提高异位甲状腺诊断符合率的方法

目的 :探讨提高异位甲状腺诊断符合率的方法。方法 :对 11例异位甲状腺的临床资料作回顾性分析。结果 :11例异位甲状腺患者都经99m锝 (99mTc)扫描甲状腺扫描而确诊 ;甲状腺功能低下者 (T3 、T4降低 ,TSH升高 ) 7例 ;行B超和穿刺细胞学检查 3例 ,结果与99mTc扫描一致。结论 :99mTc甲状腺扫描是诊断异位甲状腺的最好方法 ;细胞学检查是其确诊方法 ;B超是诊断该病有用的辅助方法     

^131I标记凝集素PNA在荷人胃癌裸鼠体内的分布

采用Ｉｏｄｏｇｅｎ法将放射性１３１Ｉ与花生凝集素（ＰＮＡ）进行标记，经腹腔注射１３１Ｉ－ＰＮＡ标记物到荷人胃癌裸鼠体内，在不同时间测定组织放射分布和γ照相。给药后第３天，肿瘤组织放射性强度是血液的４．３０倍，是正常肝组织的３．７６倍，是肌肉组织的３．８９倍；给药后第７天，肿瘤组织浓集１３１Ｉ－ＰＮＡ是正常胃组织的４．２１倍，是小肠组织的６．０５倍，是大肠组织的５．１３倍。４８小时可见肿瘤显像，７２小时显像清晰。本实验结果表明，凝集素ＰＮＡ在胃癌定位诊断和导向治疗中有着潜在的应用价值，对于人体某些表达Ｔ抗原的腺癌都可能具有作为导向治疗载体的研究前景。     

Imaging of McCune-Albright syndrome using bone single photon emission computed tomography

McCune-Albright syndrome is a rare disorder caused by a somatic, constitutively activating mutation in the gene (GNAS1) encoding the subunit of the signal transducing guanine nucleotide binding protein (G protein). The condition is characterized by polyostotic fibrous dysplasia, cafe-au-lait pigmentation and multiple endocrine hyperfunction, most commonly gonadotropin-independent precocious puberty in girls. Our patient, a 16-year-old male, with radiologically confirmed polyostotic fibrous dysplasia in cranium, thoracic and pelvic girdles, spine and extremities was studied using planar ^99mTc-hydroxymethyldiphosphonate bone scintigraphy and single photon emission computed tomography. Using bone scintigraphy, an unusually extensive and asymmetric fibrous dysplasia was observed in the cranium, face, ribs, femur, humerus, ulna, tibia and the vertebral column, all on the left side. The whole body scan revealed only a few foci on the right side. Single photon emission computed tomography demonstrated extensive unilateral involvement in the base of the skull, facial bones, maxilla and mandible. All the lesions reached only the midline. These findings formed the basis of further treatment, eg. reconstructive surgery of facial asymmetry. Conclusion McCune-Albright syndrome should be considered in the differential diagnosis when interpreting extensive unilateral predominance in paediatric bone scans. Received: 3 March 1998 / Accepted in revised form: 19 May 1998     

Radionuclide accumulation in near-shore sediments along the Bulgarian Black Sea coast

The accumulation of radionuclides in Black Sea marine ecosystems was investigated by low level gamma spectrometry. Artificial as well as natural radionuclides were determined in bottom sediments samples from 35 reference locations along the Bulgarian Black Sea coast, evenly distributed from the Rumanian to the Turkish border including the main Black Sea resorts and rivers. The measurement of radionuclides in sea bed sediments was carried out during six consecutive seasons using a HPGe detector. The data obtained show that the nuclide concentrations depend strongly on the sediment nature. Results for sandy sediments are within close range, while those for slime and silt vary to a much greater extent. The radionuclide content in the sandy sediments of the main Black Sea resorts is at the lowest limit of the determined values. Small seasonal changes of radionuclide concentration in sandy sediments were observed while greater variations in slime and silt occur. From the data obtained ¹³⁴Cs/¹³⁷Cs and ¹³⁷Cs_meas/¹³⁷Cs_Chern ratios are calculated to determine the Chernobyl part of the measured ¹³⁷Cs. The activities determined in the sediments for natural radionuclides correspond to those cited in the literature for natural levels, showing no additional anthropogenic contamination. A data base for the nuclide concentration values was created which will enable the modeling of radionuclide transfers by estimation of their concentration variations, accumulation and influence on the marine ecosystems.     

Somatostatin receptor scintigraphy in forty-eight patients with the Zollinger-Ellison syndrome

In patients with the Zollinger-Ellison syndrome, which is either sporadic or integrated into multiple endocrine neoplasia type 1, accurate localization of all the tumours is difficult and may have therapeutic implications. In an attempt to improve this localization, somatostatin receptor scintigraphy using [¹¹¹In-DTPA-D-Phe¹]-octreotide was performed prospectively in 48 consecutive patients with the Zollinger-Ellison syndrome. Thirty of them had the sporadic type of this disease. Scintigraphic data were compared with data obtained by conventional imaging methods, and also, in 32 selected patients, with those obtained by endoscopic ultrasonography. Somatostatin receptor scintigraphy showed abnormal tracer uptake in 39 patients (81%), in whom it correctly identified 50 of the 60 tumoral sites (83%) previously localized by the other imaging methods. In 17 patients (35%) somatostatin receptor scintigraphy disclosed abnormal tracer uptake at 18 different tumoral sites: 14 were located in the abdomen, including four in the liver and eight in the duodenopancreatic area, and four outside the abdomen, including two in the mediastinum. Six of the ten tumoral sites which were not correctly identified by somatostatin receptor scintigraphy were located in the duodeno-pancreatic area. However, in the 20 patients for whom conventional techniques failed to visualize any tumour in the duodenopancreatic area, somatostatin receptor scintigraphy was positive in ten (50%) whereas endoscopic ultrasonography was only positive in five (25%). In our patients with the Zollinger-Ellison syndrome, somatostatin receptor scintigraphy appeared to be a useful new addition to the battery of tests used for tumour detection.     

