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[11C-NMSP在非泌乳素瘤垂体腺瘤患者中的临床应用]

[Clinical application of 11C-NMSP to the patients with pituitary adenoma other than prolactinoma].

作者信息

Momose T, Teramoto A, Nishikawa J, Inoue Y, Watanabe T, Sasaki Y

机构信息

Department of Radiology, Faculty of Medicine, University of Tokyo.

出版信息

Kaku Igaku. 1993 Jun;30(6):627-35.

PMID:8345693
Abstract

The existence of dopamine D2 receptors in the pituitary adenoma is an important factor for bromocriptine therapy. In order to evaluate the D2 receptors in the pituitary adenoma, 11C-N-methylspiperone (NMSP) and positron emission tomography was performed in a variety of pituitary adenomas other than prolactinoma. Eight patients with pituitary adenoma including four non-functioning adenomas, two growth hormone (GH) secreting adenomas, one ACTH secreting adenoma and one TSH secreting adenoma and ten normal healthy volunteers were examined. 740 MBq of 11C-NMSP was injected and dynamic scan was performed from the time of injection to 80 min postinjection. The time dependent regional radioactivity in the striatum (st) and in the tumor tissue (tm) was measured and the binding rate, alpha, was calculated according to the following equation: Cst, tm/Ccbl = alpha x integral of t0 Ccbl dt/Ccbl + 1. The ratio of total radioactivity in the striatum or tumor over total activity in the cerebellum was plotted versus "normalized time", which was obtained by dividing integrated cerebellar radioactivity by actual cerebellar radioactivity for each timepoint. In three patients with pituitary adenoma, two scans were performed before and three hours after oral intake of 2.5 mg of bromocriptine. The alpha values for pituitary adenoma and normal striatum were 0.031 +/- 0.023 (0.017-0.088) and 0.042 +/- 0.006 (0.034-0.049), respectively. Bromocriptine reduced alpha value to various degree in pituitary adenoma (13-56%) but not in striatum (-3.7-3.3%). Our data suggests that in some of pituitary adenoma other than prolactinoma, dopamine D2 receptors existed but that nonspecific binding also contributed to the radioactivity in the tumor tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

垂体腺瘤中多巴胺D2受体的存在是溴隐亭治疗的一个重要因素。为了评估垂体腺瘤中的D2受体,对除催乳素瘤外的多种垂体腺瘤进行了11C-N-甲基螺哌隆(NMSP)和正电子发射断层扫描。检查了8例垂体腺瘤患者,包括4例无功能腺瘤、2例生长激素(GH)分泌腺瘤、1例促肾上腺皮质激素(ACTH)分泌腺瘤和1例促甲状腺激素(TSH)分泌腺瘤,以及10名正常健康志愿者。注射740 MBq的11C-NMSP,并在注射后至80分钟进行动态扫描。测量纹状体(st)和肿瘤组织(tm)中随时间变化的区域放射性,并根据以下公式计算结合率α:Cst,tm/Ccbl = α×t0时Ccbl的积分/Ccbl + 1。将纹状体或肿瘤中的总放射性与小脑总活性的比值与“归一化时间”作图,“归一化时间”是通过将每个时间点的小脑放射性积分除以实际小脑放射性得到的。对3例垂体腺瘤患者,在口服2.5 mg溴隐亭前和口服后3小时进行了两次扫描。垂体腺瘤和正常纹状体的α值分别为0.031±0.023(0.017 - 0.088)和0.042±0.006(0.034 - 0.049)。溴隐亭使垂体腺瘤的α值有不同程度降低(13% - 56%),但对纹状体无影响(-3.7% - 3.3%)。我们的数据表明,在某些除催乳素瘤外的垂体腺瘤中,存在多巴胺D2受体,但非特异性结合也对肿瘤组织中的放射性有贡献。(摘要截短于250字)

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