中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
4期
392-398
,共7页
沙非%温晓斐%卜丽红%李任飞%张同%金钟男%申宝忠
沙非%溫曉斐%蔔麗紅%李任飛%張同%金鐘男%申寶忠
사비%온효비%복려홍%리임비%장동%금종남%신보충
心肌梗死%放射性同位素%体层摄影术,发射型计算机,单光子
心肌梗死%放射性同位素%體層攝影術,髮射型計算機,單光子
심기경사%방사성동위소%체층섭영술,발사형계산궤,단광자
Myocardial infarction%Radioisotopes%Tomography,emission-computed,singlephoton
目的 在正常和心肌梗死犬模型上,研究99TcmN-2-巯基吡啶-N-氧化物(99TcmN-MPO)的药物代谢动力学特征、生物学分布特征和对急性心肌梗死的诊断能力,并与传统示踪剂99锝m-甲氧基异丁基异腈(99Tcm-MIBI)进行对比研究.方法 正常杂种犬12只.静脉注射99TcmN-MPO,于不同时间点(30 s及1、2、3、4、5、10、20、30、40、60和90 min)静脉分别采血1 ml,经γ探测器测量其放射活性;注药后10、20、30、60、90及120 min行全身SPECT显像,并于不同器官上各取同样大小的ROI,测量其放射性计数进行定量研究.每只犬均注射相同剂量的99TcmMIBI,进行相同的实验作为对照.介入学方法构建犬急性心肌梗死模型,24 h后,静脉注入99TcmN-MPO(5只)和99Tcm-MIBI(5只),并于注药后30、60min进行心肌SPECT显像.结果 在静脉注射90 min内,99TcmN-MPO和99Tcm-MIBI均表现为快速的血液清除.两种示踪剂的初始注射剂量均为370 MBq.注射后1 min,每毫克血浆的放射活性小于初始注射剂量的50%[99TcmN-MPO为(35.77±6.31)%ID/mg;99Tcm-MIBI为(34.46±6.83)%ID/mg],30 min时＜5%[99TcmN-MPO:(3.11±1.44)%ID/mg;99Tcm-MIBI:(2.93±0.39)%ID/mg].99TcmN-MPO在心脏的浓聚明显,且存留时间很长,由于其在肝脏清除的速度较快,因此可获得良好的心/肝摄取比值,注射后10 min为0.54±0.06,30 min为1.02±0.06,60 min上升到1.38±0.06.相比之下,99Tcm-MIBI的心/肝摄取比值上升较为缓慢(注射后10 min为0.46±0.03,30 min为0.63±0.03,60 min为0.62±0.12).犬心肌梗死后SPECT心肌断层扫描显示,在注射99TcmN-MPO 30 min后,心脏与肝脏分界清楚,可清楚显示心肌缺血、梗死灌注缺损区域、范围和程度;而99Tcm-MIBI注射后60 min,心脏和肝脏的分界依然不清,尤其是肝脏的高放射性对心脏下壁和左心室壁的影响很大,对心脏左心室壁的心肌梗死灌注缺损区域的显示不佳.结论 99TcmN-MPO具有心肌摄取量较高,肝脏代谢快的特点,是一种具有广阔临床应用前景的SPECT心肌灌注成像显像剂.
目的 在正常和心肌梗死犬模型上,研究99TcmN-2-巰基吡啶-N-氧化物(99TcmN-MPO)的藥物代謝動力學特徵、生物學分佈特徵和對急性心肌梗死的診斷能力,併與傳統示蹤劑99锝m-甲氧基異丁基異腈(99Tcm-MIBI)進行對比研究.方法 正常雜種犬12隻.靜脈註射99TcmN-MPO,于不同時間點(30 s及1、2、3、4、5、10、20、30、40、60和90 min)靜脈分彆採血1 ml,經γ探測器測量其放射活性;註藥後10、20、30、60、90及120 min行全身SPECT顯像,併于不同器官上各取同樣大小的ROI,測量其放射性計數進行定量研究.每隻犬均註射相同劑量的99TcmMIBI,進行相同的實驗作為對照.介入學方法構建犬急性心肌梗死模型,24 h後,靜脈註入99TcmN-MPO(5隻)和99Tcm-MIBI(5隻),併于註藥後30、60min進行心肌SPECT顯像.結果 在靜脈註射90 min內,99TcmN-MPO和99Tcm-MIBI均錶現為快速的血液清除.兩種示蹤劑的初始註射劑量均為370 MBq.註射後1 min,每毫剋血漿的放射活性小于初始註射劑量的50%[99TcmN-MPO為(35.77±6.31)%ID/mg;99Tcm-MIBI為(34.46±6.83)%ID/mg],30 min時＜5%[99TcmN-MPO:(3.11±1.44)%ID/mg;99Tcm-MIBI:(2.93±0.39)%ID/mg].99TcmN-MPO在心髒的濃聚明顯,且存留時間很長,由于其在肝髒清除的速度較快,因此可穫得良好的心/肝攝取比值,註射後10 min為0.54±0.06,30 min為1.02±0.06,60 min上升到1.38±0.06.相比之下,99Tcm-MIBI的心/肝攝取比值上升較為緩慢(註射後10 min為0.46±0.03,30 min為0.63±0.03,60 min為0.62±0.12).犬心肌梗死後SPECT心肌斷層掃描顯示,在註射99TcmN-MPO 30 min後,心髒與肝髒分界清楚,可清楚顯示心肌缺血、梗死灌註缺損區域、範圍和程度;而99Tcm-MIBI註射後60 min,心髒和肝髒的分界依然不清,尤其是肝髒的高放射性對心髒下壁和左心室壁的影響很大,對心髒左心室壁的心肌梗死灌註缺損區域的顯示不佳.結論 99TcmN-MPO具有心肌攝取量較高,肝髒代謝快的特點,是一種具有廣闊臨床應用前景的SPECT心肌灌註成像顯像劑.
