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肝肿瘤经动脉放射栓塞术后 Y 和 Ho 的肾和肠道排泄。

Renal and Intestinal Excretion of Y and Ho After Transarterial Radioembolization of Liver Tumors.

机构信息

Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany.

出版信息

AJR Am J Roentgenol. 2020 May;214(5):1158-1164. doi: 10.2214/AJR.19.22049. Epub 2020 Mar 4.

Abstract

The aim of this study was to evaluate the amount of free radioactivity in renal and intestinal excretions during the first 48 hours after transarterial radioembolization (TARE) procedures on the liver. Urinary, intestinal, and biliary excretions of patients who underwent TARE with three different types of microspheres were collected during a postinterventional period of 48 hours (divided into two 24-hour intervals). Radioactivity measurements were performed. The detected amounts of activity were correlated to clinical and procedural characteristics, times of excretion, and microsphere types. Twenty-four patients were evaluated, 10 treated with Y-glass, 10 with Y-resin, and four with Ho-poly-L-lactic acid (PLLA) microspheres. Activity excretion occurred in all cases. The highest total excretion proportions of the injected activities were 0.011% for Y-glass, 0.119% for Y-resin, and 0.005% for Ho-PLLA microspheres. Intestinal excretion was markedly less than renal excretion ( < 0.001). Excretion after TARE with Y-resin was statistically significantly higher than with Y-glass or Ho-PLLA micro-spheres ( = 0.002). For each microsphere type, the excreted activity was independent of the activity of the injected microspheres. Renal and intestinal excretion of radioactivity after TARE is low but not negligible. The radiation risk for individuals interacting with patients can be minimized if contact with urine and bile is avoided, particularly during the first 24 hours after the procedure.

摘要

本研究旨在评估经动脉放射性栓塞(TARE)治疗肝脏后 48 小时内肾和肠道排泄物中的游离放射性活度。在介入后 48 小时内(分为两个 24 小时间隔)收集接受 TARE 治疗的患者的尿液、肠道和胆汁排泄物,并进行放射性测量。将检测到的活性与临床和程序特征、排泄时间和微球类型相关联。评估了 24 例患者,10 例用 Y-玻璃微球治疗,10 例用 Y-树脂微球治疗,4 例用 Ho-聚乳酸(PLLA)微球治疗。所有病例均出现活性排泄。注射活性的总排泄比例最高的分别为 Y-玻璃微球 0.011%,Y-树脂微球 0.119%和 Ho-PLLA 微球 0.005%。肠道排泄明显少于肾脏排泄( < 0.001)。Y-树脂 TARE 后的排泄明显高于 Y-玻璃或 Ho-PLLA 微球( = 0.002)。对于每种微球类型,排泄的活性与注射的微球的活性无关。 TARE 后放射性活性的肾和肠道排泄量低,但不能忽略不计。如果避免与尿液和胆汁接触,可以将与接受治疗的患者接触的个体的辐射风险降至最低,特别是在手术后的头 24 小时内。

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