Richter J, Herreros J, Serena A, Domper M, Ramirez J C, Gómez A, Arcas R
Department of Nuclear Medicine, Clínica Universitaria de Navarra, Pamplona, Spain.
Eur J Nucl Med. 1990;16(3):167-71. doi: 10.1007/BF01146856.
A semi quantitative method with thallium has been applied in the management of cardiac transplants. In all, 142 scans were performed in 20 patients and were arranged in 3 groups that represent respectively all controls performed to the transplants (G1), and a selection of the scans obtained during the 1st rejection episode in each patient (G2) and the 2nd if present (G3). A heart/lung index was calculated through early and late images (IA, IB), obtained 5 min and 4 h post injection of thallium. A decrease in IA was detected during acute rejection in all groups. This fall was statistically significant from the mild to moderate rejection degree in G1 (P less than 0.01), and the mild rejection in G3 (P less than 0.001). IB was not modified with rejection. Comparing the biopsies with and without edema, in the absence of rejection, it has been proved that the intra myocardial edema can produce a decrease in IA (P less than 0.001). We conclude that IA is a simple and sensitive index to evaluate the graft, although intra myocardial edema can reduce its specificity.
一种用铊的半定量方法已应用于心脏移植的管理。总共对20例患者进行了142次扫描，并分为3组，分别代表对移植进行的所有对照（G1），以及每位患者在第一次排斥反应期间获得的扫描结果的选择（G2），如果有第二次排斥反应则为G3。通过在注射铊后5分钟和4小时获得的早期和晚期图像（IA，IB）计算心/肺指数。在所有组的急性排斥反应期间均检测到IA降低。从G1中的轻度至中度排斥程度（P小于0.01）和G3中的轻度排斥（P小于0.001）来看，这种下降具有统计学意义。IB并未因排斥反应而改变。在无排斥反应的情况下，比较有和没有水肿的活检结果，已证明心肌内水肿可导致IA降低（P小于0.001）。我们得出结论，IA是评估移植物的一个简单且敏感的指标，尽管心肌内水肿会降低其特异性。
