核素显像对实验性绞窄性肠梗阻的早期诊断

EARLY DIAGNOSTIC VALUE OF RADIONUCLIDE VISUALIZATION TO EXPERIMENTAL STRANGULATED BOWEL OBSTRUCTION

用家兔制成闭袢型、肠系膜静脉阻塞型及肠系膜动脉阻塞型的急性绞窄性肠梗阻模型，并以单纯性肠梗阻组和假手术组为对照。制模后１、４小时从兔耳静脉注射显像剂９９ｍ锝焦磷酸盐，用单光子发射计算机断层（ＳＰＥＣＴ）进行腹部平面显像的动态观察，并测定感兴趣区的摄取比值。结果显示：在闭袢型和肠系膜静脉阻塞型于注射显像剂后，绞窄肠段所在腹侧出现放射性浓聚，显像部位感兴趣区摄取比值明显大于单纯性肠梗阻组和假手术对照组；肠系膜动脉阻塞型上述改变不明显。本实验结果提示：闭袢型和静脉阻塞型绞窄缺血肠段早期有显像剂的聚集；ＳＰＥＣＴ的核素显像技术可作为早期诊断闭袢型和肠系膜静脉阻塞型肠梗阻有价值的辅助手段。

Different types of bowel obstruction,including strangulated loop,mesenteric venous occlusions,mesenteric arterial occlusions and simple obstruction, were induced in rabbits.After induction of occlusion, imaging agent of 99m Tc pyrophosphate was injected intravenously.Thirty minutes later,abdominal plain image was successively taken with a single photon emission computed tomography (SPECT).At the same time,the uptake ratio of region of interest was determined.The results revealed that animals in strangulated loop group and mesenteric venous occlusion group had high radioactive concentration in the area of ischemic bowel. Uptake ratio of region of interest of imaging area in the two experimental group was higher than that in simple obstruction and control group.Whereas the mesenteric arterial occlusion group did not appearantly present the changes mentioned above.These showed that there was an accumulation of agent in strangulated ischemic bowel segment in strangulated loop group and mesenteric venous occlusion group.All results suggest that radionuclide visualization with SPECT could be a valuable method for early diagnosis of acute intestinal strangulation of strangulated loop type and mesenteric venous occlusion type.