Ukuhlolwa kweNyukliya yokuPhepha kweNtliziyo
Izilingo ezininzi ezingenasiphelo zixhamla ekuphononongweni kwesifo se- coronary disease (CAD) . Phakathi kwezona zinto zi luncedo kakhulu iintliziyo zenziwa nge-thallium okanye kwiCardiolyte.
I-Thallium-201 kunye ne-technetium-99m ye-sestamibi (iCarololyte) zizinto ezimbini ezisasazwayo ezisetyenziselwa iimvavanyo, ezibizwa ngokuba "zifundo zokuqhuma iikryukliya," ezijongene nemiguqulelo yeeronari.
Ngokufakela i-thallium okanye iCarololyte egazini, ngokuqhelekileyo ngexesha lokuvavanywa kwengqondo yomzimba, umfanekiso wenhliziyo unokwenziwa obonisa indlela igazi eliqhubela ngayo kwiindawo ezahlukahlukeneyo zesisu. Ukuba i-artery coronary ivinjiwe okanye ivalwe ngokupheleleyo ngenxa yeCAD, i-muscle enikezwa ngumzobo ochaphazelekayo iya kubonakala kumfanekiso njengendawo ebumnyama-indawo yokunciphisa okanye yokuphuma kwegazi.
Ziziphi i-Thallium neSestamibi?
I-Thallium kunye neCardiolite zizinto ezifakwe kwi-radioactive eziye zasetyenziswa iminyaka emininzi kwizifundo zengqondo zengqondo. Xa ifakwe kwigazi, ezi zinto zifakela kwiintlobo ezithile zeeseli, kubandakanywa neeseli zesisu zomzimba. Ikhamera ekhethekileyo yokucambula efumana i-radioactivity ingasetyenziselwa ukwenza umfanekiso wesifo senhliziyo esiqokelele i-thallium okanye iCarololyte.
Nangona kunjalo, i-thallium neCarololyte zifakela kuphela kwiziqephu zentliziyo ye-muscle enegazi elihle.
Ukuba enye yamarriyari yecononari ivaliwe okanye ivinjiwe ngokukhawuleza, i-radioactivity encinci ifinyelela kwisistim esinikezwa ngumthi ovaliweyo.
Ziyiphi i-Nuclear Perfusion Studies eyenziwa?
Ngexesha lovavanyo loxinzelelo, i-thallium okanye i-Cardiolite ifakwe kwi-vein kwinqanaba lokusebenzisa umzimba.
Isistim e-radioactive sisasaza kuzo zonke iintliziyo zomzimba, ngokulinganayo nokuhamba kwegazi ezifunyenwe yilo msi. Umsila we-cardiac ufumana ukuhamba kwegazi oluqhelekileyo uqokelela inani elikhulu le-thallium / i-Cardiolite kune-cardiac muscle ephazamiseka yi- atherosclerotic plaque .
Uvavanyo lwe-Thallium / I-Cardiolyte lungasetyenziselwa kwizigulana ezidinga ukuvavanywa koxinzelelo kodwa azikwazi ukuzenza. Kule meko, i-adenosine ifakwe kwi-vein ukuze ifane nokusetyenziswa. (I-Adenosine ibangele ukuhamba kwegazi ukusabalalisa kwi-heart muscle ngendlela efana nokusebenzisa - indawo ezinokukhutshwa ngokukhawuleza zifumana ukuhamba kwegazi ngokukhawuleza emva kwemizuzu embalwa emva kwejoyi ye-adenosine.)
Umfanekiso wenhliziyo uya kuthi wenziwe yikhamera ekwazi "ukubona" i-radioactivity ekhishwe yi-thallium / Cardiolite. Ukususela kule mizobo, nayiphi na inxalenye yentliziyo engayifumani ukuhamba kwegazi ngokuqhelekileyo (ngenxa yokucima kwiingxube ze-coronary) iyakwaziwa "njengamabala amnyama."
Ziziphi iiprogram zeNuclear Perfusion?
