Cintilografia com leucócitos marcados para localização de infecção
Palavras-chave:
cintilografia, infecção, leucócitos marcados, febre de origem obscuraResumo
Introdução: A utilização da medicina nuclear tem apresentado um crescimento exponencial na área das doenças infecciosas e inflamatórias, especialmente em virtude de dois exames: 1) a tomografia por emissão de pósitrons (PET, do inglês, positron emission tomography) com 18F-FDG (FDG = fluoredesoxiglicose), que permite a avaliação metabólica dos tecidos e células com precisão ímpar, e 2) a cintilografia com leucócitos marcados, que emprega a marcação dos leucócitos do próprio paciente para identificação do sítio infeccioso em câmaras de cintilografia convencionais (SPECT – tomografia computadorizada por emissão de fóton único, do inglês single photon emission computed tomography). Objetivos: revisar as indicações para o uso da cintilografia com leucócitos marcados na localização de processos infecciosos. Resultados: As principais indicações para uso da cintilografia com leucócitos marcados são: 1. pesquisa de infecção associada com implantes de materiais protéticos, metálicos ou biológicos como valvas cardíacas protéticas, marcapassos, enxertos vasculares e próteses ortopédicas; 2. osteomielites; 3. endocardite infecciosa; 4. Doença Inflamatória Intestinal; 5. Infecção pós-operatória; e 6. Febre de Origem Obscura e Indeterminada. Conclusão: A cintilografia com leucócitos marcados é um exame de grande valia na localização de processos infecciosos, avaliação da sua extensão e acompanhamento da resposta ao tratamento. A medicina nuclear é especialmente útil para detecção de infecções quando os exames de imagens convencionais são limitados ou geram resultados inconclusivos.
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