CAJ | 학술논문

目的比较新型显像剂99mTc-环丙沙星显像与CT检测重症胰腺炎继发感染的价值.方法 28只健康幼猪按数字表法随机分为正常组(6只)、非感染性急性坏死性胰腺炎( ANP)组(6只)、感染性ANP组(16只).采用胰管注入牛磺胆酸钠和胰蛋白酶混合液的方法制备ANP模型.感染性ANP组于制模后2d向胰腺组织内注射3×108个大肠杆菌,非感染性ANP组注射灭活的大肠杆菌.7d后每只幼猪静脉注射370 MBq的99mTc-环丙沙星,给药后0.5、1、2、3、4、6h行SPECT断层显像,0.5h后行64层螺旋CT扫描.检查结束后处死动物,取胰腺组织行病理检查及细菌培养.比较两种影像学方法检测ANP继发感染的敏感性、特异性、准确性、阳性预测值和阴性预测值.结果正常组胰腺未见异常,细菌培养阴性；非感染性ANP组见胰腺坏死,但细菌培养阴性；感染性ANP组见胰腺坏死并感染,感染灶细菌培养均为阳性.99mTc-环丙沙星显像检测感染的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为93.8％ (15/16)、91.7％(11/12)、92.9％(26/28)、93.8％(15/16)和91.7％(11/12)；CT分别为12.5％ (2/16)、100.0％(12/12)、50.0％ (14/28)、100.0％ (2/2)、46.2％(12/26).99mTc-环丙沙星显像检测感染的敏感性、准确性、阴性预测值均显著高于CT(P值均＜0.05).结论 99mTc-环丙沙星显像检测ANP继发感染优于64层螺旋CT.
목적 비교신형현상제99mTc-배병사성현상여CT검측중증이선염계발감염적개치.방법 28지건강유저안수자표법수궤분위정상조(6지)、비감염성급성배사성이선염( ANP)조(6지)、감염성ANP조(16지).채용이관주입우광담산납화이단백매혼합액적방법제비ANP모형.감염성ANP조우제모후2d향이선조직내주사3×108개대장간균,비감염성ANP조주사멸활적대장간균.7d후매지유저정맥주사370 MBq적99mTc-배병사성,급약후0.5、1、2、3、4、6h행SPECT단층현상,0.5h후행64층라선CT소묘.검사결속후처사동물,취이선조직행병리검사급세균배양.비교량충영상학방법검측ANP계발감염적민감성、특이성、준학성、양성예측치화음성예측치.결과 정상조이선미견이상,세균배양음성；비감염성ANP조견이선배사,단세균배양음성；감염성ANP조견이선배사병감염,감염조세균배양균위양성.99mTc-배병사성현상검측감염적민감성、특이성、준학성、양성예측치화음성예측치분별위93.8％ (15/16)、91.7％(11/12)、92.9％(26/28)、93.8％(15/16)화91.7％(11/12)；CT분별위12.5％ (2/16)、100.0％(12/12)、50.0％ (14/28)、100.0％ (2/2)、46.2％(12/26).99mTc-배병사성현상검측감염적민감성、준학성、음성예측치균현저고우CT(P치균＜0.05).결론 99mTc-배병사성현상검측ANP계발감염우우64층라선CT.
Objective To evaluate 99mTc-ciprofloxacin (Infecton) scintigraphy as a method for detecting secondary infections associated with ANP in swine,in comparison with CT.Methods Twenty-eight healthy swine were randomly assigned to control group (n =6),non-infected ANP (n =6) and infected ANP group( n =16).ANP model was induced by retrograde injection of sodium taurocholate and pancreatic protease mixture into the biliary and pancreatic duct.Two days after ANP induction,swine in infected ANP group were injected with 3 x 108 E.coli into pancreatic tissue,while swine in non-infected ANP group were injected with inactivated E.coli.At 7 d after inoculation,at 0.5,1,2,3,4,and 6 h after intravenous administration of 370 MBq of Infecton,SPECT scan was performed.Then 64-slice spiral CT scan was performed.Then swine were sacrificed,and histopathology examination and bacterial culture of pancreatic tissue were performed.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the two methods to detect secondary infections were determined.Results There were no abnormality in the normal pancreas and the bacterial culture was negative.There were pancreatic necrosis in the non-infected ANP group,but the bacterial culture was negative.There were pancreatic necrosis and infection in the infected ANP group and the bacterial culture was positive.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the Infecton method were 93.8％ ( 15/16 ),91.7％ ( 11/12 ),92.9％ ( 26/28 ),93.8 ％(15/16) and 91.7％ ( 11/12),whereas these values for CT were 12.5％ (2/16),100.0％ ( 12/12),50.0％(14/28),100.0％ (2/2) and 46.2％ (12/26),respectively.The sensitivity,accuracy,and negative predictive value of the Infecton method were significantly higher than those in CT group (P ＜0.01 ).Conclusions Infecton scintigraphy may be a better procedure for detecting ANP secondary infections than CT.