[Aerosol pulmonary scintigraphy. A new test in the diagnostic strategy of pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome].
In eleven patients with AIDS and suspected Pneumocystis carinii pneumonia we measured the pulmonary clearance and half-life of aerosolized 99m Tc-DTPA (diethylenetriamine pentaacetate). We correlated the half-life with gallium scans and bronchoalveolar lavages. In all nine patients with Pneumocystis, this half-life was shorter than normal value, documenting a significant increase of lung epithelial permeability (p less than 0.001). Six of these 9 patients had abnormal gallium scans. However, in two patients with normal chest X-rays, PaO2 and gallium scans, only the reduced half-life of 99mTc-DTPA evidenced acute lung disease. After treatment, the results of the DTPA half-life correlated with the presence or absence of Pneumocystis. This method is, therefore, a sensitive initial diagnostic test in patients with suspected Pneumocystis pneumonia. A short half-life should prompt bronchoalveolar lavage even when PaO2 and/or chest X-rays and gallium scans are normal.
Meignan
M
M
Service de Médecine nucléaire, Hôpital Henri Mondor, Créteil.
Rosso
J
J
Picard
C
C
Mayaud
C
C
Revuz
J
J
Akoun
G
G
Galle
P
P
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000336:Aerosols; D001992:Bronchoalveolar Lavage Fluid; D005710:Gallium Radioisotopes; D006207:Half-Life; D006801:Humans; D008657:Metabolic Clearance Rate; D004369:Pentetic Acid / Q000493:pharmacokinetics; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging* / Q000209:etiology; D011650:Pulmonary Alveoli / Q000378:metabolism; D011653:Pulmonary Diffusing Capacity; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate
D000336:Aerosols; D005710:Gallium Radioisotopes; D004369:Pentetic Acid; D013669:Technetium Tc 99m Medronate
La scintigraphie pulmonaire aux aérosols: Un nouveau test dans la stratégie diagnostique des pneumocystoses chez les malades atteints de syndrome d'immunodéficit acquis.