^99Tc^m-硫胶体唾液显像方法学建立及在成年呼吸道疾病患者误吸中的应用  

Detection of aspiration using ^99 Tc^m-sulfur colloid salivary scintigraphy in patients with respiratory tract diseases

作　　者：陈萍[1] 侯鹏[1] 郑则广[2] 吴志达[2] 刘海平[1] 王丽娟[1] 

机构地区：[1]广州医学院第一附属医院核医学科,广州510120 [2]广州呼吸疾病研究所呼吸疾病国家重点实验室

出　　处：《中华核医学与分子影像杂志》2013年第3期192-194,共3页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的建立^99Tc^m-SC唾液显像方法学，并探讨其在检测成年呼吸道疾病患者误吸中的应用价值。方法前瞻性研究2012年4月至2012年7月间临床确诊存在误吸的成年呼吸道疾病患者8例[男7例，女1例，年龄68～80岁，平均（76±4）岁]，均进行^99Tc^m-SC唾液显像。将74．0MBq^99Tc^m-SC恒量注入患者口腔，用SPECT／CT进行后位动态采集口腔至胃部图像。由2位高年资核医学科医师共同阅片诊断，意见不一致时协商决定。左和（或）右主支气管及分支以下部位出现放射性显影为误吸阳性。该研究经院伦理委员会批准，患者或监护人均签署知情同意书。结果所有患者均顺利完成^99Tc^m-SC唾液显像，显像图像清晰。8例患者均为误吸阳性，其中两侧主支气管显影2例，右侧主支气管及分支显影4例，左侧主支气管及分支显影2例。误吸出现的时间最早为第3分钟，最晚为第24分钟，中位时间为第19分钟。结论^99Tc^m-SC唾液显像可检测成年呼吸道疾病患者由口腔分泌物导致的误吸。Objective To establish and assess the utility of ^99Tc^m-sulfur colloid （SC） salivary imaging in the routine evaluation of pulmonary aspiration in adult patients with respiratory tract diseases. Methods Eight patients （7 men, 1 woman; age range 68 to 80 years, mean age （76 ±4） years） with respiratory tract disease and history of aspiration by clinical assessment were evaluated prospectively by ^99Tc^m-SC salivary imaging from April to July 2012. A dose of 74.0 MBq ^99Tc^m-SC was added to 20 ml saline, mixed well, and administered orally to patients. Dynamic imaging was acquired with posterior projection for 30 min at a rate of 30 s per frame. Two experienced physicians assessed all examination results and reached consensus for final diagnosis. Radioactivity detected at either the bronchi or within the lung fields was reported as positive for aspiration. This study was approved by the institutional review board of Hospital Ethical Committee, and the written informed consent was obtained from patients or their guardians. Results All patients were positive for aspiration by ^99Tc^m-SC salivary imaging （8/8）. Aspiration into bilateral main bronchus was seen in 2 cases, right main bronchus and branch in 4 cases, and left main bronchus and branch in 2 cases. Aspirated tracer could be visualized as early as 3 min, latest at 24 min, and the median was 19 min. Conclusion ^99Tc^m-SC salivary imaging is useful for the detection of aspiration in adult patients with respiratory tract diseases.

关 键 词：呼吸道疾病 误吸 放射性素显像 99m锝硫胶 唾液 

分 类 号：R5[医药卫生—内科学]