核素肝胆动态显像对胆囊结石患者胆囊运动功能的研究

为了探求胆囊结石患者胆囊运动功能的状况，用(99m)锝一二乙基乙酸苯氨基亚氨二醋酸（(99m)Tc-EHIDA）为肝胆显像剂，以脂肪餐为胆囊收缩刺激剂，通过单光子计算机断层（SPECT）装置及计算机系统定量地研究了12例正常受试者和12例胆囊结石患者的胆囊运动情况。结果表明；潜伏期和排胆期在两组间无显著性差异（P＞0．05），而胆囊结石患者的排胆分数和排胆率明显低于正常对照组（P＜O．01）。说明胆囊结石患者的胆囊运动功能是降低的。     

放射性核素脑血管造影对短暂性脑缺血的诊断价值

对50例短暂性脑缺血患者用放射性核素脑血管造影观察,报告了造影所见,并就核素对TIA脑血流异常的阳性发现率、TIA核素造影的主要表现及方法学进行了讨论。     

^99mTc标记物对阴茎海绵体的血液动力学研究

用~（９９ｍ）Ｔｃ标记物对６名性功能正常男子和２４例阳萎病人阴茎海绵体血液动力学状况进行动态显像研究。６名正常男性，其阴茎动脉系统显像指数（ＰＩＡ）为９０．２０±３８．５３；盐酸罂粟碱负荷后达曲线１／２高峰值所需时间（１／２Ｐ）１．８４±０．５０分；阴茎静脉系统显像指数（ＰＩＶ）为－２１．０４±６．２７：ＰＩＡ＞６０和ＰＩＶ＞－４５被视为有关勃起动、静脉系统正常指标。本研究认为用~（９９ｍ）Ｔｃ标记物进行动态显像检测对于血管性阳萎患者病因鉴别是一种安全，无创，客观和准确的诊断方法。     

Imaging of regional lymph node metastases with 99mTc-depreotide in patients with lung cancer

Purpose The aim of this study was to evaluate the clinical usefulness of scintigraphy with ^99mTc-depreotide in the assessment of loco-regional nodal spread in patients with suspected lung cancer in comparison with computed tomography (CT).Methods Eighty-six patients were investigated with single-photon emission computed tomography (SPECT) of the thorax after i.v. injection of 740 MBq ^99mTc-depreotide. The results were evaluated in conjunction with a thoracic CT scan in all 86 patients with 204 lymph node stations. The scintigraphic results were correlated with cytological (38), histological (20) or clinical–radiological (146) findings and compared with CT. The quantitative evaluation of depreotide uptake was performed on 48 cytologically or histologically verified nodal stations from 28 patients by SPECT using region of interest analysis with four different reference regions.Results ^99mTc-depreotide scintigraphy for all 204 investigated lymph node stations had a sensitivity of 99% and a negative predictive value of 98% in determining lymph node involvement. Scintigraphy and CT showed the same level of accuracy, 76.4%. CT findings had a higher positive predictive value but a lower negative predictive value compared to ^99mTc-depreotide scintigraphy. The quantitative evaluation of depreotide uptake in lymph nodes using vertebra as a reference region showed that a cut-off level of 0.56 excludes malignant involvement of lymph nodes, while a cut-off level of 1.66 excludes benign disease in lymph nodes. About 73% of all investigated lymph node stations showed uptake values between these cut-off levels.Conclusion Absence of ^99mTc-depreotide uptake on scintigraphic imaging can exclude regional lymph node involvement with a high degree of probability and may be useful in clinical practice. The quantitative evaluation of depreotide uptake in regional lymph nodes did not increase the diagnostic accuracy of the method in general but did elucidate the lymph node status in some patients.     

Cellular uptake of radioiodine delivered by trastuzumab can be modified by the addition of epidermal growth factor

Purpose The purpose of this study was to analyse whether non-radiolabelled epidermal growth factor (EGF) can modify the cellular uptake of ¹²⁵I when delivered as [¹²⁵I]trastuzumab. ¹²⁵I was used as a marker for the diagnostically and therapeutically more interesting isotopes ¹²³I (SPECT), ¹²⁴I (PET) and ¹³¹I (therapy).Methods The cell-associated radioactivity was measured in squamous carcinoma A431 cells following addition of [¹²⁵I]trastuzumab. Different concentrations of [¹²⁵I]trastuzumab and unlabelled EGF were used, and the total, membrane-bound and internalised radioactivity was measured. We also analysed how EGF and trastuzumab affected the cell growth. Results It was generally found that the cellular ¹²⁵I uptake was decreased by the addition of EGF when [¹²⁵I]trastuzumab was added for short incubation times. However, if the incubation times were longer, EGF increased the ¹²⁵I uptake. This shift came earlier when higher [¹²⁵I]trastuzumab concentrations were applied. The addition of EGF also influenced cell proliferation, and concentrations above 10 ng/ml reduced cell growth by approximately 20% after 24 h of incubation.Conclusion By adding unlabelled EGF, it was possible to modify the cellular uptake of [¹²⁵I]trastuzumab. This points towards new approaches for the modification of radionuclide uptake in EGFR- and HER2-positive tumours.