人脑功能显像研究药物成瘾的新进展

神经功能影像技术为认识人类药物成瘾的神经药理学机制提供了很大帮助.该文在阅读神经功能影像技术在药物成瘾研究中应用的及国内外相关文献的基础上,探讨药物成瘾者在依赖、戒断、复发等不同状态下脑内血流灌注、葡萄糖代谢、神经受体及转运体等发生的形态和功能活动的改变,以寻求与药物成瘾相关的神经核团、神经通路以及受体作用系统,从而了解药物成瘾的神经生物学基础,为寻找有效的治疗措施提供理论基础.     

组织细胞坏死性淋巴结炎CT及PET-CT影像表现并文献复习北大核心CSCD

目的:探讨组织细胞坏死性淋巴结炎CT及PET-CT表现及临床特点,旨在提高对该病的诊断水平。方法:回顾性分析12例经组织病理学诊断为组织细胞坏死性淋巴结炎的影像资料及临床资料,男4例,女8例,年龄13~47岁,平均(28.75±12.02)岁,所有病例均接受了CT检查,3例病例进行CT强化扫描,3例病例进行全身18F-FDG PET-CT检查。结果:(1)分布位置:12例病例表现为颈部淋巴结增大,集中分布在颈部Ⅱ~Ⅴ区,2例伴有腋窝淋巴结增大,2例伴腹盆部淋巴结增大(为PET-CT检查发现)。(2)淋巴结形状(225个淋巴结):椭圆形淋巴结占43.7%,圆形淋巴结占39.1%,长条状淋巴结占17.2%。(3)淋巴结的短径分布情况(225个淋巴结),多数在10mm以下。(4)淋巴结强化方式:多数为均匀强化,少部分出现环形强化,动脉期CT值约为(74.66±13.45)HU,静脉期CT值约为(92.72±15.76)HU,延迟强化显著。(5)50组淋巴结的18F-FDG代谢情况:淋巴结的最大标准摄取值(SUVmax)集中分布在5~10,平均值为6.85±2.76,且SUVmax值与淋巴结短径具有正相关性。结论:组织坏死性淋巴结炎好发于颈部,CT及PET-CT检查对组织细胞坏死性淋巴结炎的诊断具有一定的价值,最终确诊依赖于临床资料、影像及病理的综合分析。     

99mTcO4-SPECT/CT显像对分化型甲状腺癌术后残留甲状腺组织的评估价值

目的:探讨99mTcO4-甲状腺SPECT/CT显像对分化型甲状腺癌(DTC)患者术后残甲及颈部腺外转移灶的评估价值。方法:入组240例拟行术后131I清甲治疗的DTC患者。患者131I治疗前行99mTcO4-甲状腺SPECT/CT显像,服131I后5天行SPECT/CT全身扫描,必要时行颈部断层扫描。把131I显像结果作为标准,评价99mTcO4-甲状腺SPECT/CT显像对术后残甲和颈部腺外转移灶的评估价值。结果:99mTcO4-甲状腺SPECT/CT显像对DTC患者术后残甲评价的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为83.7%、89.5%、84.2%、98.9%、32.1%;其对DTC患者术后颈部腺外转移灶评估的灵敏度为40.2%。结论:99mTcO4-甲状腺SPECT/CT显像可作为DTC患者清甲治疗前对残甲的评估检查方法;但在发现颈部腺外转移灶的敏感度方面尚不如131I显像。     

^99Tc^m—TRODAT-1脑SPECT用于体质指数与纹状体多巴胺转运蛋白相互关系的研究

目的 探讨BMI与人脑纹状体DAT的相互关系及对99Tcm-TRODAT-1脑SPECT显像的影响.方法 31名健康志愿者（男16名,女15名）分别进行颅脑MRI和99Tcm-TRODAT-1脑SPECT显像.对SPECT图像进行三维重建,参照MRI图像,在SPECT图像横断面纹状体（ST）显示最清楚的连续4层图像上对脑左、右ST（LST、RST）分别进行ROI勾画,取小脑（CB）作为本底参考区,分别计算ST/CB、LST/CB和RST/CB的放射性摄取比值.采用SPSS 15.0软件,分别对ST/CB、LST/CB、RST/CB与BMI、年龄进行Pearson相关性分析;然后以BMI、年龄为自变量,ST/CB为因变量进行多因素回归分析.结果 31名健康志愿者99Tcm-TRODAT-1脑SPECT显像示双侧ST左右对称,放射性前部高于后部.其ST/CB、LST/CB和RST/CB的平均值分别为1.71±0.16,1.70±0.16和1.72±0.17;女性ST/CB、LST/CB和RST/CB的平均值分别为1.74±0.18,1.71±0.19和1.76±0.19;男性ST/CB、LST/CB和RST/CB的平均值分别为1.68±0.14,1.68±0.13和1.69±0.15.ST/CB、LST/CB和RST/CB与BMI均呈负相关（r=-0.53,-0.57,-0.47,P均＜0.05）.ST/CB与年龄呈负相关（r=-0.39,P=0.03）.多因素回归分析发现仅BMI为显著影响因素（回归系数β=-0.53,t=-3.36,P=0.002）.结论 健康人脑ST DAT水平随着BMI、年龄的增高而呈降低趋势.女性STDAT水平略高于男性.提示在99Tcm-TRODAT-1脑SPECT显像中,不但要考虑年龄、性别等影响因素,而且要注意BMI也是重要影响因素.     

99Tcm-TRODAT-1脑SPECT用于体质指数与纹状体多巴胺转运蛋白相互关系的研究

Objective To assess the relationship between the BMI and the brain DAT, and the influence of BMI on the brain SPECT imaging with 99Tcm-TRODAT-1. Methods MRI and 99Tcm-TRODAT-1SPECT imaging were performed in 31 healthy volunteers(16 males and 15 females), and then the three-dimensional reconstruction of SPECT images were completed. Based on the MRI images, right striatum (RST) and the left striatum (LST) were drawn as ROI on the 4 most clearly consecutive transverse slices.The cerebellum (CB) was taken as the background reference area and the corresponding uptake ratios of ST/CB, LST/CB and RST/CB were calculated. The Pearson correlation tests for radio-uptake ratios (ST/CB, LST/CB, RST/CB), BMI and age were performed, Then multiple linear regression analysis using ST/CB as dependent variable and BMI and age as independent variables was performed. SPSS 15.0 was used in data analysis. Results The ST imaging was symmetrical. The radioactivity was higher in the ST front area than that of the back area. The average uptake ratios of ST/CB, LST/CB, RST/CB were 1.71±0.16,1.70 ± 0. 16 and 1.72±0.17 respectively, in which the three ratios of the female were 1.74 ± 0. 18, 1.71±0. 19 and 1.76 ± 0. 19 respectively and those of the male were 1.68 t 0. 14, 1.68 ± 0. 13 and 1.69± 0.15respectively. ST/CB, LST/CB and RST/CB were negatively correlated with patients'BMI (r = -0. 53,-0.57,-0.47, all P＜0.05). The ST/CB was negatively correlated with patients' age(r=-0.39, P=0. 03). The multiple linear regression analysis showed that the BMI was significant independent variable (β=-0.53, t= -3.36, P=0. 002). Conclusions TheSTDAT,evel may decrease as patients' BMI and age increase. Females' DAT level is slightly higher than males'. For ST DAT imaging, age, gender and BMI should be all taken into consideration.