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1.
The aim of this study was to compare prospectively the accuracy of whole-body positron emission tomography (PET), CT and MRI in diagnosing primary and recurrent ovarian cancer. Nineteen patients (age range 23–76 years) were recruited with suspicious ovarian lesions at presentation (n = 8) or follow-up for recurrence (n = 11). All patients were scheduled for laparotomy and histological confirmation. Whole-body PET with FDG, contrast-enhanced spiral CT of the abdomen, including the pelvis, and MRI of the entire abdomen were performed. Each imaging study was evaluated separately. Imaging findings were correlated with histopathological diagnosis. The sensitivity, specificity and accuracy for lesion characterization in patients with suspicious ovarian lesions (n = 7) were, respectively: 100, 67 and 86 % for PET; 100, 67 and 86 % for CT; and 100, 100 and 100 % for MRI. For the diagnosis of recurrent disease (n = 10), PET had a sensitivity of 100 %, specificity of 50 % and accuracy of 90 %. The PET technique was the only technique which correctly identified a single transverse colon metastasis. Results for CT were 40, 50 and 43 %, and for MRI 86, 100 and 89 %, respectively. No statistically significant difference was seen. Neither FDG PET nor CT nor MRI can replace surgery in the detection of microscopic peritoneal disease. No statistically significant difference was observed for the investigated imaging modalities with regard to lesion characterization or detection of recurrent disease; thus, the methods are permissible alternatives. The PET technique, however, has the drawback of less accurate spatial assignment of small lesions compared with CT and MRI. Received: 9 April 1999; Revised: 22 June 1999; Accepted: 25 August 1999  相似文献
2.
Purpose The purpose of this study was to depict 18F-fluoro-2-deoxy-D-glucose (FDG) accumulation in atherosclerotic lesions of the thoracic and carotid arteries on CT and MR images by means of automatic co-registration software. Methods Fifteen hospitalised men suffering cerebral infarction or severe carotid stenosis requiring surgical treatment participated in this study. Automatic co-registration of neck MR images and FDG-PET images and of contrast-enhanced CT images and FDG-PET images was achieved with co-registration software. We calculated the count ratio, which was standardised to the blood pool count of the superior vena cava, for three arteries that branch from the aorta, i.e. the brachial artery, the left common carotid artery and the subclavian artery (n=15), for atherosclerotic plaques in the thoracic aorta (n=10) and for internal carotid arteries with and without plaque (n=13). Results FDG accumulated to a significantly higher level in the brachial artery, left common carotid artery and left subclavian artery at their sites of origin than in the superior vena cava (p=0.000, p=0.000 and p=0.002, respectively). Chest CT showed no atherosclerotic plaque at these sites. Furthermore, the average count ratio of thoracic aortic atherosclerotic plaques was not higher than that of the superior vena cava. The maximum count ratio of carotid atherosclerotic plaques was significantly higher than that of the superior vena cava but was not significantly different from that of the carotid artery without plaque. Conclusion The results of our study suggest that not all atherosclerotic plaques show high FDG accumulation. FDG-PET studies of plaques with the use of fused images can potentially provide detailed information about atherosclerosis.  相似文献
3.
肿瘤非手术治疗后FDG PET随访的临床价值   总被引:1,自引:0,他引:1  
目的 探讨 FDG PET影像诊断在肿瘤非手术治疗后临床随访中的价值。 方法 选择实质性肿瘤高强度聚焦超声 (HIFU)治疗后 2 1例 ,鼻咽癌患者放射治疗后 14例 ,共 35例 ,随访中同期行 FDG PET和 CT、MRI检查 ,并将结果进行双盲比较。 结果  2 1例实质性肿瘤 HIFU治疗后 2~ 3个月复查 ,19例 CT、MRI表现密度和信号有变化 ,但形态、大小未见明显改变 ,另 2例 CT、MRI密度和信号变化不明显 ;PET示 17例肿瘤中心大部分放射性分布缺损 ,但以肿瘤边缘部分为主仍有 FDG代谢活跃现像 ,提示部分肿瘤存活 ,其中 6例在 FDG代谢活跃局部经穿刺活检证实肿瘤存活 ;4例 PET表现为 FDG摄取缺损 ,其中 1例局部穿刺活检证实为坏死组织。 14例鼻咽癌放疗后 12~ 18个月复查 ,CT和 MRI提示 11例未见局部肿瘤复发 ,PET显示其中 3例有局灶性 FDG浓聚病变 ,其中 1例局部穿刺活检证实为局部肿瘤复发 ;2例 CT和 MRI提示肿瘤复发 ,FDG显像病变处有明显的放射性浓聚 ;余 1例放射治疗后脑损伤 FDG PET显示为放射性分布缺损区。 结论  FDG显像在实质性肿瘤 HIFU治疗后疗效判断和鼻咽癌放射治疗后肿瘤复发诊断上较 CT和 MRI准确 ,两者结合分析在临床随访中更具有明显的优势  相似文献
4.
PURPOSE: Morphologic imaging after radiofrequency ablation (RFA) of liver metastases is hampered by rim-like enhancement in the ablation margin, making the identification of local tumor progression (LTP) difficult. Follow-up with PET/CT is compared to follow-up with PET alone and MRI after RFA. METHODS AND MATERIALS: Sixteen patients showed 25 FDG-positive colorectal liver metastases in pre-interventional PET/CT. Post-interventional PET/CT was performed 24h after ablation and was repeated after 1, 3 and 6 months and then every 6 months. PET and PET/CT data were compared with MR data sets acquired within 14 days before or after these time points. Either histological proof by biopsy or resection, or a combination of contrast-enhanced CT at fixed time points and clinical data served as a reference. RESULTS: The 25 metastases showed a mean size of 20mm and were treated with 39 RFA sessions. Ten lesions which developed LTP received a second round of RFA; four lesions received three rounds of treatment. The mean follow-up time was 22 months. Seventy-two PET/CT and 57 MR examinations were performed for follow-up. The accuracy and sensitivity for tumor detection was 86% and 76% for PET alone, 91% and 83% for PET/CT and 92% and 75% for MRI, respectively. CONCLUSIONS: In comparison to PET alone, PET/CT was significantly better for detecting LTP after RFA. There were no significant differences between MRI and PET/CT. These preliminary results, however, need further verification.  相似文献
5.
GOALS: 18F FDG PET/CT is used for diagnosis, staging and establishing the response to therapy in various malignancies, including breast cancer (BC). Dedicated breast MRI (BMRI) is gaining a role in the management of BC patients (pts), demonstrating high sensitivity and specificity for detection of small lesions. We were therefore prompted to review our experience with PET and BMRI in BC. METHODS: This is a retrospective study of 21 women with BC, 30-76 years old, who had BMRI and whole-body FDG PET/CT at our institution from Jun 2002 to May 2005. A total of 6 patients (group A) had BMRI and PET/CT in the preoperative period and 15 patients (group B) had BMRI and PET/CT after surgery. Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed. RESULTS: For group A, BMRI identified breast lesions in 4 patients, while PET/CT was able to identify breast lesions in 5 patients. All these were proven to be malignancy on pathology examination. In group B, BMRI detected recurrent breast lesions in 8 patients, with 88.9% sensitivity and 83.3% specificity. In the same patient population, PET/CT was 33.3% sensitive and 91.7% specific. As a whole body examination, PET/CT revealed metastatic disease in 6 patients (100% sensitive and 90% specific). Overall, sensitivities and specificities for breast disease detection were 85.7% and 85.7% for BMRI, and 75% and 92.3% for 18F FDG PET/ CT. CONCLUSIONS: As expected, BMRI is more sensitive than PET/CT in the detection of breast lesions. However, PET/CT as a whole-body examination changed the management of disease by detection of distant lesions in 6 of the 21 patients. Our study suggests that 18F FDG PET/CT and BMRI should be considered as complimentary imaging tools in the pre- and postoperative work-up of patients diagnosed with breast cancer.  相似文献
6.
李立伟  刘京璇 《空军总医院学报》1999,15(3):132-134,F003,F004
目的:探讨PET在颅内胶质瘤术后,放射治疗后随诊中的作用。方法:对16例颅内胶质瘤术事并放射治疗后的病例采用双盲法将PET与CT/或MRI结果进行比较。结果:16例中14例(占87.5%)CT和/或MRI表现不规则环形或结节状明显强化,不能准确作出手术后改变和/或放射治疗后脑损伤,残存肿瘤或神经复发的诊断;其中9例残存肿瘤或肿瘤复发病灶^18F-FDG PET影像均表现为葡萄糖代谢率明显增高,另5例术后放射治疗后脑损伤病例和2例术后软化灶^18F-FDG PET影像均显示局部病变区为放射性分布缺损或明显低下。结论:与CT和MRI相比,PET在胶质瘤术后放射治疗后的脑损伤和肿瘤复发的定性诊断上具有明显的优势,若结合CT和MRI多种影像结果分析,更能提供病变解剖结构和功能改变的综合信息,尤其是对胶质瘤术后放射治疗后的临床随访非常重要。  相似文献
7.
Purpose of the present study was to evaluate the role of 18F-FDOPA PET/CT for predicting survival in patients with suspected recurrent glioma.  相似文献
8.

