Knight L C
Section of Nuclear Medicine, Temple University School of Medicine and Hospital, Philadelphia, PA 19140.
Semin Nucl Med. 1990 Jan;20(1):52-67. doi: 10.1016/s0001-2998(05)80176-x.
Most of the components of the thrombotic and fibrinolytic systems have at some time been evaluated as a means of carrying a radiolabel specifically to thrombi, although very few have been promising enough to emerge from investigational status to routine clinical use. New approaches are being explored, including improved methods of labeling platelets, chemically modified forms of previously tested plasma proteins, and new biomolecules, including monoclonal antibodies specific for fibrin and platelets. The current goal is to find one or more radiotracers that bind specifically and rapidly to thrombi, and that also have a rapid blood disappearance rate, permitting a clear diagnosis within a few hours after injection. Because this test may be needed to assess the course of therapy in an anticoagulated patient, the ideal radiopharmaceutical should be able to locate thrombi without interference by anticoagulants. Until a suitable thrombus-specific radiopharmaceutical becomes generally available, many hospitals will continue to attempt to make a diagnosis with nonspecific radiopharmaceuticals that can at best provide blood pool images to indicate filling defects. Several of the new approaches seem likely to provide the radiopharmaceutical sought, although clinical trials are at an early stage.
血栓形成和纤维蛋白溶解系统的大多数成分都曾在某个时候被评估为将放射性标记物特异性输送到血栓的一种手段，尽管很少有成分有足够的前景从研究阶段发展到常规临床应用。目前正在探索新的方法，包括改进的血小板标记方法、先前测试过的血浆蛋白的化学修饰形式以及新的生物分子，包括针对纤维蛋白和血小板的单克隆抗体。当前的目标是找到一种或多种能特异性且快速地与血栓结合、血液清除率也很快的放射性示踪剂，以便在注射后几小时内就能做出明确诊断。由于可能需要这项检查来评估抗凝患者的治疗过程，理想的放射性药物应该能够定位血栓而不受抗凝剂的干扰。在合适的血栓特异性放射性药物普遍可用之前，许多医院将继续尝试使用非特异性放射性药物进行诊断，这些药物充其量只能提供血池图像以显示充盈缺损。尽管临床试验尚处于早期阶段，但一些新方法似乎有可能提供所寻求的放射性药物。
