~(18)F-FDG PET对非小细胞肺癌预后预测价值的研究进展

目的:探讨18F-FDG PET对非小细胞肺癌预后的研究进展,指导临床中PET的应用。方法:应用计算机在PUBMED数据库检索2002~2007年有关18F-FDG PET对非小细胞肺癌预后的文章,并限定文献语种为英文,检索词fluorodeoxyglucose(FDG)、positron emmition tomography(PET)和non-small cell lung cancer和prognosis。同时,计算机检索中国期刊全文数据库2002~2007年的相关文章,检索词为PET和肺肿瘤,限定文章语言种类为中文。对选择的资料进行初审,选取和PDG-PET以及与其非小细胞肺癌预后相关的文献,然后查找全文。排除标准:1)重复研究;2)个案报道。共收集到相关文献59篇,排除重复或类似的同一研究,最终纳入30篇符合标准的文献。结果:大部分研究证明,肺癌原发灶的18F-氟脱氧葡萄糖(18F-FDG)标准摄取值(standardized uptake value,SUV)与患者的预后相关,治疗前后SUV值高的患者预后相对SUV值低的患者对放化疗敏感性差;进一步的研究显示,其复发的概率相对高,预后较差。但是放疗...     

18F‐fluorodeoxyglucose positron emission tomography imaging in brain tumours: The Western Australia positron emission tomography/cyclotron service experience

¹⁸F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) scans in the first 49 patients referred with either possible brain tumour or brain tumour recurrence were reviewed. FDG‐PET imaging was reported with reference to anatomical imaging. Based on the report the FDG study was classified as either positive or negative for the presence of tumour. Thirty‐eight cases were included in the analysis, 21 having pathological data and 17 with diagnostic clinical follow up. Eleven were excluded, as they had inadequate follow‐up data. Of the 21 cases with pathology, 18 were shown to have tumour. In this group there were five false‐negative scans and two false‐positive PET scans. Seventeen cases were assessed by clinical follow up, nine were considered to have been tumour. There were two false negatives with one false positive. The overall sensitivity, specificity and positive and negative predictive values were 74, 73, 87 and 53% respectively. This is similar to figures previously quoted in published work. Despite relatively limited numbers, the utility of FDG PET imaging in our hands is similar to published reports. With a positive predictive value of 87%, a positive FDG study indicates a high likelihood that there is brain tumour present. A negative study does not exclude the presence of tumour.     

放射性核素动态显像在小儿先天性肥厚性幽门狭窄中的临床应用价值

目的:评价放射性核素动态显像在小儿先天性肥厚性幽门狭窄中的临床应用价值。方法:将对照组、病例组、手术组患儿进行放射性核素液体胃排空动态显像,对所有图像进行反流及其持续时间的观察,定量计算反流率、胃排空率和半排时间。结果:病例组反流率、反流持续时间均高于对照组,手术组反流率和反流持续时间均较病例组降低;与对照组比较,病例组胃排空率明显降低(P<0.05),半排时间延长(P<0.05);与病例组比较,手术组胃排空率升高(P<0.05),其半排时间缩短(P<0.05),而手术组与对照组比较,胃排空率和半排时间差异无显著性(P>0.05)。结论:放射性核素动态胃排空显像是动态、定量评价小儿先天性肥厚性幽门狭窄胃排空能力、反流状况及其治疗效果的一项重要的无创性检测手段。     

MRI detection of myocardial perfusion defects due to coronary artery stenosis with MS-325

PURPOSE: To assess the value of an intravascular, albumin-targeted contrast agent, MS-325, in visualizing myocardial ischemia with magnetic resonance imaging (MRI). MATERIALS and METHODS: Left anterior descending coronary artery (LAD) stenosis was created in 19 pigs using a closed-chest modified angioplasty technique. Myocardial ischemia was detected by first-pass, contrast-enhanced MRI at peak dipyridamole stress and was compared to Technetium-99m (Tc-99m) sestamibi single photon emission computed tomography (SPECT). Regional coronary blood flow was determined using microspheres. RESULTS: Inducible myocardial ischemia with >40% reduction in stress myocardial blood flow was created in eight animals. An MRI defect, classified as > or=75% reduction in peak myocardial signal intensity in the affected territory, was detected in 92.3% of these animals. In the presence of mild coronary stenosis, there was uniform enhancement with MRI and tracer uptake by SPECT. Concordance of MRI and SPECT for detecting perfusion defects was 85%. CONCLUSION: The pattern of prolonged and persistent MR hypoenhancement of the ischemic myocardial bed using MS-325, which is retained primarily in the vascular bed due to its albumin-binding properties, facilitates the detection of myocardial perfusion defects.     

Dual-modality imaging of function and physiology

Dual-modality imaging is a technique in which computed tomography (CT) or magnetic resonance imaging is combined with positron emission tomography or single-photon emission CT to acquire structural and functional images with an integated system. The data are acquired in a single procedure; the patient remains on the scanner table while undergoing both x-ray and radionuclide studies to facilitate correlation between the structural and functional images. The resulting data can aid in localization, enabling more specific diagnosis than can be obtained with a conventional imaging study. In addition, the anatomic information can be used to compensate the correlated radionuclide data for physical perturbations such as photon attenuation, scatter radiation, and partial volume errors. Thus, dual-modality imaging provides a priori information that can improve both the visual quality and the quantitative accuracy of the radionuclide images. Dual-modality imaging systems are also being developed for biologic research involving small animals. Small-animal dual-modality systems offer advantages for measurements that currently are performed invasively with autoradiography and tissue sampling. By acquiring data noninvasively, dual-modality imaging permits serial studies in a single animal, enables measurements to be performed with fewer animals, and improves the statistical quality of the data.     

