^(99)Tc^m-硫胶体显像测定小肠通过时间的临床研究

Measurement of small bowel transit time by 99 TcmSC imaging: preliminary clinical study

目的建立９９Ｔｃｍ硫胶体（ＳＣ）显像法，测定小肠通过时间（ＳＢＴＴ），并与加服乳果糖法比较其通过时间及应用价值。方法用９９ＴｃｍＳＣ固体试餐对２０例健康志愿者及２６例胃肠道疾患患者进行显像，以测定ＳＢＴＴ；１周后，同一受试者进食核素加乳果糖试餐后以同样方法再次显像，并进行乳果糖氢呼气试验，或用反卷积分析法计算ＳＢＴＴ“谱”；或用５０％结肠填充时间减５０％胃排空时间计算平均ＳＢＴＴ。结果①２０例健康志愿者的平均ＳＢＴＴ为（４２±０５）ｈ；口盲肠时间为（４３±０６）ｈ；乳果糖可加快ＳＢＴＴ，平均加快（１８±０６）ｈ。②２６例胃肠道疾患患者，由于疾病不同，ＳＢＴＴ改变不一。结论９９ＴｃｍＳＣ显像方法简单，无创，合乎生理。乳果糖可加快ＳＢＴＴ，缩短检查时间，有助于判断食物到达回盲部时间，有一定的应用价值。

Objective To develop a method of measuring small bowel transit time (SBTT) by 99 Tcmsulfur collid (SC) imaging and to compare with the method of added lactose in the test meal Methods 20 healthy volunteers and 26 patients with gastrointestinal disorders were studied In fasting state, the subjects were asked to ingest the 99 TcmSC labeled solid meal within 5 minutes, then the image acquisition was immediately started with SPECT The images were acquired every 15 min during the first hour, at 30 min intervals during 24 hours and hourly thereafter until 80% radioactivity had entered the colon One week later, the same procedure of imaging with 15 g lactulose added in the test meal was performed The regions of interest (ROIs) were taken at stomach and colon, and the SBTT was calculated by deconvolution or by subtraction of the 50% time of gastric emptying from the 50% time of colon filling Results The mean SBTT of 20 healthy volunteers was (4205) h, oralcaecum transit time (OCTT) was (4306) h; lactulose shortened the SBTT by (1806) h; 26 patients showed different results of SBTT due to their different gastrointestinal disorders bases Conclusions 99TcmSC imaging was a noninvasive and useful method to measure SBTT. The added lactulose can shorten the examination time and help to identify the time of food to the ileocecal region