Mearns A J, Hart G C, Cox J A
Department of Thoracic Surgery, Bradford Royal Infirmary.
Gut. 1989 Sep;30(9):1256-9. doi: 10.1136/gut.30.9.1256.
Standard oesophageal scintigraphic techniques using 99mTc-colloids rarely identify oesophageal mucosal damage. Sucralfate can be labelled with 99mTc for the detection of oesophageal mucosal ulceration. This method uses two separate supine swallows of 10 MBq 99mTc-colloid in 10 ml, followed by a single supine swallow of 30 MBq 99mTc-sucralfate. The data are processed to give time-activity curves, mean transit times and condensed dynamic images. When oesophageal ulceration is detected, the time-activity curves using sucralfate show residual activity in the oesophagus after the transit time indicated by the colloid swallow. The condensed dynamic image shows a persistence of activity at the level of the ulceration. Erect sucralfate images taken immediately after the dynamic sequence show no oesophageal localisation. The results from a study of 62 patients have shown excellent correlation between the dynamic 99mTc-sucralfate images and endoscopy findings. Sequential sucralfate studies for healing also correlate well. The use of labelled sucralfate to detect oesophageal ulceration could modify the indications for endoscopy in gastrooesophageal reflux disease.
使用99mTc胶体的标准食管闪烁扫描技术很少能识别食管黏膜损伤。硫糖铝可用99mTc标记以检测食管黏膜溃疡。该方法包括先两次分别仰卧位吞咽10毫升含10MBq 99mTc胶体的溶液，然后再仰卧位单次吞咽30MBq 99mTc硫糖铝。对数据进行处理以得出时间-活性曲线、平均通过时间和浓缩动态图像。当检测到食管溃疡时，使用硫糖铝的时间-活性曲线显示在胶体吞咽所指示的通过时间后食管内仍有残留活性。浓缩动态图像显示溃疡部位有持续的活性。在动态序列后立即拍摄的直立位硫糖铝图像未显示食管定位。一项对62例患者的研究结果表明，动态99mTc硫糖铝图像与内镜检查结果之间具有极好的相关性。连续的硫糖铝愈合研究相关性也很好。使用标记硫糖铝检测食管溃疡可能会改变胃食管反流病内镜检查的适应证。
