摘要
目的:调查锝99m标记的抗鼠粒细胞Fab段抗体(硫索单抗)作为一种诊断性显色剂在诊断疑似的儿童急性非典型性阑尾炎中的潜在作用。方法:在注射硫索单抗后15-30min及1h、2h、4h时间点上可获得一系列的平面显像及单光子发射计算机断层扫描(SPECT)成像。在40例疑似有急性非典型性阑尾炎的病例中。
Purpose The aim of this study was to investigate the potential role of a technetium 99m - labeled antigranulocyte murine antibody Fab' fragment (sulesomab) as a diagnostic imaging agent in children with suspected acute nonclassic appendicitis. Methods Serial planar images at 15 to 30 minutes, 1, 2, and 4 hours and single-photon emission computed tomography (SPECT) images were acquired after sulesomab injection. In 40 children with suspected acute nonclassic appendicitis, imaging results were confirmed surgically in 21 patients, whereas 19 nonsurgical patients resolved presenting signs and symp-toms and were considered to not have appendicitis. Results Sulesomab imaging had 95% sensitivity, 90% specificity, 95% negative predictive value, and 90% positive predictive value for a-cute appendicitis. In 78% of patients, sulesomab accurately detected or excluded acute appendicitis and would have changed management plans. No patients had adverse events, and no human antimurine antibody response occurred in 18 evaluable patients. Conclusions Sulesomab was well tolerated with no side effects and with no apparent immunogencity. Appendicitis was rapidly and accurately detected. In pediatric patients with suspected nonclassic appendicitis, management decisions incorporating sulesomab imaging provided benefit in separating surgical from nonsurgical patients.
