Antoniou Katerina M, Malagari Katerina, Tzanakis Nikolaos, Perisinakis Kostas, Symvoulakis Emmanouil K, Karkavitsas Nikolaos, Siafakas Nikolaos M, Bouros Demosthenes
Department of Thoracic Medicine, University Hospital of Heraklion, Crete, Greece.
BMC Pulm Med. 2006 Feb 16;6:4. doi: 10.1186/1471-2466-6-4.
Clearance of inhaled technetium-labeled diethylenetriamine pentaacetate (99mTc-DTPA) is a marker of epithelial damage and an index of lung epithelial permeability. The aim of this study was to investigate the role of 99mTc-DTPA scan in patients with Idiopathic Pulmonary Fibrosis (IPF). Our hypothesis is that the rate of pulmonary 99mTc-DTPA clearance could be associated with extent of High Resolution Computed Tomography (HRCT) abnormalities, cell differential of bronchoalveolar lavage fluid (BALF) and pulmonary function tests (PFTs) in patients with IPF.
We studied prospectively 18 patients (14 male, 4 female) of median age 67 yr (range 55-81) with histologically proven IPF. HRCT scoring included the mean values of extent of disease. Mean values of these percentages represented the Total Interstitial Disease Score (TID). DTPA clearance was analyzed according to a dynamic study using a Venticis II radioaerosol delivery system.
The mean (SD) TID score was 36 +/- 12%, 3 patients had mild, 11 moderate and 4 severe TID. Abnormal DTPA clearance half-time (t1/2 < 40 min) was found in 17/18 (94.5%) [mean (SD) 29.1 +/- 8.6 min]. TID was weakly correlated with the DTPA clearance (r = -0.47, p = 0.048) and with % eosinophils (r = 0.475, p = 0.05). No correlation was found between TID score or DTPA and PFTs in IPF patients.
Our data suggest that 99mTc-DTPA lung scan is not well associated with HRCT abnormalities, PFTs, and BALF cellularity in patients with IPF. Further studies in large scale of patients are needed to define the role of this technique in pulmonary fibrosis.
吸入的锝标记二乙三胺五乙酸（99mTc-DTPA）清除率是上皮损伤的标志物，也是肺上皮通透性的指标。本研究旨在探讨99mTc-DTPA扫描在特发性肺纤维化（IPF）患者中的作用。我们的假设是，IPF患者肺部99mTc-DTPA清除率可能与高分辨率计算机断层扫描（HRCT）异常程度、支气管肺泡灌洗（BALF）细胞分类及肺功能测试（PFT）相关。
我们前瞻性地研究了18例经组织学证实为IPF的患者（14例男性，4例女性），中位年龄67岁（范围55 - 81岁）。HRCT评分包括疾病范围的平均值。这些百分比的平均值代表总间质疾病评分（TID）。使用Venticis II放射性气雾剂输送系统通过动态研究分析DTPA清除率。
TID评分的平均值（标准差）为36±12%，3例为轻度，11例为中度，4例为重度TID。17/18（94.5%）的患者DTPA清除半衰期异常（t1/2 < 40分钟）[平均值（标准差）29.1±8.6分钟]。TID与DTPA清除率呈弱相关（r = -0.47，p = 0.048），与嗜酸性粒细胞百分比呈正相关（r = 0.475，p = 0.05）。在IPF患者中，未发现TID评分或DTPA与PFT之间存在相关性。
我们的数据表明，99mTc-DTPA肺扫描与IPF患者的HRCT异常、PFT及BALF细胞计数相关性不佳。需要对大量患者进行进一步研究以确定该技术在肺纤维化中的作用
