核研所氪-81m肺通氣造影劑與氙-133評估臨床肺疾病之比較研究

A Comparative Study of Krypton-81m Prepared from INER in Taiwan and Xenon-133 Ventilation Agents for Evaluation of Clinical Lung Disease

10.6332/ANMS.1404.002

程紹智(Shiou-Chi Cherng)；楊世平(Shih-Ping Yang)；陳群互(Chun-Hu Chen)；羅靄人(Ai-Ren Lo)；鄭武隆(Wu-Long Cheng)；黃文盛(Wen-Sheng Huang)

氪-81m ； 氙-133 ； 肺通氣造影劑 ； 81mKr ； 133Xe ； pulmonary ventilation imaging agent

核子醫學雜誌

14卷4期（2001 / 12 / 01）

201 - 207

繁體中文

背景：國內核能研究所已能自製氪-81m肺通氣造影劑，本研究的主要目的即在評估此自製的氪-81m氣體能否安全且有效地應用於人體肺造影；其次，比較氪-81m與另一通氣造影劑氙-133，在偵測各種肺疾病時的優劣。方法：總共有52位受檢者（5位健康志願者，47位病患）參與本研究，每位皆在同一天內接受氪-81m通氣、氙-133通氣及鎝-99m血清白蛋白巨聚合顆粒（99mTc-MAA）灌注三種肺造影檢查，造影結果與臨床最終診斷對照後，再從臨床實用性、安全性、影像品質及對待各種肺疾病的偵測等多方面，分析比較兩種通氣造影劑的差異。結果：52位受試者皆安全日有效地完成肺造影。氙-133通氣造影實施時，有7位出現短暫而輕微的副作用，氪-81m則無。整體而言，氪-81m之影像品質較氙-133為佳。11位具肺栓塞症的病人中，有6位是單純肺栓塞症患者，氪-81m和氙-133皆偵測出其中5位，1位只有氪-81m偵測出；其餘5位是同時合併有肺栓塞及阻塞性肺疾病的病人，氪-81m和氙-133皆偵測出3位，另2位只有氪-81m偵測出。36位具阻塞性肺疾病的病人中，氪-81m和在氙-133皆偵測出其中21位，9位氪-81m和氙-133皆未偵測出；所剩的6位，只有氪-81m偵測出的有2位另外4位只有氙-133偵測出。結論：核研所自製的氪-81m通氣造影劑能安全且有效地應用於人體肺造影，從臨床實用性、安全性、影像品質及對肺桂塞症的偵測等多方面分析，氪-81m皆優於氙-133。

Background: The Institute of Nuclear Energy Research (INER) in Taiwan successfully developed a 81Rb/81mKr generator. The aims of this study were to evaluate whether the self-made 81mKr was safe and effective for ventilation (V) scintigraphy in humans and to compare the difference between 81mKr and 133Xe V imaging in detection of various lung disease.Methods: Five volunteers and 47 patients were enrolled in this study. Each volunteer or patient underwent studies with 81mKr V, 133Xe V and 99mTc MAA perfusion on the same days. Images were judged and scintigraphic results were consulted with the final diagnosis. A comparative analysis of 81mKr and 133Xe images was performed for clinical utility, safety, image quality and detective value in patients with various lung diseases.Results: All volunteers and patients successfully underwent lung scans. During 133Xe V studies, 7 patients had some temporary and minimal side effects, but none of the patients had side effects during 81mKr V studies. In general, the image quality of 81mKr was better than that of 133Xe. Of the 11 patients with pulmonary embolism (PE), six had PE alone; 81mKr and 133Xe results agreed in five patients, but 81mKr detected PE in the remaining patient. Of the remaining five patients who suffered from PE with obstructive airway disease, 81mKr and 133Xe agreed in three, but 81mKr detected PE in another two patients. Of these, 36 had obstructive airway disease; twenty-one of the 36 patients were detected by 81mKr and 133Xe, but nine were missed by both studies. Of the remaining six patients, two were detected only by 81mKr and four were detected only by 133Xe.Conclusions: Self-made 81mKr was safe and effective for V scintigraphy in humans. When 81mKr was used as a V agent to detect pulmonary embolism, it appeared superior to 133Xe.