NONINVASIVE ARTERIAL THROMBUS IMAGING WITH TC-99M MONOCLONAL ANTIFIBRIN ANTIBODY
NONINVASIVE ARTERIAL THROMBUS IMAGING WITH TC-99M MONOCLONAL ANTIFIBRIN ANTIBODY
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DOI：
10.1161/01.cir.85.1.298
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发表时间：
1992-01-01
期刊：
影响因子：
37.8
通讯作者：
RITCHIE, JL
中科院分区：
文献类型：
--
作者：
CERQUEIRA, MD;STRATTON, JR;RITCHIE, JL
背景资料。T2G1s抗纤维蛋白单抗可与纤维蛋白特异结合，但不与纤维蛋白原结合。在犬急性动脉血栓形成模型中，我们确定了使用99m标记的Fab‘片段对血栓进行成像的可行性。在14只犬中，采用2小时暂时性闭塞、挤压伤和局部注射凝血酶的方法造成10只颈动脉血栓和13只股动脉血栓。假手术颈动脉作为对照。在临时阻断结束时静脉注射抗纤维蛋白抗体。分别于即刻、1小时和2小时进行掌侧放射性核素连续成像。在处死狗2小时后，我们测量了5毫米长的血栓段、邻近受损动脉和对照动脉的抗体摄取率。抗体从血液中清除，平均+/-SDT1/2为121+/-23分钟。血栓重218+/-140毫克。血栓内抗体摄取呈片状，血栓与受损动脉壁紧密粘连。在体外抗体摄取最多的节段，对照动脉与血细胞计数/g/秒的比值为0.65+/-0.46，损伤动脉/血液比值为2.35+/-1.01(p<；0.0001与对照组相比)，血栓/血液比值为4.24±/-2.58(p<；0.0001与对照组相比)。在三只狗身上，用T2G1s注射In-111标记的同型卵巢肿瘤抗体，但不被血栓或邻近动脉壁摄取。对活体颈动脉核素图像的目测分析显示，所有10个颈动脉血栓在2小时内摄取。定量图像分析，测量血栓与对侧颈动脉的比率，显示随时间增加的摄取，即刻、1小时和2小时图像的比率分别为1.1+/-0.3、1.6+/-2.0和2.2+/-1.3。所有的定量比在1.3或更大的视觉上被识别。T2G1s抗体的TC-99m标记Fab‘片段在静脉注射后被急性动脉血栓特异性摄取。摄取在2小时内逐渐增加，所有血栓都在2小时内通过放射性核素成像检测到。这些结果表明，在血栓形成后2小时内无创检测动脉血栓是可行的。
Background. The T2G1s monoclonal antifibrin antibody binds specifically to fibrin but not to fibrinogen.Methods and Results. In a canine model of acute arterial thrombosis, we determined the feasibility of imaging thrombi using a Tc-99m-labeled Fab' fragment. In 14 dogs, 10 carotid and 13 femoral artery thrombi were produced using 2-hour temporary occlusion, crush injury, and local thrombin injection methods. A sham-operated carotid artery served as control. Antifibrin antibody was injected intravenously at the end of temporary occlusion. Serial palnar radionuclide images were obtained immediately and at 1 and 2 hours. Following killing the dogs at 2 hours, we measured antibody uptake ex vivo in 5-mm-long segments of thrombus, the adjacent injured artery, and a control artery. Antibody was cleared from the blood with a mean +/- SD t1/2 of 121 +/- 23 minutes. The thrombi weighed 218 +/- 140 mg. Antibody uptake in the thrombi was patchy, and the thrombi were closely adherent to the injured arterial wall. In the segment with maximal ex vivo antibody uptake, the ratio of control artery to blood counts/g/sec was 0.65 +/- 0.46, the injured artery-to-blood ratio was 2.35 +/- 1.01 (p < 0.0001 versus control), and the thrombus-to-blood ratio was 4.24 +/- 2.58 (p < 0.0001 versus control). In three dogs, an isotypematched ovarian tumor antibody labeled with In-111 was injected with T2G1s but was not taken up in the thrombus or the adjacent arterial wall. Visual analysis of the in vivo carotid radionuclide images showed uptake by 2 hours in all 10 carotid thrombi. Quantitative image analysis, measured as the thrombus-to-opposite carotid artery ratio, showed increasing uptake over time with ratios of 1.1 +/- 0.3, 1.6 +/- 2.0, and 2.2 +/- 1.3 on the immediate, 1-hour, and 2-hour images, respectively. All quantitative ratios of 1.3 or greater were visually identified.Conclusions. Tc-99m-labeled Fab' fragments of the T2G1s antibody are taken up specifically by acute arterial thrombi after intravenous injection. Uptake is progressive over a 2-hour period, and all thrombi are detected by radionuclide imaging at 2 hours. These results show that it is feasible to noninvasively detect arterial thrombi within 2 hours of formation.