Tsarin Ginin Harshen Nukiliya na Zuciya
Yawancin gwaje-gwaje marasa gwagwarmaya suna da amfani a cikin gwajin cutar cututtuka (CAD) . Daga cikin mafi amfani shine zane-zane da aka yi da ko dai thallium ko Cardiolyte.
Thallium-201 da technetium-99m sestamibi (Cardiolyte) su ne abubuwa biyu na rediyo da aka yi amfani da su a gwaje-gwajen, wanda ake kira "binciken nazarin furotin na nukiliya," wanda yake neman jigilar kwakwalwa cikin suturar jini.
Ta hanyar toshe thallium ko Cardiolyte cikin jini, yawanci a lokacin gwajin zuciya na zuciya, ana iya yin hoton zuciyar zuciya wanda ya nuna yadda jini ke gudana zuwa sassa daban-daban na ƙwayar zuciya. Idan sakonnin na jijiyoyin zuciya ya ɓangare ko kuma an katange shi daidai saboda CAD, ƙwaƙwalwar da aka bayar ta hanyar ƙwaƙwalwar cututtuka za ta nuna sama a kan hoton kamar wuri mai duhu - wani yanki na rageccen jini.
Menene Thallium da Sestamibi?
Thallium da Cardiolite sune abubuwa masu rediyo da aka yi amfani dashi shekaru da yawa a cikin nazarin hotunan na zuciya. Lokacin da injected cikin jini, wadannan abubuwa sun haɗa zuwa wasu nau'o'in kwayoyin halitta, ciki har da ƙwayoyin tsoka. Za'a iya amfani da kyamarar hoto na musamman da ke gano radiyo don yin siffar zuciyar tsoka wanda ya tara thallium ko Cardiolyte.
Duk da haka, thallium da Cardiolyte sun haɗa ne kawai zuwa sassan zuciya na tsoka wanda ke da jini mai kyau.
Idan an katange suturar na jijiyoyin zuciya ko kuma an katange shi, wani dan kadan dan rediyo yana kai ga tsoka da aka ba ta wannan hadari.
Ta Yaya Harshen Tsaro na Nuclear ya yi?
A lokacin gwajin gwagwarmayar, ko thallium ko Cardiolite an yi shige a cikin wani nau'i a matsayi na matsakaicin motsa jiki.
Abin da ya sake rediyo ya rarraba kanta a cikin ƙwayar zuciya, a cikin girman jini wanda aka samu ta wannan tsoka. Kwayar cardiac samun jinin jini na yau da kullum ya tara yawan thallium / Cardiolite fiye da tsoka na zuciya wanda aka hana shi da wani nau'i na atherosclerotic .
Za a iya amfani da gwajin Thallium / Cardiolyte a marasa lafiya waɗanda suke buƙatar gwajin gwagwarmayar amma ba su iya motsa jiki ba. A cikin waɗannan lokuta, adinosine an allura shi a cikin wani nau'i don simintin motsa jiki. (Adenosine yana sa jini ya gudana a cikin tsohuwar zuciya a hanyar da yayi daidai da aikin motsa jiki - wuraren da za su iya samun gwanin jini na dan kadan saboda minti kaɗan bayan ingancin adenosine.)
Hoton zuciya za a yi ta hanyar kyamara wanda zai iya "ganin" rediyon da aka kwashe ta thallium / Cardiolite. Daga wadannan hotunan, duk wani ɓangare na zuciya da basu karbi jini na al'ada ba (saboda rushewa a cikin jigilar jini) za'a iya gane su "launi mai duhu."
Mene ne Farfarin Nuclear Nazarin Nazari?
Amfani da tallium ko furotin na Cardiolite yana kara ƙaddamar da gwagwarmayar gwagwarmaya a binciko gwajin CAD. Kwalejin thallium / Cardiolite na yau da kullum yana da kyau a nuna cewa babu wani abu mai mahimmanci a cikin jigilar jini.
A gefe guda kuma, marasa lafiya da magungunan ciwo mai ma'ana ba su da matsala sosai.
Ana amfani da nazarin furotin na nukiliya a cikin yanayi uku. Na farko, su masu amfani ne a marasa lafiya wanda ake zargi da samun barci angina saboda ajali na gyarawa a cikin suturar jini.
Abu na biyu, ana amfani da waɗannan nazarin a marasa lafiya wanda aka magance su da lafiya (wato, ba wanda ba shi da haɗuwa) don angina marar ƙarfi ko wani ɓarna na ƙananan ƙananan na ST (NSTEMI) , kuma waɗanda suka bayyana don daidaitawa. Idan tullium / Cardiolyte gwaje-gwaje ba su nuna wani gagarumin gado ba, yana da inganci don ci gaba da likita kawai.
In ba haka ba, ya kamata a yi la'akari da su don maganin angioplasty da tsutsawa , ko kuma tiyata .
Na uku, ana amfani da waɗannan nazarin don yin la'akari da yiwuwar ƙwayar zuciyar zuciya ba tare da rikici mai tsanani a cikin maganin jini ba. Idan ƙwayar zuciya ta "haskakawa" har zuwa thallium / Cardiolyte, to amma yana iya zama mai yiwuwa - kuma za a iya tsammanin yin gyare-gyare ko kuma kewaye da maganin ya inganta aikin zuciya. In ba haka ba, ba za a sa ran tsarin revascularization zai ba da dama mai yawa ba.
Menene Risks na Faɗakarwar Nuclear Perfusion Scans?
Wadannan karatun ba su da kariya ba su da lafiya. Sakamakon su kawai shi ne cewa an yi amfani da ƙananan adadin radiation. Matsayin radiation mai karɓa yana jin damuwarsa don samar da ƙananan haɗarin cutar, kuma ga marasa lafiya wanda aka zaba su iya amfani da su ba tare da la'akari da wannan ƙananan haɗari ba.
Sources:
Anderson J, Adams C, Antman E, et al. Shirin ACC / AHA na 2007 don kula da marasa lafiya da rashin ciwo maras tushe / rashin tayar da hankula na ST-elevation: rahotanni na Kwalejin Kasuwancin Kasuwanci ta Amirka da Ƙungiyar Ayyuka ta Ƙungiyar Amurkan Amurka game da Sharuɗɗan Ɗaukaka (Kwamitin Rubutun don sake tsara Jagoran 2002 don Gudanarwa na marasa lafiya tare da halayen rashin tausayi / ba-ST-altitude infarction): ci gaba tare da haɗin gwiwar Cibiyar Kwalejin Kwararrun Ƙwararrun Amurka, Kwalejin Amurka ko Kwararru, Ƙungiyar Cibiyar Nazarin Harkokin Kiwon Lafiyar Harkokin Kasuwanci, Ƙungiyar ta Hanyoyin Cutar Kwayoyin Tsarin Hoto da Tsarin Harkokin Kasuwanci, da Society of Thoracic Surgeons. J Am Coll Cardiol 2007; 50: e1
Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Jarabaccen amfani da kwayar cutar da tasiri na revascularization a kan rashin lafiya a cikin marasa lafiya tare da cututtukan cututtukan jini da haguwar ventricular hagu: a meta-bincike. J Am Coll Cardiol 2002; 39: 1151.