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DOI: 10.1055/s-0038-1629703
Sympathische Reinnervation nach Herztransplantation -Doppelnuklidstudie mit 123J-MIBG und 201Tl
Sympathetic Reinnervation Following Heart Transplantation -A Double-Tracer Study with 123I-MIBG and 201TlPublication History
Eingegangen:
19 October 1993
in revidierter Form:
24 January 1994
Publication Date:
04 February 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034924/199403/lookinside/thumbnails/10-1055-s-0038-1629703_de-1.jpg)
Zusammenfassung
Zum Nachweis der sympathischen Reinnervation wurden 15 Patienten 2 bis 69 Monate nach Herztransplantation im Rahmen einer Doppelnuklidstudie mit 123|-MIBG und 201TI untersucht. Da MIBG eine sich dem Noradrenalin analog verhaltende Substanz ist, gestattet es Rückschlüsse auf die Integrität und Funktion des sympathischen Nervensystems. Zum Landmarking der Myokardregion diente 201TI. Planare anteriore Aufnahmen wurden 15 min und 4 h p. i. von 220 MBq 123|-MIBG und 37 MBq 201TI angefertigt. Der kardiale MIBG-Uptake wurde aus dem Quotienten der kardialen und mediastinalen Aktivität errechnet. Acht Patienten zeigten 2 bis 34 Monate nach Transplantation keinen Hinweis auf Sympathikus-Reinnervation. Ein deutlicher anterobasaler MIBG-Uptake konnte bei 6 Langzeit-transplantierten mit einem Organalter von 37 bis 69 Monaten nachgewiesen werden. Ein Patient mit einem 59 Monate alten Herzen zeigte keinen MIBG-Uptake. Ein vermehrter MIBG-Uptake der antero-basalen Region war bei 40% der untersuchten Patienten mit einem mittleren Organalter von 51 Monaten als Zeichen partieller sympathischer Reinnervation nachweisbar.
Summary
Sympathetic reinnervation was evaluated in 15 patients 2-69 months after heart transplantation using a double-tracer technique with 123|-MIBG and 201TI. Since MIBG is accumulated in the same manner as norepinephrine it may serve as a tracer of the integrity and function of the sympathetic nervous system. 201TI was used for landmarking. Planar anterior imaging was performed 15 min and 4 h after i.v. injection of 220 MBq 123|-MIBG and 37 MBq 201TI. Image quantitation was based on the ratio of myocardial to mediastinal MIBG-uptake. Cardiac regions of interest were defined according to the 201TI uptake. There was no evidence of sympathetic reinnervation in 8 patients 2-34 months after transplantation. Increased MIBG-uptake could be observed in the anterior basal region in 6 long-term cardiac transplants (37-69 months). One patient with a 59-month-old transplanted heart did not reinnervate. Increased MIBG-uptake in the anterior basal region indicating partial sympathetic reinnervation could be shown in 40% of the investigated patients with an average organ age of 51 months.
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