内乳前哨淋巴结显像中的^(99m)T_C-硫胶体标记时间、性状与显影效能

The study of ^(99m)T_C-sulphur colloidal particles’ properties and internal mammary sentinel nodes lymphoscintigraphy

背景与目的:放射性核素内乳前哨淋巴结(IMSN)显像可引导术中γ探测、摘取IMSN进行活检,由确切的病理学证据指导术后放疗,但用腋窝前哨淋巴结显像的方法观察,则IMSN的显像率很低。本研究旨在探讨改变示踪剂99mTC-硫胶体(SC)的标记时间、分析其性状,以提高IMSN的显像率。方法:将99mTC-SC标记过程中的煮沸时间由说明书要求的3～5min缩短为2min,用透射电子显微镜(TEM)观察胶体颗粒的直径、分布和稳定性,然后进行IMSN显像。结果:新标记条件下胶体颗粒的形态、分布在3h内基本保持稳定,90%的胶粒直径为10nm;之后颗粒逐渐聚合、沉积,4h后直径大于100nm。标记后3h内新鲜使用情况下,IMSN显示清晰。结论:新条件下制备的9mTC-SC在标记后3h内,胶粒性状能满足进入深部毛细淋巴管的要求,使内乳前哨淋巴结显影。

Background and purpose： Internal mammary sentinel nodes （IMSNs） lymphoscintigraphy could guide in y-detecting and removing the IMSNs for the purpose of biopsy during the operation,which is helpful to determine the necessity of postoperative radiotherapy. However,IMSNs imaging rate remains low if using axillary lymph nodes （ALNs） lymphoscintigraphy. This study was to investigate the tracer＇s properties and try to improve the IMSNs imaging rate through changing the label procedure. Methods： The boiling time of ^99mTc-sulphur colloidal particles was shortened from 3-5 minutes to 2 minutes during the label procedure, then the colloidal particles＇ diameter, ＇distribution and stability were observed by Transmission Electron Microscope （TEM）, then the IMSNs lymphoscintigraphy was performed. Results： This colloidal tracer＇s shape and distribution remained stable for 3 hours, and 90% of the particles had a diameter of 10 nm, the particles tended to aggregate afterwards. 4 hours after labeling, the diameter of particles exceeded 100 nm. IMSNs could be clearly imaged if the tracer was freshly used （within 3, hours after labeling）. Conclusion： Within 3 hours after the labeling the unfiltered colloidal tracer with modified procedure, the particle could be used and internal mammary lymph nodes could be imaged more clearly.