病毒性心肌炎CBV—lgM抗体与心功能的研究

目的：探讨病毒性心肌炎（VM）患血清CBV－lgM抗体与左室总射血分值（EF）值及峰射血率（PER）,峰充血率（PFR）的关系,以及心肌显像与心肌各局部EF值的关系。方法：对120例心肌炎患以ELISA法测CBV-lgM抗体,用^99mTc-MIBI心肌显像对其中37例行核素心室造影,测左室总体EF值及局部EF值,并测其PER和PFR;设正常对照40例。结果：（1）：CBV－lgM抗体阳性120例中有VM85例（70．83％）,对照组仅2例（5％）,P＜0．01,（2）^99mTc-MIBI心肌断层显像异常120例中有VM105例（87．5％）,对照组仅1例（2．5％）,P＜0．01;（3）CBV－lgM抗体阳性与^99mTc-MIBI心肌显像VM异常符合率为78．95％;（4）CBV－lgM抗体阳性中37例核素心室造影测得左室总EF降低21例（56．7％）;（5）节段性EF值降低33例（89．19％）;（6）PER,PFR降低20例（54．05％）;（7）心肌显像异常与EF降低符合率89．19％;（8）37例核素心室造影测定;PER降低22例（59．46％）,PFR降低21例（56．7％）;（9）各节段EF降低;侧壁（LAT）12例（33．43％）,下壁（INF）15例（40．54％）,心尖部（AP）12例（33．43％）,下间隔（IN－SEP）24例（64．86％）,室间隔（SEP）31例（83．78％）,结论：病毒性心肌炎患血清CBV－lgM抗体水平与心肌显像和心功能有良好的相关性,有助于该病的诊断和预后判断。     

99m Tc-MIBI监测肿瘤照射后生物学效应的

目的　研究照射后肿瘤细胞摄取MIBI能力的变化及其与肿瘤细胞凋亡、坏死和增殖状态的关系。方法　将离体肿瘤细胞和实验动物按照射剂量 0、5、10、2 0Gy与照射后 2 4、48、72h进行分组比较。离体肿瘤细胞分别测定单位质量肿瘤细胞摄取99mTc MIBI的放射性计数值 (计数·min- 1 ·mg- 1 cellprotein) ,凋亡指数 (ApoptosisIndex ,AI) ,集落形成率 (Platingefficiency,PE)。实验动物计算肿瘤组织微分摄取率 (differentialuptakeratio,DUR)和AI值。结果　不同剂量照射后 ,肿瘤细胞的99mTc MIBI摄取值与AI值呈负相关 (r=- 0 93) ,与PE值呈正相关 (r =0 84)。 2 4hDUR值与AI负相关 (r=- 0 793)。结论　不同剂量照射后 ,肿瘤细胞活力变化可能用99mTc MIBI作为示踪剂得到反映     

乳腺肿块~(99)Tc~m-MIBI显像、X线钼靶及细针细胞学检查的对比研究

目的　评价联合运用核素显像 (SMM)、X线钼靶照相 (MG)及细针细胞学穿刺 (FNAC)种方法在乳腺癌早期诊断中的价值。方法　对 5 7例女性乳腺肿块患者术前行SMM检查 ,对其中 5 4例分别行MG及FNAC检查 ,以术后病理结果为金标准 ,判断以上 3种方法在乳腺癌早期诊断中的灵敏度及特异性。结果　除 3例局部切除术者外 ,其余 5 4例SMM发现乳腺恶性肿瘤 31例 ,MG为 2 8例 ,FNAC为 37例 ,SMM、MG及FNAC的灵敏度分别为 79 5 %、71 8%、94 9% ,准确性分别为 78 9%、72 2 %、96 3% ;联合运用 3种方法 5 4例患者至少有 1种方法可以诊断。肿瘤99Tcm 甲氧基异丁基异腈 (MIBI)聚集与肿瘤的大小、孕激素受体及c erbB 2蛋白表达相关 (P <0 0 5 )。结论　联合运用SMM、MG及FNAC可以提高乳腺癌的早期诊断率 ,乳腺99Tcm MIBI阳性显像可能对预后估计及化疗方案的选择有一定的价值。     