门控心肌灌注显像对病毒性心肌炎的诊断价值

目的 探讨门控心肌灌注显像对病毒性心肌炎的诊断价值。方法 对38例病毒性心肌炎进行门控^99mTc-甲氧基异丁基异腈(MIBI)心肌显像。结果 门控^99mTc-MIBI心肌显像异常者28例．占心肌炎患者的74％(28／38)。其中放射性分布Ⅱ度(明显放射性分布稀疏区)24例，占86％；Ⅲ度放射性分布缺损区4例．占14％。病灶呈Ⅰ型单灶性损害3例．占11％；Ⅱ型多灶性损害21例，占75％；Ⅲ型大面积损害4例．占16％。结论 门控心肌灌注显像能较直观地表现病变心肌的部位、形态、范围和程度，为病毒性心肌炎的诊断提供较为敏感的检查手段。     

核素肾动态显像用于儿童先天性输尿管囊肿的诊断和随访

目的分析儿童先天性输尿管囊肿在^99mTc—EC肾动态显像（RDI）中的表现，并评价其临床应用价值。方法22例经泌尿系统B超、静脉肾盂造影（IVP）及手术探察确诊为肾积水或肾重复畸形合并输尿管囊肿的患儿，行利尿RDI检查，6例术后复查。分析24min内经叠加的1帧／2min系列影像，并评估随访结果。结栗输尿管囊肿在RDI系列影像中，表现为显像早期膀胱局部放射性分布缺损，后期有或无填充。随访复查病例，患肾功能提高（t=2．94，P〈0．05），2例膀胱影恢复正常。先天性输尿管囊肿RDI、B超、IVP的阳性率均为81．8％。结论先天性输尿管囊肿的RDI表现有合理的生理基础，其明确的特征性影像可为诊断提供较为准确的依据；用于随访时较B超和IVP检查有独特的优势。     

小儿异位胃粘膜核素显像的诊断价值

【目的】评价小儿异位胃粘膜99mTcO4-显像的临床诊断价值,对临床诊断提供参考依据。【方法】94例下消化道出血(疑异位胃粘膜)患者进行了99mTcO4-显像,显像资料均参照临床最终结果进行评价。【结果】94例患者中显像阳性者32例,其中29例证实为麦克尔憩室,2例为小肠重复畸形,1例为空肠粘膜下血管畸形。显像阴性62例,可追踪住院病例28例,经手术及胃、肠镜证实胃溃疡或肠息肉8例,1例麦克尔憩室,其余病例根据临床表现和治疗好转出院排除胃粘膜异位症9。9mTcO4-显像诊断异位胃粘膜的灵敏度为96.9%,特异度为96.4%,准确度为96.7%。【结论】小儿异位胃粘膜核素显像具有较高的诊断价值,且无创、简单易行、快速可靠,是临床诊断异位胃粘膜首选的影像学方法。     

核素肾动态显像诊断糖尿病肾病的研究

目的探讨核素肾动态显像诊断糖尿病肾病(DN)的价值,为临床治疗和预后判断提供依据。方法将25例糖尿病患者根据尿蛋白定性和定量结果分成无蛋白尿组10例和蛋白尿组15例,另选择健康者14例作为对照组。所有受试者均行核素肾动态显像,并同时测定血肌酐(Cr)、血尿素氮(BUN)、尿白蛋白(ALB)水平。结果无蛋白尿组肾小球滤过率(GFR)及滤过分数(FF)高于对照组(P<0.05和P<0.01);蛋白尿组GFR及肾有效血浆流量(ERPF)明显低于对照组(P<0.01),FF、血Cr、尿ALB高于对照组(P<0.01和P<0.05)。GFR、ERPF与病程、血Cr、BUN、尿ALB显著负相关(P<0.01和P<0.05)。结论核素肾动态显像可早期诊断DN,并可了解肾功能的受损程度,为治疗方案的选择提供依据。     

清热活血中药对干燥综合征患者^99mTc04^-腮腺显像的影响

目的研究清热活血中药对干燥综合征患者腮腺功能的影响.方法比较干燥综合征患者和健康对照组的99mTcO4-腮腺功能.服用由忍冬藤、黄芩、牡丹皮、扦扦活、鬼箭羽、生地黄等组成的清热活血中药4～6个月,观察干燥综合征99mTc04-腮腺显像的影响.结果24例干燥综合征患者比7例健康对照组腮腺的摄取分数稍低,但没有统计学意义.干燥综合征患者的排泌分数显著低于对照组(P＜0.01).11例患者治疗后复查,左右腮腺的摄取和排泌分数分别由治疗前的1.45±0.41、1.46±0.39和9.3%±11.9%、9.1%±12.1%,提高到1.63±0.39、1.62±0.44和22.6%±8.7%、24.2%±9.3%,有显著差异(P＜0.01).结论干燥综合征患者腮腺的损害以排泌功能更为明显.清热活血中药对腮腺的摄取和排泌功能均有显著改善.