[Dynamic pulmonary scintigraphy with Tc99m radioaerosol for the evaluation of the permeability of the alveolo-capillary barrier].
Pulmonary clearance of small droplet 99mTc-DTPA radioaerosol was studied in 100 patients (12 normal subjects, N; 10 asymptomatic healthy smokers, FA; 31 patients with interstitial lung diseases, IP; 47 patients with chronic obstructive lung disease, BPCO). The first seven minutes of clearance were described with the function At = Ao*exp (-K*t) and the time constant K was considered representative of the 99mTc-DTPA clearance rate and hence of the alveolar-capillary barrier permeability. Groups FA, IP and BPCO showed a significant (p less than 0.05) or a highly significant (p less than 0.01) increase in permeability when compared to group N. No correlation was found between permeability and bronchial obstruction tests. The following conclusions were drawn: --99mTc-DTPA dynamic lung scanning is an easy, non-invasive method to assess derangements of alveolar-capillary barrier permeability secondary to epithelial damage; --permeability increase is a very early effect of cigarette smoke damage to the epithelium; --other mechanisms of epithelial injury are present in diffuse lung disease; --while the clinical role of this new pathophysiological test is not yet clear, it is likely that it may become a very early marker of pulmonary epithelial damage in diffuse lung disease.
Maini
C L
CL
Cattedra di Medicina Nucleare, Università degli Studi, Ancona.
Bonetti
M G
MG
Giordano
A
A
Pistelli
R
R
Antonelli Incalzi
R
R
Marchetti
L
L
D000328:Adult; D000336:Aerosols; D000368:Aged; D002199:Capillary Permeability; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008173:Lung Diseases, Obstructive / Q000503:physiopathology; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011650:Pulmonary Alveoli / Q000098:blood supply* / Q000503:physiopathology; D011658:Pulmonary Fibrosis / Q000503:physiopathology; D011877:Radionuclide Imaging; D012907:Smoking / Q000503:physiopathology; D013667:Technetium; D016284:Technetium Tc 99m Pentetate
D000336:Aerosols; D009942:Organometallic Compounds; D013667:Technetium; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate
Scintigrafia polmonare dinamica con 99mTc radioaerosol per la valutazione della permeabilità della barriera alveolo-capillare.