Purpose

To investigate the diagnostic value of retrospective fusion of pelvic MRI and 18F-fluorodeoxyglucose (18F-FDG) PET images for assessment of locoregional extension and nodal staging of endometrial cancer.

Materials and methods

Thirty patients with biopsy-proven endometrial cancer underwent preoperative contrast-enhanced PET/CT (PET/ceCT) and pelvic dynamic contrast-enhanced MRI for initial staging. Diagnostic performance of PET/ceCT, contrast-enhanced MRI, and retrospective image fusion from PET and MRI (fused PET/MRI) for assessing the extent of the primary tumor (T stage) and metastasis to regional LNs (N stage) was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis.

Results

Fused PET/MRI and MRI detected 96.7% of the primary tumors, whereas PET/ceCT detected 93.3%. Accuracy for T status was 80.0% for fused PET/MRI, and MRI proved significantly more accurate than PET/ceCT, which had an accuracy of 60.0% (p = 0.041). Patient-based sensitivity, specificity and accuracy for detecting pelvic nodal metastasis were 100%, 96.3% and 96.7% for both fused PET/MRI and PET/ceCT, and 66.7%, 100% and 96.7% for MRI, respectively. These three parameters were not statistically significant (p = 1).

Conclusion

Fused PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for assessment of the primary tumor and nodal staging in patients with endometrial cancer.  相似文献
9.

Purpose

To assess the clinical value of retrospective image fusion of neck MRI and 18F-fluorodeoxyglucose (18F-FDG) PET for locoregional extension and nodal staging of neck cancer.

Materials and methods

Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated.

Results

Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant.

Conclusion

Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer.  相似文献
10.
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