목적 재정상화심기경사견모형상,연구99TcmN-2-구기필정-N-양화물(99TcmN-MPO)적약물대사동역학특정、생물학분포특정화대급성심기경사적진단능력,병여전통시종제99득m-갑양기이정기이정(99Tcm-MIBI)진행대비연구.방법 정상잡충견12지.정맥주사99TcmN-MPO,우불동시간점(30 s급1、2、3、4、5、10、20、30、40、60화90 min)정맥분별채혈1 ml,경γ탐측기측량기방사활성;주약후10、20、30、60、90급120 min행전신SPECT현상,병우불동기관상각취동양대소적ROI,측량기방사성계수진행정량연구.매지견균주사상동제량적99TcmMIBI,진행상동적실험작위대조.개입학방법구건견급성심기경사모형,24 h후,정맥주입99TcmN-MPO(5지)화99Tcm-MIBI(5지),병우주약후30、60min진행심기SPECT현상.결과 재정맥주사90 min내,99TcmN-MPO화99Tcm-MIBI균표현위쾌속적혈액청제.량충시종제적초시주사제량균위370 MBq.주사후1 min,매호극혈장적방사활성소우초시주사제량적50%[99TcmN-MPO위(35.77±6.31)%ID/mg;99Tcm-MIBI위(34.46±6.83)%ID/mg],30 min시＜5%[99TcmN-MPO:(3.11±1.44)%ID/mg;99Tcm-MIBI:(2.93±0.39)%ID/mg].99TcmN-MPO재심장적농취명현,차존류시간흔장,유우기재간장청제적속도교쾌,인차가획득량호적심/간섭취비치,주사후10 min위0.54±0.06,30 min위1.02±0.06,60 min상승도1.38±0.06.상비지하,99Tcm-MIBI적심/간섭취비치상승교위완만(주사후10 min위0.46±0.03,30 min위0.63±0.03,60 min위0.62±0.12).견심기경사후SPECT심기단층소묘현시,재주사99TcmN-MPO 30 min후,심장여간장분계청초,가청초현시심기결혈、경사관주결손구역、범위화정도;이99Tcm-MIBI주사후60 min,심장화간장적분계의연불청,우기시간장적고방사성대심장하벽화좌심실벽적영향흔대,대심장좌심실벽적심기경사관주결손구역적현시불가.결론 99TcmN-MPO구유심기섭취량교고,간장대사쾌적특점,시일충구유엄활림상응용전경적SPECT심기관주성상현상제.
Objective The purpose of the present study is to compare the pharmacokinetic and biodistribution properties of 99Tcm N-mercaptopyridine-N-oxide (99 Tcm N-MPO) with 99 Tcm-sestamibi (99 Tcm-MIBI) in normal dogs, and to investigate the potential of 99TcmN-MPO as a myocardial perfusion agent in canines with acute myocardial infarction. Methods Twelve healthy mongrel dogs were injected intravenously with 99TcmN-MPO (n = 6) or 99Tcm-MIBI (n = 6). Tracer kinetics in body fluids were determined by collecting blood of 1 ml via a femoral vein catheter at 30 s, 1,2,3,4,5, 10, 20, 30, 40, 60and 90 min post-injection (p. i.). The collected blood samples were weighed and counted for radioactivity in a γ-counter. Anterior and posterior planar γ-camera images were collected at 10, 20, 30, 60, 90, and 120 min after injection, with organ uptake quantified by region-of-interest (ROIs) analysis. For comparison, 99Tcm-MIBI was also evaluated in the same twelve dogs. Canine infarct models were set up by micro-invasive interventional embolization. SPECT images in the canine infarct model were collected 24 hours after myocardial infarction at 30 min and 60 min after the administration of 99Tcm N-MPO (n = 5) or 99Tcm-MIBI (n = 5). Results Both of 99Tcm N-MPO and 99Tcm-M1BI had a rapid blood clearance with less than 50% of initial radioactivity remaining at 1 min [99TcmN-MPO: (35. 77 ± 6. 31)% ID/mg ,99Tcm-MIBI (34. 46 ± 6. 83) % ID/mg] and less than 5% at 30 min p. i. [99Tcm N-MPO(3. 11 ± 1.44) % ID/mg,99Tcm-MIBI (2.93 ±0. 39)% ID/mg] . After injection, 99TcmN-MPO showed significant accumulation in the myocardium and prolonged retention. This rapid liver clearance of 99TcmN-MPO led to favorable heart-to-liver ratios, reaching values of 0. 54 ±0. 06 at 10 min, 1.02 ±0. 06 at 30 min, and 1.38 ±0. 06 at 60 min p. i.In contrast, the heart/liver ratio of 99Tcm-MIBI remained low at all time points (0. 46 ± 0. 03 at 10 min,0. 63 ±0. 03 at 30 min, and 0. 62 ± 0. 12 at 60 min p. i.). SPECT imaging studies in canines with acute myocardial infarction indicated that good visualization of the left ventricular wall and perfusion defects could be achieved at 30 min after administration of 99TcmN-MPO, but not 99Tcm-MIBI. Conclusion The combination of high heart uptake and rapid liver clearance makes 99TcmN-MPO a promising new radiotracer for myocardial perfusion imaging.