~(18)F-FDG、~(99)Tc~m-MIBI和~(111)In-奥曲肽对肺癌诊断和治疗评价的比较

目的　比较18F 脱氧葡萄糖 (FDG)、99Tcm 甲氧基异丁基异腈 (MIBI)和111In 奥曲肽在肺癌诊断和治疗评价时的优缺点。方法　研究对象包括99Tcm MIBISPECT显像 90例 ,111In 奥曲肽SPECT显像 2 1例以及18F FDGPET显像 118例。其中 15例进行了MIBI和奥曲肽 ,7例做了FDG与MIBI 2种显像。 2 6例用MIBI,12例用FDG进行了治疗前后的比较。结果　MIBI显像对大于 1cm的肺内占位病变的诊断、鉴别诊断和治疗后评价有较好效果 ,其核素血管显像可以帮助了解肺内大血管受累情况 ,但受血流灌注和多药耐药的影响。病灶对奥曲肽的摄取显著高于MIBI(P <0 0 1) ,但两者相关性不高 (r=0 47)。PET可以发现更小的病灶 ,具有更好的图像质量。结论　MIBI显像具有较好的效价比 ,而奥曲肽显像可以更好地显示所有“存活”的肿瘤细胞。     

99Tcm-PPM及99Tcm-MIBI肺显像诊断原发性肺癌

目的 探讨99Tcm－培普利欧霉素（PPM）及99Tcm-甲氧基异丁基异腈（MIBI）肺显像诊断原发性肺癌的临床价值。方法 对28例临床诊断肺肿瘤患者进行99Tcm-PPM ey 99T0-MIBI肺肿瘤显像并进行比较。结果 肺癌与良性病变对99T -PPMey 99T-MIBI观的摄取差异有显著性（P＜0．01）,以肺癌晚期显像摄取比值（T／NT,X－S）作为判断良恶性阈值,99Tcm-PPM及99Tcm-MIBI对肺癌诊断的灵敏度,准确性分别为90％,89．3％,和80％,82．1％,两者结合显像阳性率为95％,病灶对放射性药物的摄取与肿瘤大小无明显相关（P＞0．05）,结论 99Tcm-PPM ey 99T-MIBI肺显像对肺癌的诊断,鉴别诊断有一定的临床价值。两者联合应用可提高肺癌的阳性检出率,单独使用99Tcm-PPM优于99Tcm-MIBI。     

冠状动脉造影正常的心肌梗死患者~(99)Tc~m-MIBI心肌灌注显像

目的　探讨99Tcm 甲氧基异丁基异腈 (MIBI)心肌灌注断层显像 (MPI)对冠状动脉造影(CAG)正常的心肌梗死 (MI)患者的临床应用价值。方法　 5例患者中 4例为急性MI,1例为异常Q波原因待查 ,均经CAG证实冠状动脉正常。于CAG后 7～ 10d行运动 静息99Tcm MIBIMPI。结果　 5例患者中 4例MPI异常 (均为固定放射性缺损 ) ,1例正常。 1例异常Q波待诊患者经MPI确诊为MI。4例MPI显示的MI部位较ECG大 ;1例ECG示透壁性MI者MPI正常。随访期间 ,1例因心功能不全行室壁瘤切除术。结论　99Tcm MIBIMPI对CAG正常的MI诊断及梗死部位、程度和预后的判断有较高价值     

Correlation between P-glycoprotein (P-gp) expression in parathyroid and Tc-99m MIBI parathyroid image findings

The major factor to influence localization of parathyroid adenomas is tumor size. P-glycoprotein (P-gp) expression in parathyroid adenomas has been considered to be an another possible factor to influence localization of parathyroid adenomas because false-negative studies have been reported with large tumors and true-positives reported with very small tumors in previous studies. The aim of this study was to characterize Tc-99m MIBI uptake and retention by parathyroid adenomas and to correlate this with cell surface expression of P-gp. Sixteen patients with parathyroid adenoma (larger than 1.5 gm) underwent dual-phase (10min and 2hr) Tc-99m MIBI parathyroid image immediately before parathyroid exploration. Tissues were obtained from normal and abnormal parathyroid glands and from the thyroid gland. Immunohistochemistry (IHC) was obtained with monoclonal antibodies to identify P-gp expression in all tissues. All of the 16 parathyroid adenomas and 32 normal control specimens (16 normal parathyroid and 16 normal thyroid specimens) were submitted for P-gp detection by IHC. The dual-phase Tc-99m MIBI parathyroid image accurately localized 14 parathyroid adenomas, but not the remaining 2 adenomas. The 14 parathyroid adenomas with significant Tc-99m MIBI uptake in delayed 2hr images revealed negative P-gp expression, but the 2 adenomas without significant Tc-99m MIBI uptake, as well as normal parathyroid and normal thyroid specimens, revealed positive P-gp expression when evaluated by IHC. Not only the size of parathyroid adenomas, but also significant P-gp expression limited the sensitivity of dual-phase Tc-99m MIBI parathyroid image to localize parathyroid adenomas before operation.     

