Enter intravenously.
To study the blood circulation of the brain.
Preparation of the preparation.
The preparation is prepared immediately before use by adding 5.0 ml of sodium pertechnetate, 99mTc from a technetium-99m generator into a vial of lyophilizate. The following conditions must be observed:
- A solution of sodium pertechnetate, 99mTc should be obtained no later than 24 hours after the previous elution of the technetium-99m generator.
- The resulting solution of sodium pertechnetate, 99mTc should be used to prepare the drug Teoksim, 99mTc for 2 hours. The finished product can be stored for no more than 30 minutes.
After the addition of the eluate from the technetium generator and thorough mixing, the contents of the vial are administered intravenously.
Entered dose: 0.5 mg d, 1-HMPAO isomer labeled 185-740 MBq of technetium-99 m. SPECT is used for evaluation. Plane tomography is performed in four projections. SPECT is carried out according to a known method in 10-15 minutes. after the administration of the drug.
Identification of foci of inflammation.
Preparation of labeled leukocytes:
Required Reagents:
1. Dextrose citrate (DC):
- sodium citrate - 22 g
- citric acid - 8 g
- dextran 500 - 22.4 g
- water for injection-up to 1L
The solution is sterilized through a millipore filter (0.2 r).
2. 2% solution of methyl cellulose in physiological solution, for which dissolve 2 g Methocell E50 Premium (Dow) in 100 ml sterile, apyrogenic physiological solution, mix until completely dissolved. The solution is filtered through a 0.45 p filter. Store the solution at 2-4 ° C.
Necessary equipment:
- Plastic non-heparinized syringe with a volume of 60 ml - 2 pcs.
- Plastic centrifuge tubes with lids sterile with a capacity of 25 - 30 ml (hereinafter referred to as centrifuge tubes) - 7 pcs.
The procedure for the isolation and labeling of leukocytes is carried out under sterile conditions, for which it is necessary:
- Add 9 ml of DC to each of 2 60 ml of plastic non-heparinized syringes.
- Select 51 ml of patient's blood in each syringe using a needle 19G (butterfly). Close the syringes with sterile stoppers. Carefully mix blood and DC.
- Add 2 ml of a 2% solution of methyl cellulose to each of the 4 centrifuge tubes.
- Add 20 ml of blood from syringes without needles to 4 prepared centrifuge tubes, gently stir and cover with caps. Leave for sedimentation of red blood cells for 1 hour at room temperature.
- The remaining 20 ml of blood is added to a clean centrifuge tube.
Centrifuge the test tube with blood for 10 minutes. at 2000g. The resulting pure plasma is used for labeling and injection. Keep the plasma at room temperature. Apply the label "A" to the test tube.
- After the sedimentation of erythrocytes, carefully transfer the platelet-rich and leukocyte-rich supernatant to a clean centrifuge tube. Centrifuge for 5 min. at 150g. The resulting sediment contains leukocytes.
- Remove as much plasma as possible into a clean centrifuge tube and centrifuge for 10 minutes. at 2000g , to obtain a plasma containing methylcellulose. This plasma is used for washing cells after labeling. Apply the label "B" to the test tube.
- Resuspend the leukocyte sediment by lightly shaking the test tube. Add 1 ml of clean plasma from the tube "A".
- To determine the viability of the isolated leukocytes with the help of lifetime staining with trypan blue.For labeling, leucon coconut is suitable, containing at least 90% of viable cells.
- In a standard reagent bottle add 340 - 550 MBq pertechnetate in a volume of 2-3 ml and mix thoroughly for 3 minutes. Thus it is necessary to observe the following:
- solution of sodium pertechnetate, 99mTc should be obtained not later than 24 hours after the previous elution of the technetium-99m generator
- the obtained solution of sodium pertechnetate, 99mTc should be used to prepare the drug Teoksim, 99mTc for 2 hours. The finished product can be stored for no more than 30 minutes.
- The finished product is added to the cell suspension and incubated at room temperature for 10 min. At the end of the incubation, free GMPA, 99mTc block by adding 10 ml of plasma from the tube "B". Centrifuge for 5 min. at 150g.
- Remove the entire supernatant, gently resuspend the labeled leukocytes in 5 ml of plasma from tube "A". The resulting preparation is ready for intravenous administration to the patient and should be used immediately after preparation.
Diagnosis of inflammatory foci:
The intravenous activity is 370 - 450 MBq.The study is conducted 1 hour and 4 hours after the administration. The received scintigrams are evaluated visually.
Radiation loads on the organs and entire body of the patient when used drug Teoksim, 99mTc
| | Absorbed dose, mGy / MBq |
| Organs and Systems | When evaluating the state of perfusion of the brain | After intravenous administration of labeled leukocytes |
| Tear glands | 0,069 | - |
| Gallbladder | 0,055 | - |
| Spleen | - | 0,157 |
| Kidneys | 0,037 | - |
| Thyroid | 0,030 | - |
| The superior part of the large intestine | 0,027 | - |
| Liver | 0,018 | 0,024 |
| Red marrow | - | 0,005 |
| Small intestine | 0,016 | - |
| Lower part of large intestine | 0,012 | - |
| Bladder | 0,011 | 0,006 |
| Brain | 0,008 | - |
| Ovaries | 0,006 | 0,004 |
| Testes | 0,001 | - |
| Effective equivalent dose, mSv / MBq | 0,0178 | 0,0165 |