99Tc^m-MAA显像诊断腹膜透析后疑似胸腹瘘3例报道  

The Clinical Value of 99Tc^m-MAA Scintigraphy for Diagnosing Pleuroperitoneal Communication in CAPD Patients

作　　者：闵文普 韩云峰 赵明 陈璟 高凌云 周健[2] MIN Wenpu;HAN Yunfeng;ZHAO Ming;CHEN Jing;GAO Lingyun;ZHOU Jian(Department of Nuclear Medicine, The First People′s Hospital of Jingzhou, Jingzhou 434000, China;Department of Nuclear Medicine,Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]荆州市第一人民医院核医学科,湖北荆州434000 [2]华中科技大学同济医学院附属同济医院核医学科,湖北武汉430030

出　　处：《标记免疫分析与临床》2020年第4期716-720,共5页Labeled Immunoassays and Clinical Medicine

基　　金：湖北省卫生计生科研基金资助(编号:WJ2017M079)。

摘　　要：目的探讨99Tcm-MAA核素显像对腹膜透析患者胸腹瘘的诊断价值。方法对3例临床疑似胸腹瘘的持续性非卧床腹膜透析(CAPD)患者行99Tcm-MAA核素动态及延迟显像,监测腹腔渗漏情况,拟定辅助临床诊治方案。结果1例患者延迟显像至24 h,未见明确腹腔渗漏征象,患者沿用原治疗方案,最终胸水量逐渐减少,至完全消失。1例患者右侧胸腔于9 min开始出现放射性分布,且随时间延迟逐渐增浓,诊断右侧胸腹瘘;1例患者右侧胸腔于1 h静态相时见弥漫性放射性分布,诊断为右侧胸腹瘘;临床因此调整了两者的透析方案,采用间断式腹膜透析,随后临床症状明显缓解,体征逐渐消失。结论99Tcm-MAA核素显像作为一种简便、无创、灵敏度高的检查方法,能对CAPD患者胸腹瘘准确定性、定位诊断,并为其后期治疗方案的调整提供可靠依据。Objective To investigate the clinical value of Technetium-99m labeled macroaggregated albumin(99Tcm-MAA)scintigraphy used for the diagnosis of pleuroperitoneal communication(PPC)in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods Two clinic-radiological suspected PPC patients during CAPD underwent dynamic and delayed imaging with 99Tcm-MAA,for identifying PPC to aid the treatment planning design.Results One case with negative 99Tcm-MAA imaging results was followed with the original treatment plan,and by the end of the plan,her pleural effusion disappeared completely.The other case showed the passage of radioactive material to the right chest at 9min after administration of 99Tcm-MAA,which gradually increased overtime,thereby demonstrating the presence of PPC at this level.And then an intermittent peritoneal dialysis(IPD)was used to replace CAPD in this patient.Eventually,her clinical symptoms and sighs disappeared.Conclusion 99Tcm-MAAscintigraphy is a simple,non-invasive and high sensitivity method for the qualitative and positioning diagnosis of PPD in CAPD patients.Furthermore,it can also provide a reliable reference for the adjustment of late-stage treatment plan.

关 键 词：99Tc^m-MAA 核素显像 腹膜透析 胸腹瘘 

分 类 号：R817.5[医药卫生—影像医学与核医学]