SU1757641A1 - Method for determining absorbing ability disturbances in small intestine - Google Patents

Abstract

Usage: The invention relates to medical radiology and concerns a method for determining the absorption capacity of a small intestine. The goal is to increase the accuracy of determination, reduce the time of the study and reduce the radiation load on the patient. 99Mus retechnetat was orally administered in a gelatin capsule, immediately after the radiopharmaceutical was injected, dynamic gamma scheduling was performed for 60 minutes, then the rate of absorption of ди radio formulants and the half-time of its release from the intestine were calculated using the release of interest areas in the small intestine and heart, and the time required for its half-release from the intestine by selecting zones of interest in the small intestine and the heart was calculated by means of extracting areas of interest from the intestine by selecting the areas of interest in the small intestine and heart, and the time of its half-release from the intestine using the release of areas of interest in the small intestine and the heart was calculated by means of extracting areas of interest from the intestine and the heart by selecting the zones of interest in the small intestine and the heart, the time required for its half-release from the intestine using the release of areas of interest in the small intestine and the heart was calculated. histograms, and with the rate of absorption less than 1.5 + 0.8 and the half-life of the radiopharmaceutical more than 14.0 ± 1.3 minutes, impaired absorption of the small intestine is determined. Positive effect; The prearranged method allows differentiated selection of the type of artificial nutrition in postoperative patients; enteral probe - with the direct absorption capacity of the small intestine, or parenteral - with the violation of this function.-С

Description

The invention relates to the field of medicine, in particular to gastroenterology, and can be used to diagnose various diseases of the gastrointestinal tract, to study their pathogenesis and to monitor the effectiveness of treatment,

The most objective information about the absorption capacity of the small intestine can be obtained using radionuclide diagnostic methods. The following are known:

1, A method of sequential radiometry of individual zones of the abdomen area using oleic acid labeled with 1 1J.

2, Method based on radiometry of the thyroid gland after intraintestinal (via a probe) administration of K131J

3. Method of profile scanning of the abdominal cavity.

4. A method based on radiometry of the whole body and abdomen using trioleate-glycerin - 131J.

5. Method of radiometry of the whole body with local screening of the stomach and duodenum.

The closest to the proposed method is the method selected for the prototype for the radio-nuclide determination of the motor-sonication function of the stomach, intestines and the absorption capacity of the small intestine.

However, the prototype has the following disadvantages;

1. There is no information about the speed indices of absorption: the rate of absorption, the half-time of RFG in blood. Meanwhile, the evaluation of these indicators is the main criterion of the vascular capacity of the small intestine,

2. The accuracy of the method is reduced due to the fact that the radiopharmaceutical is prescribed to the patient orally in solution and, therefore, absorption begins earlier. in oral and in the stomach. In addition, a decrease in the accuracy of diagnosis is due to the difficulties that inevitably arise in the blind selection of individual screens for the stomach and intestines.

3. The duration of the method (24 hours) involves the use of a radio toxic and relatively long-lived radionuclide - J, which will create a greater radiation load on the patient and, according to recommendations, should be excluded from the practice of radionuclide diagnostics.

The aim of the invention is to improve the accuracy of diagnosis, reduce the radiation load on the patient, reduce the time of the study.

This goal is achieved by dynamic scintigraphic application. rfc - pertechnetate in a gelatin capsule and subsequent computer processing of a graphic image of the rate of absorption of the radionuclide from the intestine into the blood.

The proposed method has a number of distinctive features;

1. A short-term dynamic gsm-mascintigraphic is performed with a 99mTs-pertechnetate preparation (half-life is 6 hours, gamma radiator) in combination with low radiotoxicity.

Previously, we determined the topographic-anatomical characteristic of the place of dissolution of the capsule in the alimentary canal. For this, x-ray examination was performed on 5 patients. It was found that in all the fasted patients, a capsule filled with a radiocontrast-cardiotrack enters the pylorus almost immediately after swallowing, and after 3-6 minutes it appears in the duodenal bulb, where its rapid dissolution occurs. These features provide an increase in diagnostics while reducing the radiation load on the patient.

