Uso combinado de aspiraci贸n por punci贸n transbronquial y tomograf铆a computarizada de emisi贸n fot贸nica 煤nica con p>99mp>Tc-2-metoxi-isobutil-isonitrilo para el diagn贸stico de ganglios linf谩ticos mediast铆nicos agrandados

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• 作者：Alfonso Fiorelli ; Pierfrancesco Rambaldi ; Giovanni Vicidomini ; Umberto di Serio ; Marina Accardo ; Antonio Rotondo ; Mario Santini
• 关键词：Tecnecio-99m hexakis-2-metoxi-isobutil-isonitrilo ; Tomografí ; a de emisió ; n fotó ; nica ú ; nica torá ; cica ; Adenopatí ; a ; Aspiració ; n por punció ; n transbronquial
• 刊名：Archivos de Bronconeumolog铆a
• 出版年：January, 2014
• 年：2014
• 卷：50
• 期：1
• 页码：3-9
• 全文大小：1103 K

文摘

Background

<p>To demonstrate the diagnostic accuracy of an integrated approach of blind trans-bronchial needle aspiration (TBNA) and p>99mp>Tc-2-methoxy-isobutyl-isonitrile single photon emission computed tomography (p>99mp>Tc-MIBI-SPECT) in diagnosing mediastinal lymph adenopathy.

Methods

<p>Sixty one consecutive patients with mediastinal lymph adenopathy undergoing both TBNA and p>99mp>Tc-MIBI-SPECT were prospectively enrolled. Mediastinoscopy was attended in case of negative TBNA.

Results

<p>Eighty three adenopathies were sampled (73 malignant and 10 benign). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of TBNA was 74%, 100%, 100%, and 34%, respectively; and of p>99mp>Tc-MIBI-SPECT was 96%, 80%, 97%, and 73%, respectively. Combining TBNA and p>99mp>Tc-MIBI-SPECT results sensitivity, specificity, PPV, NPV of 97%, 100%, 100%, and 83%, respectively, was obtained. TBNA alone avoided medistianoscopy in 65% of cases, while an integrated approach could have potentially obviated mediastinoscopy in 76%.

Conclusions

<p>p>99mp>Tc-MIBI-SPECT improved the sensitivity and the NPV of TBNA, reducing the need of mediastinoscopy.