Tc-99m HIG scintigraphy in detection of active inflammation in ankylosing spondylitis

Amaç: Ankilozan spondilit vakalarında aktif hastalığın belirlenmesi tedavi ile olası kalıcı deformitelerin önlenmesi açısından önemlidir. ancak aktif hastalığın belirlenmesinde özgün laboratuvar testleri ve görüntüleme yöntemleri yoktur. Bu çalışmada hastalık aktivitesinin belirlenmesinde Tc-99m insan immünoglobulin (HIG) sintigrafisinin kullanılabilirliğini araştırdık. Gereç ve Yöntemler: Çalışmaya 29 hasta alındı. Aktif enflamasyon klinik ve serolojik testlerle belirlendi. Tc-99m metilendifosfonat ile kemik ve HIG sintigrafileri 2-5 gün arayla elde edildi. MDP ve HIG sintigrafileri için kontrol grupları oluşturuldu. Tüm sintigrafik çalışmalar görsel olarak değerlendirildi, kantifikasyon için sakroiliak eklem endeks değerleri hesaplandı. Bulgular: Beş hastada klinik değerlendirmede aktif enflamasyon saptandı (sakroileit 2, sakroileit ve spinal enflamasyon 1, aşil tendiniti 1, koksofemoral eklem artriti 1). HIG klinik olarak aktif sakroileiti olan 3 hastanın tümünde pozitif iken farklı lokalizasyonlarda aktif hastalığı olan diğer 2 kişide negatifti. HIG sintigrafisi ile elde edilen SIE değerleri klinik aktif hastalarda inaktif olanlardan yüksekti. İnaktif hastalarla kontrol grubu arasında HIG sintigrafisinde anlamlı fark yoktu. Kemik sintigrafisi ile elde edilen SIE değerleri hasta grubunda kontrol grubuna göre yüksekti (p

Ankilozan spondilit hastalarında aktif enflamasyonun tespitinde Tc-99m HIG sintigrafisi

Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS) is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG) scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP) and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII) were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1) patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05) in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05) in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58)

Kaynakça

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Kaynak Göster

Molecular Imaging and Radionuclide Therapy
  • ISSN: 2146-1414
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1992

1.3b473

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