Practical example

Patients are examined in the morning on an empty stomach. Dynamic gammascintigraphy is performed on a gamma camera of the RNO type — Gamma, Searle (Holland), complete with a computer CM 14/20 (USSR). 1-2 minutes before the start of the study, the patient swallows a standard gelatin capsule 1x3 cm in size containing 99mTC - pertehnetate . Radchopharmaceutical is individually dosed in the amount of 0.2 MKAh of the patient's body weight. Unlike the prototype, the use of a radiopharmaceutical in a gelatin capsule eliminates its absorption in the mouth and stomach, which increases the accuracy of determining the absorption capacity of the small intestine.

Dynamic gamm scintigraphy is performed with the patient in a supine position. The center of the gamma camera detector is located at the TPC, and from the point of view of the scintillation crystal, the intestines of the heart fell. Information was recorded in the mode of 1 frame per minute. This radionuclide is recommended for widespread use in the practice of radionuclide diagnostics. The radial load calculated according to, with our method of determination, is 1.0 m 3 in the whole body and 2.5 m 3 in the drain of the stomach and intestines. The prototype uses oleic acid labeled with J, which belongs to the second class of radiotoxicity (half-life of 8.03 sous g, gamma-beta radiation). The beam of the Negr, the weight of the body is 3.5 m 3 in, and 5.4 m 3 in the wall of the gastrointestinal tract. In addition, when oleic acid is used - J, 13IJ is cleaved from the carrier and captured by the thyroid gland with subsequent additional tissue and integral dose in the nation,

2. When released into the intestine (MTcO), as well as C1- and J- are absorbed by passive diffusion following Na +, reflecting the energy-dependent transmembrane-dependent transfer of nutrients from the inteteronte to the blood with the participation of Ma-K -ATP, which is sensitive to various pathogenic factors. -az The use of dynamic gammascintigraphy with subsequent computer processing of information allows one to continuously record the rate (rate) of absorption of i MTc04) from the intestine into the blood, which greatly improves the accuracy of diagnosis, t, because it is known that it is the rate of nutrients entering the blood from the intestine that is the main regulator parameter of the absorption process in the intestine.

3. A feature of the method is also the note of the indicator in a gelatin capsule orally. This eliminates the absorption of the indicator in the oropharynx and stomach and improves the accuracy of diagnosis,

The study lasts up to 60 minutes. After its completion with the help of the light peer on the display screen, it is possible with great accuracy and. in contrast to the prototype, individually for the patient, to limit the radioactivity zones of interest, presented in the form of a multi-color pt; the heart area and the intestinal region. In the prototype, in order to limit the radioactive zones, lead screens are used, the individual selection of which is difficult and is carried out without taking into account the true boundaries of the radioactive spot, which reduces the accuracy of diagnosis

The information from the zones of interest is processed by the computer and displayed as graphs on the display screen.

The absorption capacity of the small intestine was determined by the time of radiopharmaceutical removal from the intestine into the blood by half (T 1/2 min) and by the rate of absorption of the radiopharmaceutical from the intestine into the blood (in conventional units) Absorption rate of the radiopharmaceutical was calculated as the slope of the ascending segment precardial curve to the x-axis.

The information we obtained allows us to conclude that when the rate of absorption of MTF - pertechnetate is 1.5X0.08 and the half-life of the radioindicator from the small intestine into the blood is 12.0 ± 1.3 minutes, the intestinal function is not impaired.

At an absorption rate of 0.9 ± 0.08 (, 01) and a half-life of 19.3 ± 2.3 minutes, the impairment is taken out of the air; a moderate degree.

Thus, the proposed diagnostic method is characterized by high accuracy, speed of execution, is accompanied by a low radiation load on the patient and does not tire the patients.

Claims (1)

Invention Formula The method of determining the violation of the aspiration capacity of the small intestine by radiometry after oral administration of a radiopharmaceutical, characterized in that, in order to improve the accuracy of determination, shorten the examination time and reduce the patient's radiation load, a 99mTc-pertechnetatate is used as a radiopharmaceutical in the gelatin capsule immediately after administration the radiopharmaceutical was subjected to dynamic gamma scintigraphy for 60 minutes, the rate of absorption of the radiopharmaceutical and the half-life of it were calculated when the rate of absorption is less than 1.5 ± 0.08 and the half-life of the radiopharmaceutical is more than 14.0 ± 1.3 minutes, the absorption capacity of the small intestine is determined.