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Real-time detection of gastrointestinal leaks via bismuth chelate-enhanced X-ray gastroenterography
Biomaterials ( IF 12.8 ) Pub Date : 2024-06-02 , DOI: 10.1016/j.biomaterials.2024.122646 Jinbin Pan 1 , Jiaojiao Wang 2 , Yujie Zhao 1 , Bing Han 1 , Gang Shu 2 , Min Ma 1 , Xu Wang 3 , Xi Wei 4 , Wenjing Hou 4 , Shao-Kai Sun 5
Biomaterials ( IF 12.8 ) Pub Date : 2024-06-02 , DOI: 10.1016/j.biomaterials.2024.122646 Jinbin Pan 1 , Jiaojiao Wang 2 , Yujie Zhao 1 , Bing Han 1 , Gang Shu 2 , Min Ma 1 , Xu Wang 3 , Xi Wei 4 , Wenjing Hou 4 , Shao-Kai Sun 5
Affiliation
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Anastomotic leaks are among the most dreaded complications following gastrointestinal (GI) surgery, and contrast-enhanced X-ray gastroenterography is considered the preferred initial diagnostic method for GI leaks. However, from fundamental research to clinical practice, the only oral iodinated contrast agents currently available for GI leaks detection are facing several challenges, including low sensitivity, iodine allergy, and contraindications in patients with thyroid diseases. Herein, we propose a cinematic contrast-enhanced X-ray gastroenterography for the real-time detection of GI leaks with an iodine-free bismuth chelate (Bi-DTPA) for the first time. The Bi-DTPA, synthesized through a straightforward one-pot method, offers distinct advantages such as no need for purification, a nearly 100 % yield, large-scale production capability, and good biocompatibility. The remarkable X-ray attenuation properties of Bi-DTPA enable real-time dynamic visualization of whole GI tract under both X-ray gastroenterography and computed tomography (CT) imaging. More importantly, the leaky site and severity can be both clearly displayed during Bi-DTPA-enhanced gastroenterography in a rat model with esophageal leakage. The proposed movie-like Bi-DTPA-enhanced X-ray imaging approach presents a promising alternative to traditional GI radiography based on iodinated molecules. It demonstrates significant potential in addressing concerns related to iodine-associated adverse effects and offers an alternative method for visually detecting gastrointestinal leaks.
中文翻译：
铋螯合物增强X射线胃肠造影实时检测胃肠漏
吻合口漏是胃肠道 (GI) 手术后最可怕的并发症之一，增强 X 射线胃肠造影被认为是胃肠道漏的首选初始诊断方法。然而，从基础研究到临床实践，目前唯一可用于胃肠道漏检的口服碘造影剂面临着敏感性低、碘过敏、甲状腺疾病患者禁忌等诸多挑战。在此，我们首次提出使用无碘铋螯合物（Bi-DTPA）实时检测胃肠道泄漏的电影对比度增强 X 射线胃肠造影。 Bi-DTPA通过简单的一锅法合成，具有无需纯化、收率接近100%、可大规模生产、生物相容性好等显着优点。 Bi-DTPA 卓越的 X 射线衰减特性可在 X 射线胃肠道造影和计算机断层扫描 (CT) 成像下实现整个胃肠道的实时动态可视化。更重要的是，在食管漏大鼠模型中进行 Bi-DTPA 增强胃肠造影时，可以清楚地显示漏气部位和严重程度。所提出的电影般的 Bi-DTPA 增强 X 射线成像方法为基于碘化分子的传统 GI 射线照相提供了一种有前景的替代方案。它在解决与碘相关的不良反应相关的问题方面表现出巨大的潜力，并提供了一种视觉检测胃肠道渗漏的替代方法。
更新日期：2024-06-02
中文翻译：
铋螯合物增强X射线胃肠造影实时检测胃肠漏
吻合口漏是胃肠道 (GI) 手术后最可怕的并发症之一，增强 X 射线胃肠造影被认为是胃肠道漏的首选初始诊断方法。然而，从基础研究到临床实践，目前唯一可用于胃肠道漏检的口服碘造影剂面临着敏感性低、碘过敏、甲状腺疾病患者禁忌等诸多挑战。在此，我们首次提出使用无碘铋螯合物（Bi-DTPA）实时检测胃肠道泄漏的电影对比度增强 X 射线胃肠造影。 Bi-DTPA通过简单的一锅法合成，具有无需纯化、收率接近100%、可大规模生产、生物相容性好等显着优点。 Bi-DTPA 卓越的 X 射线衰减特性可在 X 射线胃肠道造影和计算机断层扫描 (CT) 成像下实现整个胃肠道的实时动态可视化。更重要的是，在食管漏大鼠模型中进行 Bi-DTPA 增强胃肠造影时，可以清楚地显示漏气部位和严重程度。所提出的电影般的 Bi-DTPA 增强 X 射线成像方法为基于碘化分子的传统 GI 射线照相提供了一种有前景的替代方案。它在解决与碘相关的不良反应相关的问题方面表现出巨大的潜力，并提供了一种视觉检测胃肠道渗漏的替代方法。
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