Noninvasive detection of human cardiac transplant rejection with indium-111 antimyosin (Fab) imaging.
Noninvasive detection of human cardiac transplant rejection with indium-111 antimyosin (Fab) imaging.
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发表时间：
1987-11
期刊：
影响因子：
37.8
通讯作者：
W. Frist;T. Yasuda;G. Segall;B. Khaw;Strauss Hw;H. Gold;Stinson Eb;P. Oyer;J. Baldwin;M. Billingham
中科院分区：
文献类型：
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作者：
W. Frist;T. Yasuda;G. Segall;B. Khaw;Strauss Hw;H. Gold;Stinson Eb;P. Oyer;J. Baldwin;M. Billingham
心脏移植后排斥反应的诊断目前是通过右心室肌内膜活检。为了评价抗肌球蛋白显像作为检测人类心脏排斥反应的非侵入性方法，在20项研究中，用铟-111标记鼠单克隆抗肌球蛋白抗体的Fab片段，并在移植后7天至9年内静脉给予18名患者（年龄45 ± 12岁）。在每次成像研究时获得肌内膜活检标本。8例患者的活检结果证实为排斥反应，8例患者的活检结果为阴性且无排斥反应证据。在4项研究中观察到不一致性，2项扫描阳性，活检无排斥反应，2项扫描阴性，活检阳性。该技术的敏感性、特异性和总体准确性均为80%。放射性标记的抗肌球蛋白抗体Fab片段的成像可能在心脏移植受者的排斥反应的非侵入性识别的价值。
Diagnosis of rejection after cardiac transplantation is currently made by right ventricular endomyocardial biopsy. To evaluate antimyosin imaging as a noninvasive means of detecting human cardiac rejection, the Fab fragment of murine monoclonal antimyosin antibodies was labeled with indium-111 and given intravenously to 18 patients (age 45 +/- 12 years) in 20 studies 7 days to 9 years after transplantation. Endomyocardial biopsy specimens were obtained at the time of each imaging study. Eight patients had positive scans confirmed by biopsy as rejection, and eight patients had negative scans and no evidence of rejection on biopsy. Discordance was observed in four studies, two with positive scans and no rejection on biopsy and two with negative scans and positive biopsy. The sensitivity, specificity, and overall accuracy of the technique were each 80%. Imaging with radiolabeled antimyosin antibody Fab fragments may be of value in the noninvasive identification of rejection in the cardiac transplant recipient.