Detection of invasive pulmonary aspergillosis in mice using lung perfusion single-photon emission computed tomography with [99mTc]MAA
Detection of invasive pulmonary aspergillosis in mice using lung perfusion single-photon emission computed tomography with [99mTc]MAA
复制标题
使用 [99mTc]MAA 肺灌注单光子发射计算机断层扫描检测小鼠侵袭性肺曲霉病
DOI：
10.1093/mmy/myz131
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发表时间：
2020
期刊：
影响因子：
2.9
通讯作者：
Izumikawa Koichi
中科院分区：
文献类型：
--
作者：
Yoshida Masataka;Tashiro Masato;Nishi Kodai;Mishima Maki;Kawano Kei;Takazono Takahiro;Saijo Tomomi;Yamamoto Kazuko;Imamura Yoshifumi;Miyazaki Taiga;Kudo Takashi;Yanagihara Katsunori;Mukae Hiroshi;Izumikawa Koichi
迫切需要开发更好的诊断策略来改善侵袭性肺曲霉病（IPA）患者的预后。我们假设肺灌注单光子发射计算机断层扫描 (SPECT) 可能比胸部计算机断层扫描 (CT) 检测 IPA 更敏感和特异，因为它是一种血管侵袭性肺部感染，其特征与细菌性肺炎不同。我们使用 SPECT 注射锝-99m 标记的大聚集白蛋白 ([99mTc]MAA) 来测量未感染小鼠、IPA 小鼠和细菌性肺炎小鼠的肺灌注。进行组织病理学分析以评估灌注缺陷与霉菌侵袭之间的相关性。我们还尝试定量评估 SPECT 图像，以确定小鼠肺部受影响区域灌注水平下降的差异。 IPA 小鼠模型的组织病理学分析显示，灌注缺陷区域与霉菌存在区域之间存在明显匹配，表明 SPECT 图像上灌注缺陷的位置反映了肺部霉菌的血管侵袭。其中一些灌注缺陷在 CT 图像浸润出现之前就可以看到。定量分析证实，IPA 模型中受影响区域的灌注显着减少，但细菌性肺炎模型中则没有 (P< 0.0001)。这种成像方法可能比目前用于识别患者肺部是否存在霉菌的替代方法更好。
There is an urgent need for development of better diagnostic strategies to improve outcomes in patients with invasive pulmonary aspergillosis (IPA). We hypothesized that lung perfusion single-photon emission computed tomography (SPECT) may be more sensitive and specific than computed tomography (CT) of the chest for detection of IPA because it is an angioinvasive pulmonary infection with characteristics that are different from those of bacterial pneumonia. We used SPECT with injection of technetium-99m-labeled macroaggregated albumin ([99mTc]MAA) to measure pulmonary perfusion in noninfected mice, mice with IPA, and mice with bacterial pneumonia. Histopathologic analysis was performed to evaluate the correlation between the perfusion defect and mould invasion. We also attempted to quantitatively evaluate the SPECT images to identify differences in decreased perfusion levels in affected areas in the mouse lung. Histopathologic analysis in the IPA mouse model showed a clear match between areas with a perfusion defect and the presence of mold, indicating that the location of the perfusion defect on a SPECT image reflects angioinvasion of the mould in the lungs. Some of these perfusion defects could be seen before appearance of the infiltrate of CT images. Quantitative analysis confirmed that perfusion in the affected areas was significantly decreased in the IPA model but not in the bacterial pneumonia model (P< .0001). This imaging method may be preferable to the alternative methods presently used to identify the presence of mold in a patient's lungs.