Evans J L, Mountford P J, Herring A N, Richardson M A
Department of Nuclear Medicine, Kent and Canterbury Hospital, UK.
Nucl Med Commun. 1993 Feb;14(2):108-11. doi: 10.1097/00006231-199302000-00006.
Measurements were made of the fraction of injected radioactivity which was secreted in breast milk following 99Tcm-MAG3 dynamic renal scans of two nursing mothers. The activity concentration in the milk expressed at different times after injection was found to decrease monoexponentially, with effective half-lives of 3.2 and 4.0 h. Two models were applied to each set of data and predicted an overall mean infant effective dose equivalent per unit administered activity of 2.9 muSv MBq-1 and maximum of 4.5 muSv MBq-1. The results demonstrated that it was not essential to interrupt breast feeding following administration of 100 MBq 99Tcm-MAG3 for a dynamic renal scan. If a renal perfusion scan is performed using greater activities of 99Tcm-MAG3, the mother should interrupt feeding and not resume until measurements on her expressed milk samples indicate that the effective dose equivalent to the infant will be less than 1 mSv. However, it was noted that a considerably lower radiation dose to the infant could be achieved by using 99Tcm-DTPA. Therefore, it was concluded that whenever clinically appropriate 99Tcm-DTPA should be used for both types of renal investigations of breast-feeding mothers.
对两名哺乳期母亲进行了99锝-巯基乙酰三甘氨酸（99Tcm-MAG3）动态肾扫描后，测量了注入放射性中分泌到母乳中的部分。发现在注射后不同时间母乳中的活度浓度呈单指数下降，有效半衰期分别为3.2小时和4.0小时。对每组数据应用了两种模型，预测每单位给药活度下婴儿的总体平均有效剂量当量为2.9微希沃特每兆贝可（μSv MBq-1），最大值为4.5微希沃特每兆贝可（μSv MBq-1）。结果表明，进行100兆贝可（MBq）99Tcm-MAG3动态肾扫描后，不必中断母乳喂养。如果使用更高活度的99Tcm-MAG3进行肾灌注扫描，母亲应中断喂奶，直到对其挤出的母乳样本测量表明婴儿的有效剂量当量小于1毫希沃特（mSv）时才能恢复喂奶。然而，注意到使用99锝-二乙三胺五乙酸（99Tcm-DTPA）可以使婴儿接受的辐射剂量大大降低。因此得出结论，只要临床适用，99Tcm-DTPA应用于哺乳期母亲的两种类型的肾脏检查。
