Document Detail

Tc-99m-HL91 imaging in the early detection of neuronal injury in a neonatal rat model of hypoxic ischemia*.
MedLine Citation:
PMID:  22610194     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: : Hypoxic-ischemic insult in newborns results in progressive neuronal loss. For neuroprotective therapy to be effective, it is important to identify high-risk neonates soon after birth. Tc-labeled imaging agent, Tc-99m-HL91, developed as a putative hypoxic reagent, has been reported to demonstrate increased uptake in ischemic myocardium. We hypothesized that Tc-99m-HL91 is sensitive for the early identification of hypoxic-ischemic injury in neonatal rat brains.
DESIGN: : Laboratory investigation.
SETTING: : University research laboratory.
SUBJECTS: : Sprague-Dawley rat pups.
INTERVENTIONS: : Postnatal day-7 pups were divided into four groups: hypoxic-ischemia, hypoxia-only, ischemia-only, and controls. In the early (2 hrs), intermediate (20 hrs), and late (44 hrs) reoxygenation phases, Tc-99m-HL91 in vivo and ex vivo imaging and quantitative autoradiography were performed. Regions of interest were drawn to calculate the contrast ratio of Tc-99m-HL91 uptake between the ipsilateral and contralateral hemispheres. Pathology, cerebral blood flow, and blood-brain barrier damage were determined.
MEASUREMENTS AND MAIN RESULTS: : After hypoxic-ischemia, there were very few pyknotic neurons in the early phase, many pyknotic neurons in the intermediate phase, and extensive neuronal loss in the late phase postreoxygenation. Blood-brain barrier damage occurred in the early phase, progressed in the intermediate phase, and became extensive in the late phase. The hypoxia-only and ischemia-only pups showed no neuronal or blood-brain barrier damage and had higher cerebral blood flow postreoxygenation compared with the hypoxia-ischemia pups. Regions of interest analysis of in vivo and ex vivo images and autoradiography revealed significantly higher Tc-99m-HL91 contrast ratio at early and intermediate phases, not late phase of hypoxic-ischemic group. Hypoxic-ischemia group had significantly higher contrast ratio values in the early and intermediate phases than the hypoxia-only and ischemia-only groups. A contrast ratio value of 0.15 in the early phase on postnatal day 7 had a sensitivity of 0.95 and specificity of 0.89 in detecting significant hypoxic-ischemic lesions on postnatal day 21.
CONCLUSION: : Tc-99m-HL91 uptake is sensitive for the early detection of hypoxic-ischemic injury in neonatal brains.
Bi-Fang Lee; Lan-Wan Wang; Sheng-Hsiang Lin; Ting-Jyun Jhuo; Nan-Tsing Chiu; Chao-Ching Huang; Chien-Chung Hsia; Lie-Hang Shen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  40     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1930-8     Citation Subset:  AIM; IM    
From the Departments of Nuclear Medicine (BFL, TJJ, NTC) and Pediatrics (CCH), and Institute of Clinical Medicine (LWW, SHL, CCH), National Cheng Kung University, College of Medicine, Tainan, Taiwan; Department of Pediatrics (LWW), Chi Mei Medical Center, Tainan, Taiwan; and Institute of Nuclear Energy (CCH, LHS), Atomic Energy Council, Executive Yuan, Lungtan, Taiwan.
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