Ukusebenzisa i-thallium okanye i-Cardiolite perfusion imaging kunyuse kakhulu ukuchaneka kovavanyo loxinzelelo ekufumaneni i-CAD ephazamisayo. Uvavanyo oluqhelekileyo lwe-thallium / uvavanyo lweCarololite luphawu olubalaseleyo lokuba akukho mingcipheko ebalulekileyo kwimibhobho ye-coronary.
Ngakolunye uhlangothi, izigulane ezingenangqamaniso zesikhusekiso se-perfusion zininzi kakhulu zokuba zikhuselekile.
Ucwaningo lwe-nyukliya lusetyenziswa kwiimeko ezintathu eziqhelekileyo. Okokuqala, zinokusetyenziswa kwizigulane ezikhankanywa ukuba zibe ne- angina esomeleleyo ngenxa yokuvalwa kweemingcipheko kwiimitha ze-coronary.
Okwesibini, ezi zifundo zisetyenziswe kwizigulane ezithe zonyango (oko kungukuthi, ngokungekho emthethweni) kwi- angina engaqinisekanga okanye engekho-ST segment infyoction infarction (NSTEMI) , kwaye ngubani obonakala ezinzileyo. Ukuba iimvavanyo zabo ze-thallium / zeCarololyte azibonisi ukukhutshwa okubalulekileyo kwe-restricted blockages, kunokukhuseleka ngokuqhubekayo kunye neyeza lonyango kuphela.
Ngaphandle koko, kufuneka baqwalaselwe ngengozi ye- angioplasty kunye ne- stenting , okanye ukuhlinzwa ngonyango .
Okwesithathu, ezi zifundo zisetyenziselwa ukuvavanya ukufaneleka kweentliziyo zentliziyo ngaphaya komngcipheko okhuselekileyo kwi-coronary artery. Ukuba i-heart muscle "ikhanyisa" kunoma yiyiphi na i-thallium / iCardiolyte, ngoko isasebenza ngokufanelekileyo - kunye nokugquma okanye ukudlula umthamo kunokulindelwa ukuphucula umsebenzi wentliziyo. Ngaphandle koko, inqubo yokuvuselela ayiyi kulindela ukubonelela ngeenzuzo ezininzi.
Ziziphi iiengozi zeNyukliya zokuPhepha kweeNyukliya?
Ezi zifundo ezingenasvasive zikhuselekile. Ingxaki yabo kuphela kukuba i-radiation isetyenziswa. Umgangatho womziza isigulane esifumanayo uvakalelwa ukuba uvelise umngcipheko omncinci kuphela, kunye nezigulane ezikhethiweyo ezifanelekileyo ukuba uncedo olungaphezulu kweyona mngcipheko omncinci.
Imithombo:
Anderson J, Adams C, uAntman E, et al. I-ACC / AHA 2007 izikhokelo zolawulo lwezigulane ezine-angina ezingaqinisekiyo / ezingekho-ST-elevation infyoction: iNgxelo ye-American College of Cardiology / i-American Heart Association Task Force kwiZikhokelo zokuSebenza (IKomiti yokuBhala ukuhlaziya izikhokelo ze-2002 zoLawulo Izigulane ezingenazinzileyo ze-Angina / ezingekho-ST-Elevation Myocardial Infarction): zenziwe ngokubambisana ne-American College of Emergency Physicians, i-American College okanye i-Physicians, uMbutho wezeMpilo oPhezulu oMxhatshazo, uMbutho weeNqwelo zeMpilo kunye neZingenelo, kunye noMbutho weeNgcali zeTraac. J Am Coll Cardiol 2007; 50: e1
U-Allman KC, uShaw LJ, uHachamovitch R, Udelson JE. Ukuhlolwa kokuphila kweMyocardial kunye neempembelelo zokuhlaziywa kwezilwanyana kwizigulane ezinezifo zesifo somgulo kunye nesifo sokungasebenzi kwesimo se-ventricular: i-meta-analysis. J Am Coll Cardiol 2002; 39: 1151.