Çiftçi Öznur Dilek, Gül Serdar Savaş, Açıksarı Kurtuluş, Maman Adem, Çavuşoğlu Türker, Bademci Refik, Taskiran Dilek, Erbaş Oytun
Department of Nuclear Medicine, Gaziosmanpaşa University School of Medicine, Tokat, Turkey.
Department of Emergency Medicine, Istanbul Bilim University School of Medicine, Istanbul, Turkey.
J Surg Res. 2016 Feb;200(2):495-500. doi: 10.1016/j.jss.2015.09.006. Epub 2015 Sep 9.
Corrosive esophageal injury due to accidental ingestion is a serious clinical problem in children particularly in developing countries. The present study was conducted to evaluate the diagnostic utility of technetium-99m-pyrophosphate ((99m)Tc-PYP) scintigraphy in the early stage of esophageal burns by using different concentrations of sodium hydroxide (NaOH) in an experimental rat model.
Twenty-eight male Sprague-Dawley rats, weighing 200-250 g, were used in the study. Esophageal burn model was created in 21 rats by gastrically infusion of various concentrations of NaOH. The rats were divided randomly into three groups: mild-burn group (n = 7) received 15% NaOH, moderate-burn group (n = 7) received 30% NaOH and severe-burn group (n = 7) received 45% NaOH. Seven rats were identified as control group and received normal saline. Three hours after burn injury, 1-mCi (99m)Tc-PYP was administered through tail vein. Two hours after (99m)Tc-PYP administration, static imaging with gamma camera was performed. Then, histopathologic assessment of esophageal samples was achieved properly.
All NaOH-applied groups (mild, moderate, and severe) showed a significant higher uptake ratio when compared to control group (P < 0.005). NaOH-applied groups displayed important histologic alterations such as mucosal disintegration, edema, inflammation, and stromal damage when compared to control group. Pearson correlation analysis revealed a significant correlation between the (99m)Tc-PYP uptake ratio and histologic score (P < 0.0005).
The scintigraphic imaging may provide advantages in the early stage of esophageal burns in some patients whom endoscopic procedure is contraindicated because of its high risk of complications such as bleeding and perforation.
因意外摄入导致的腐蚀性食管损伤是儿童尤其是发展中国家的一个严重临床问题。本研究旨在通过在实验大鼠模型中使用不同浓度的氢氧化钠(NaOH)来评估锝-99m-焦磷酸盐((99m)Tc-PYP)闪烁扫描在食管烧伤早期的诊断效用。
本研究使用了28只体重200 - 250克的雄性Sprague-Dawley大鼠。通过胃内注入不同浓度的NaOH在21只大鼠中建立食管烧伤模型。大鼠被随机分为三组:轻度烧伤组(n = 7)接受15% NaOH,中度烧伤组(n = 7)接受30% NaOH,重度烧伤组(n = 7)接受45% NaOH。7只大鼠被确定为对照组并接受生理盐水。烧伤损伤后3小时,通过尾静脉注射1毫居里(99m)Tc-PYP。在注射(99m)Tc-PYP后2小时,使用伽马相机进行静态成像。然后,对食管样本进行适当的组织病理学评估。
与对照组相比,所有应用NaOH的组(轻度、中度和重度)均显示出显著更高的摄取率(P < 0.005)。与对照组相比,应用NaOH的组表现出重要的组织学改变,如黏膜崩解、水肿、炎症和基质损伤。Pearson相关性分析显示(99m)Tc-PYP摄取率与组织学评分之间存在显著相关性(P < 0.0005)。
对于一些因内镜检查有出血和穿孔等高并发症风险而禁忌进行内镜检查的患者,闪烁扫描成像可能在食管烧伤早期提供优势。