Afzelius Pia, Fuglsang Stefan
Department of Nuclear Medicine, Aalborg University Hospital, Hobrovej, Aalborg, Denmark; Department of Clinical Physiology and Nuclear Medicine, Center of Functional and Diagnostic Imaging and Research, Faculty of Health Sciences, Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark; Section of Clinical Physiology, Department of Diagnostics, Copenhagen University Hospital Glostrup, Glostrup, Denmark.
Clin Physiol Funct Imaging. 2014 Mar;34(2):143-50. doi: 10.1111/cpf.12078. Epub 2013 Aug 1.
The semi-quantitative analysis of salivary gland scintigraphy with (99m) Tc-pertechnetate has been used to evaluate salivary gland function. However, no objective parameters distinguishing abnormal from normal functions have been established thus far. We propose using a simple kinetic model applied to the four major salivary glands. This kinetic model is based on a two-compartment model and the assumption of first-order kinetics to characterize normal salivary gland function and other selected parameters to evaluate the normal function of salivary glands.
Thirty patients referred for (99m) Tc-pertechnetate thyroid scintigraphy were studied. Dynamic imaging of the head in a fixed anterior projection was performed after an intravenous bolus injection of 150 MBq (99m) Tc-pertechnetate using a gamma scintillation camera. After 30 min, lemon juice was orally administered through a syringe. Time activity curves were generated for each of the four major salivary glands (i.e. the right and left submandibular and right and left parotid glands). Excretion fractions (the fraction of mobilizable radioactivity after administering lemon juice) and the gland activity-to-thyroid activity ratio were calculated. The data were fitted to both a one- and two-phase uptake model.
The median uptake slope and maximal activity were significantly higher in the parotid glands than the submandibular glands (P<0·0001). The gland-to-thyroid ratio was higher in the parotid glands than the submandibular glands (P<0·0001), and the ejection fractions were higher in the parotid glands (P<0·0001). No difference was found in functional contributions of the parotid and submandibular glands.
Tracer accumulation can be represented by a one-phase simple uptake model. The background regions that have been previously recommended in the literature are acceptable.
用高锝酸盐（99m）Tc进行唾液腺闪烁扫描的半定量分析已用于评估唾液腺功能。然而，迄今为止尚未建立区分异常与正常功能的客观参数。我们建议使用一个简单的动力学模型应用于四大唾液腺。该动力学模型基于双室模型和一级动力学假设来表征正常唾液腺功能以及评估唾液腺正常功能的其他选定参数。
对30例因高锝酸盐（99m）Tc甲状腺闪烁扫描而转诊的患者进行研究。静脉推注150MBq高锝酸盐（99m）Tc后，使用γ闪烁相机在固定的前位投影下对头部进行动态成像。30分钟后，通过注射器口服柠檬汁。为四大唾液腺（即左右颌下腺和左右腮腺）分别生成时间-活性曲线。计算排泄分数（给予柠檬汁后可动员放射性的分数）以及腺体活性与甲状腺活性之比。数据拟合单相和双相摄取模型。
腮腺的摄取斜率中位数和最大活性显著高于颌下腺（P<0.0001）。腮腺的腺体与甲状腺比值高于颌下腺（P<0.0001），腮腺的排泄分数更高（P<0.0001）。腮腺和颌下腺的功能贡献未发现差异。
示踪剂蓄积可用单相简单摄取模型表示。文献中先前推荐的背景区域是可接受的。
