Qureshy A, Kubota K, Ono S, Sato T, Fukuda H
Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Clin Nucl Med. 2001 Oct;26(10):847-55. doi: 10.1097/00003072-200110000-00008.
To investigate the use of orally administered iodine-123-labeled 15-(4-iodophenyl)-3(R,S)-methyl-pentadecanoic acid (I-123 BMIPP) for thoracic duct imaging in normal and pathologic states and to study the tracer distribution and dynamics in healthy participants.
The radiotracer was administered with solid (in three healthy persons and one patient) or liquid meals (in three other healthy persons). Solid meals contained relatively more fat content than did the liquid meal. Images were acquired to trace the passage of radiotracer from the intestine to the systemic venous circulation via the lymphatic route. Multiple static planar images were acquired in the anterior and posterior views. Blood samples were analyzed for radioactivity and serum triglyceride levels.
In the healthy participants, I-123 BMIPP was absorbed from the intestine and reached the venous circulation through the thoracic duct. The thoracic part of the duct was visualized successfully in all healthy persons within 80 minutes. The radiotracer dynamics varied according to the type of meal administered. The patient had chylomediastinum and right chylothorax and underwent thoracic duct ligation. In the patient, marked stasis in the collateral lymphatic channels was seen, as was chylous leakage into the mediastinal space and right pleural cavity. Passage of tracer to the general venous circulation was delayed. A normal thoracic duct was not seen in this patient.
Scintigraphy by orally administered I-123 BMIPP is a simple method to image the thoracic duct and to monitor its lesions. Meals with a higher fat content result in better BMIPP absorption and may be used as a standard method.
研究口服碘-123标记的15-（4-碘苯基）-3（R，S）-甲基十五烷酸（I-123 BMIPP）在正常和病理状态下用于胸导管成像，并研究健康受试者体内示踪剂的分布和动力学。
向3名健康人和1名患者口服给予放射性示踪剂固体餐，向另外3名健康人给予液体餐。固体餐的脂肪含量相对高于液体餐。采集图像以追踪放射性示踪剂从肠道经淋巴途径进入体循环静脉的过程。从前位和后位采集多个静态平面图像。分析血样的放射性和血清甘油三酯水平。
在健康受试者中，I-123 BMIPP从肠道吸收并通过胸导管到达静脉循环。在80分钟内，所有健康人的胸导管胸部均成功显影。放射性示踪剂的动力学因所给予餐食的类型而异。该患者患有乳糜纵隔和右侧乳糜胸，并接受了胸导管结扎术。在该患者中，可见侧支淋巴通道明显淤滞，乳糜液漏入纵隔间隙和右侧胸腔。示踪剂进入体循环静脉的过程延迟。该患者未见正常胸导管。
口服I-123 BMIPP闪烁扫描是一种成像胸导管及其病变的简单方法。脂肪含量较高的餐食可使BMIPP吸收更好，可作为标准方法使用。
