Darstellung früher atherosklerotischer Läsionen der A. carotis mit ¹¹¹In-markiertem polyklonalem humanem IgG (HIG)

Zusammenfassung

Ziel: Zur Erfassung morphologischer und funktioneller Veränderungen bei frühen atherosklerotischen Gefäßveränderungen wurde in der vorliegenden prospektiven Vergleichsstudie die Wertigkeit der Szintigraphie mit ^l11ln-markiertem humanem Immunglobulin G (^l11ln-HIG) im Vergleich zur hochauflösenden Sonographie verglichen.

Methoden: 58 Patienten (38 Männer, 20 Frauen; mittleres Alter 60 ± 7 Jahre) mit einer Dyslipoproteinämie und sonographisch nachgewiesenen atherosklerotischen Läsionen der A. carotis wurden untersucht. Nach i.v. Applikation von 18,5 MBq ¹¹¹In-HIG wurden a.p. Szintigramme der Halsregion angefertigt. Weiters wurde eine zweidimensionale Real-time-B-Mode-Sonographie der linken und rechten Arteria carotis durchgeführt.

Ergebnisse: Die ¹¹¹ln-HIG-Szintigraphie im Vergleich zum morphologischen Goldstandard (Sonographie) hatte für den Nachweis von atherosklerotischen Läsionen der Carotiden eine Sensitivität von 70 bis 73%, eine Spezifität von 33-41% und einen positiven Vorhersagewert von 77-82%. Es bestand keine statistisch signifikante Korrelation zwischen den Ergebnissen der Szintigraphie und der Sonographie.

Schlußfolgerung: Die Ergebnisse deuten darauf hin, daß mit den beschriebenen bildgebenden Verfahren verschiedene Aspekte der Atherosklerose diagnostiziert werden. Einerseits werden funktionelle (^ll1ln-HIG), andererseits werden morphologische Veränderungen (Sonographie) atherosklerotischer Läsionen dokumentiert.

Summary

Aim: To assess the value of scintigraphy with ¹¹¹In-HIG for diagnosis and evaluation of the stage and the clinical extent of carotid artery disease in humans a prospective clinical comparative trial of scintigraphy vs. sonography was performed.

Methods: 58 patients (38 male, 20 female; mean age 60 ± 7 years) with hyperlipidemia and ultrasonographically detectable carotid artery lesions were studied. After i.v. injection of 18.5 MBq ¹¹¹ In-HIG, anterior scintigraphic images of the neck were acquired. Real time two-dimensional B-mode ultrasonography of the left and the right carotid arteries was performed.

Results: ¹¹¹In-HIG-scintigraphy as compared to the morphological gold standard (ultrasonography) had a sensitivity of 70-73%, specificity of 33-41% and a positive predictive value of 77-82% for detecting carotid atherosc’erotic lesions. There was, however, no significant correlation between scintigraphy and ultrasonography.

Conclusion: However, the data provide evidence that the two imaging techniques are visualizing different aspects of atherogenesis. On the one hand a functional one reflecting the activity of the disease (¹¹¹In-HIG) and on the other hand the morphological one resembling the extent of the disease (ultrasonography).

Schlüsselwörter

¹¹¹lndium-HIG (humanes lgG)-Szintigraphie - Sonographie - Atherosklerose

Key words

¹¹¹lndium-HIG (human lgG)-scintigraphy - sonography - atherosclerosis

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