受损-肺功能异常）和B组（肺功能正常）。对HIG、HRCT进行半定量分析，得到相应评分。结果两组患者HIG评分差异有统计学意义（0.6 +/- 0.07 vs 0.51 +/- 0.08, P < 0.001）。HIG评分与PFTs结果呈显著负相关，与HRCT评分呈显著正相关。HIG表现出与HRCT相似的临床表现。在其评分的最佳截止水平（分别为0.56和7），HIG具有较高的敏感性（77.5 vs 57.5%）和较低的特异性（75 vs 91.7%）。两种方法的结合以牺牲特异性为代价增加了异常发现的敏感性。结论HIG显像可用于CTD肺部受累程度的早期发现和评估，与HRCT联合使用可进一步提高对患者的检出率。
Purpose In patients with connective tissue diseases (CTD), the early detection and evaluation of the severity of the pulmonary involvement is mandatory. High-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) are considered to be valuable noninvasive diagnostic modalities. Radiopharmaceuticals have also been used for this purpose. Our aim was the evaluation of technetium-labeled human polyclonal immunoglobulin G (HIG) lung scintigraphy in the early detection and assessment of the severity of the pulmonary involvement in CTD patients.Methods Fifty-two nonsmoking CTD patients were studied by PFTs, HRCT, and HIG. According to PFTs, patients were divided in group A (impaired PFTs-abnormal pulmonary function) and group B (normal pulmonary function). Semiquantitative analysis was done on HIG and HRCT and corresponding scores were obtained.Results Significant difference was found between HIG scores in the two groups (0.6 +/- 0.07 vs 0.51 +/- 0.08, P < 0.001). There was a statistically significant negative correlation between HIG scores and PFTs results and a positive correlation between HIG and HRCT scores. HIG demonstrated similar clinical performance to HRCT. At the best cut-off levels of their score (0.56 and 7, respectively), HIG had a superior sensitivity (77.5 vs 57.5%) with lower specificity (75 vs 91.7%). The combination of the two methods increased the sensitivity of abnormal findings at the expense of specificity.Conclusions HIG scintigraphy can be used in the early detection and evaluation of the severity of the pulmonary involvement in CTD, whereas, when used in combination with HRCT, the detection of affected patients can be further improved.