摘要
目的评价Na99mTcO4示踪显像(TTI)在微血管术后血管危象诊断中的临床应用价值。方法20只健康成年家兔施行后肢断肢再植术后随机分为A(15只),B(5只)二组,A组术后20min在伤口局部冷敷(<5℃)10 min后制备成血管危象动物模型,B组予以保暖。A,B组和C组(5只正常对照家兔)由耳缘静脉注射Na99mTcO4 74MBq后动态采集(1帧/10 s)10 min,然后行静态显像,计算并分析再植部分和正常肢对应部分的放射性摄取比值(T/NT)。结果根据术肢远端放射性聚集程度将显像结果分为0,Ⅰ,Ⅱ三级,T/NT分别为(0.142±0.061),(0.472±0.055),(0.843±0.184)(t =7.23,13.65,2.71,P <0.01)。A组TTI全为0级,B组Ⅰ级2例,II级3例,C组全为II级。将0级(T/NT<0.25)作为微血管术后血管危象的定性和半定量诊断标准。结论TTI能直观而准确地反映微血管术后末端的血供状况,对早期无创性诊断微血管术后血管危象具有重要的临床价值。
Objective: To evaluate the clinical feasibility of Na99mTcO4 trace imaging (TTI) in experimental vascular crisis after microvascular surgery (AMS) in rabbits. Methods: 20 healthy adult rabbits with replanted limb were divided into A (15 rabbits) and B (15 rabbits) groups. Their vascular crisis model were made by local freezing (<5℃) for 10 minutes in A group, whole body warming was given in B group. Dynamic and static images were performed on each of rabbits in A, B and C (5 normal rabbits) groups. The radioactivity uptake of replanted limb/normal limb ratio (T/NT) was analyzed using region of interest analysis. Results: 0,Ⅰ and Ⅱ scales were classified according to their radionuclide distribution, the T/NT were (0.142±0.061), (0.472±0.055), (0.843±0.184) (t =7.23, 13.65, 2.71, P <0.01) respectively. All rabbits in group A were 0 scale of TTI, 2 rabbits of Ⅰ scale and 3 rabbits of Ⅱ scale were in B groups, all rabbits in C group were of Ⅱ scales. The 0 scales (T/NT<0.25) of TTI can be as a qualitative and semiquantitative standard on diagnosing the vascular crisis AMS. Conclusions: The blood supply degree of extreme limb AMS can be reported accurately and directly by TTI. TTI plays an important role on the early and untraumatic diagnosis of the vascular crisis AMS.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第15期56-57,共2页
China Journal of Modern Medicine
