Tsujii H
Int J Radiat Oncol Biol Phys. 1985 Sep;11(9):1603-12. doi: 10.1016/0360-3016(85)90212-3.
A total of 216 99mTc-pertechnetate-sialographies, by applying stimulations by citric acid, were performed for studying radiation effects on the salivary glands in 145 patients. From a scintigram of the salivary gland, the time-activity-curves were obtained for analysis of salivary function. The shape of the time-activity-curve with respect to stimulus-response pattern was classified into four types according to the degree of radiation-induced dysfunction. We found that the acid stimulation was enhancing accumulation of the isotope into the salivary gland as well as influencing salivary discharge. A ratio (Rc) of pre- and post-stimulation counts permitted a construction of quantitative dose-response curves; the curve for the parotids had a slight rise of Rc's over 0-20 Gy, whereas that for the submandibular glands had a significant rise over 10-30 Gy; in both glands the rise of Rc's was followed by a steep fall. The parotids appeared to be more sensitive to radiation than the submandibular glands at 0-3 months following 20-70 Gy, but after 3 months both glands were similarly impaired. The gland volume irradiated was also of great importance in determining the degree of salivary dysfunction. The maximum uptakes averaged per unit area (salivary-to-background ratio) and determined during the initial 30 minutes were greater in the submandibular than in the parotid glands following greater than 20 Gy. In both glands the maximum uptakes were gradually impaired with time over 3-36 months following 50-70 Gy.
对145例患者进行了总共216次应用柠檬酸刺激的99m锝高锝酸盐唾液造影，以研究辐射对唾液腺的影响。从唾液腺闪烁图中获取时间-活性曲线，用于分析唾液功能。根据辐射诱发功能障碍的程度，将刺激-反应模式的时间-活性曲线形状分为四种类型。我们发现，酸刺激不仅增强了同位素在唾液腺中的积聚，还影响了唾液分泌。刺激前后计数的比值（Rc）可构建定量剂量-反应曲线；腮腺的曲线在0-20 Gy范围内Rc略有上升，而颌下腺的曲线在10-30 Gy范围内有显著上升；在两个腺体中，Rc上升后均紧接着急剧下降。在20-70 Gy照射后的0-3个月内，腮腺似乎比颌下腺对辐射更敏感，但3个月后两个腺体的受损程度相似。照射的腺体体积在确定唾液功能障碍程度方面也非常重要。在超过20 Gy照射后，颌下腺每单位面积的最大摄取量（唾液与本底比值）在最初30分钟内平均比腮腺更大。在50-70 Gy照射后的3-36个月内，两个腺体的最大摄取量均随时间逐渐受损。