Cardiac resynchronization therapy evaluated by myocardial scintigraphy with <Superscript>99m</Superscript>Tc-MIBI: changes in left ventricular uptake,dyssynchrony, and function

Purpose   ^99mTc-MIBI gated myocardial scintigraphy (GMS) evaluates myocyte integrity and perfusion, left ventricular (LV) dyssynchrony and function. Cardiac resynchronization therapy (CRT) may improve the clinical symptoms of heart failure (HF), but its benefits for LV function are less pronounced. We assessed whether changes in myocardial ^99mTc-MIBI uptake after CRT are related to improvement in clinical symptoms, LV synchrony and performance, and whether GMS adds information for patient selection for CRT. Methods  A group of 30 patients with severe HF were prospectively studied before and 3 months after CRT. Variables analysed were HF functional class, QRS duration, LV ejection fraction (LVEF) by echocardiography, myocardial ^99mTc-MIBI uptake, LV end-diastolic volume (EDV) and end-systolic volume (ESV), phase analysis LV dyssynchrony indices, and regional motion by GMS. After CRT, patients were divided into two groups according to improvement in LVEF: group 1 (12 patients) with increase in LVEF of 5 or more points, and group 2 (18 patients) without a significant increase. Results  After CRT, both groups showed a significant improvement in HF functional class, reduced QRS width and increased septal wall ^99mTc-MIBI uptake. Only group 1 showed favourable changes in EDV, ESV, LV dyssynchrony indices, and regional motion. Before CRT, EDV, and ESV were lower in group 1 than in group 2. Anterior and inferior wall ^99mTc-MIBI uptakes were higher in group 1 than in group 2 (p<0.05). EDV was the only independent predictor of an increase in LVEF (p=0.01). The optimal EDV cut-off point was 315 ml (sensitivity 89%, specificity 94%). Conclusion  The evaluation of EDV by GMS added information on patient selection for CRT. After CRT, LVEF increase occurred in hearts less dilated and with more normal ^99mTc-MIBI uptake.     

肺癌^18F—FDG和^99mTc—MIBI显像研究

目的探讨18F-FDG和99mTc-MIBI两种显像方法对肺癌诊断价值.方法患者禁食4小时以上,静脉注入37MBq18F-FDG,静卧45分钟后进行FDG显像.MIBI显像方法是早餐吃油煎鸡蛋喝牛奶,静脉注入1.11GBq 99mTc-MIBI,之后60分钟进行胸部断层显像检查,32例肺癌患者加作120分钟延迟显像.结果41例FDG显像的阳性率是92.7%(38/41),靶本比2.90±1.35.41例MIBI60分钟显像的阳性率是75.6%(31/41),靶本比1.92±0.59;32例延迟显像的阳性率为78.1%(25/32),靶本比1.78±0.53.FDG的靶本比和阳性率高于MIBI(P＜0.05),鳞癌和腺癌FDG显像的靶本比无差异(P＞0.05).结论FDG的显像质量和阳性率均优于MIBI,MIBI阴性显像结果是否与多药耐药有关有待进一步研究.     

乳腺癌99Tcm-MIBI显像与P-gp、MRP表达的关系

目的探讨乳腺癌患者^99Tc^m-甲氧基异丁基异腈（MIBI）显像与癌组织中P-糖蛋白（P—gp）、多药耐药相关蛋白（MRP）表达的关系。方法对36例未经治疗的乳腺癌患者行^99Tc^m-MIBI早期（10min）与晚期（180min）平面显像，应用免疫组织化学方法检测手术后标本中P—gP、MRP的表达，并将患者分为4组：A组，P—gP和MRP均阳性（7例）；B组，P—gP阳性和MRP阴性（15例）；C组，P—gP阴性和MRP阳性（6例）；D组，P-gP和MRP均阴性（8例）。比较各组早期和晚期肿瘤与对侧正常组织放射性比值（T／N）及肿瘤部位放射性清除率（WR）之间的差异。结果早期T／NA、B组均高于D组，差异有显著性（P值分别为0．001和0．045）；晚期T／N各组间差异无显著性（P=0．686）；清除率A、B、C组均高于D组，差异有显著性（P值分别为〈0．001、0．001和0．014）。结论^99Tc^m-MIBI显像清除率与乳腺癌P—gP、MRP表达呈正相关（r=0．839，P〈0．001），^99Tc^m-MIBI显像清除率分析可用于乳腺癌P—gP、MRP表达水平及功能状态的评估。