Fujii T, Tanaka M, Hongo M, Hirayama J, Hirose Y, Okubo S, Kobayashi T, Handa K, Yano K, Yokota K
First Department of Internal Medicine, Shinshu University School of Medicine.
Kaku Igaku. 1990 Oct;27(10):1109-17.
In order to estimate the pulmonary extravascular and intravascular spaces, lung uptake ratio of 201Tl (L/T) and lung distribution ratio of 99mTc-albumin (H/T'), expressed as ratios of total counts of the bilateral lungs to the administered doses of the radionuclides, were obtained from the both scintigrams with 201Tl and 99mTc-albumin respectively, using a scintillation camera coupling to a minicomputer. Mean values of L/T and H/T' were 2.8 +/- 0.8% and 4.9 +/- 1.4% in the controls, 3.9 +/- 1.8% and 5.3 +/- 1.9% in heart diseases without left heart failure, and 7.0 +/- 2.2% and 7.1 +/- 2.9% in those with left heart failure, respectively. Ratios of L/T to H/T' in diffuse interstitial pneumonia and heart diseases, especially in cases with left heart failure were higher than those in controls. The values of H/T' and L/T were inversely proportional to cardiac output and cardiac index, and the values of L/T were directly proportional to pulmonary artery wedge pressure, but the discrepancies of the relationship between these values and some clinical findings including cardiac output, cardiac index, pulmonary artery wedge pressure and other findings of left heart failure, were observed in not a few cases. In the regional pulmonary areas, lung uptake of 201Tl was in parallel with pulmonary perfusion in many cases, but the discrepancies between them were demonstrated in some cases, too. These methods seem to be useful for the estimation of the pulmonary extravascular and extravascular spaces, and for the detection of dysfunction of the left ventricle.
为了评估肺血管外和血管内间隙,通过将闪烁相机与小型计算机相连,分别从201Tl和99mTc - 白蛋白闪烁图中获取201Tl的肺摄取率(L/T)和99mTc - 白蛋白的肺分布率(H/T'),它们分别表示为双侧肺的总计数与放射性核素给药剂量的比值。对照组中L/T和H/T'的平均值分别为2.8±0.8%和4.9±1.4%,无左心衰竭的心脏病患者中分别为3.9±1.8%和5.3±1.9%,而左心衰竭患者中分别为7.0±2.2%和7.1±2.9%。弥漫性间质性肺炎和心脏病患者,尤其是左心衰竭患者的L/T与H/T'比值高于对照组。H/T'和L/T值与心输出量和心脏指数呈反比,L/T值与肺动脉楔压成正比,但在不少病例中观察到这些值与一些临床指标(包括心输出量、心脏指数、肺动脉楔压和左心衰竭的其他表现)之间关系存在差异。在局部肺区域,许多情况下201Tl的肺摄取与肺灌注平行,但在某些情况下也存在两者之间的差异。这些方法似乎有助于评估肺血管外和血管内间隙,以及检测左心室功能障碍。