曲美他嗪对新西兰白兔缺血/再灌注心肌细胞凋亡的影响

目的探讨曲美他嗪对缺血/再灌注（I/R）心肌细胞凋亡的影响及其机制.方法30只雄性新西兰白兔随机分入假手术组、对照组和治疗组,每组10只.治疗组在普通饲料喂养基础上,每只每日给予曲美他嗪2mg/kg灌胃.14 d后制备I/R模型.采用末端脱氧核甘酸转换酶介导的生物素平移缺口末端标记技术（TUNEL）检测心肌细胞凋亡,用黄嘌呤氧化酶法测定血清超氧化物歧化酶总活力（T-SOD）和硫代巴比妥酸法测定血清丙二醛（MDA）浓度.结果与假手术组比较,对照组心肌细胞凋亡显著增加,T-SOD下降,MDA浓度增加,治疗组T-SOD及MBA与假于术组比较无明显差异,但心肌细胞凋亡明显高于假手术组;与对照组相比,治疗组凋亡指数明显减少,T-SOD显著增加,血清MDA浓度明显降低.结论新西兰兔在持续缺血后再灌注心肌细胞出现明显的凋亡现象,体内抗氧化酶活力下降,曲美他嗪预治疗对缺血后再灌注诱导的心肌细胞凋亡具有一定的抑制作用,曲美他嗪的细胞保护作用可能通过其抗氧化作用机制.     

曲美他嗪对离体鼠心缺血再灌注损伤的保护作用

【目的】探讨曲美他嗪预处理一周对离体鼠心缺血再灌注损伤的影响。【方法】 30只 15周龄的SD大鼠随机分成 3组 ,分别以曲美他嗪 2 0mg/(kg·d)、40mg/(kg·d)及蒸馏水每天灌胃 1次 ,7d后用Langendroff离体心脏灌注法 ,缺血 45min后复灌 ,测量全程左室内压和心电图的变化。【结果】曲美他嗪 40mg/(kg·d)、2 0mg/(kg·d)组的复跳时间分别为 ( 2 14± 0 5 4)、( 5 2 6± 1 0 6 )min ,均较对照组的 ( 10 32± 1 89)min为短 (P均 <0 0 0 1)。复灌后与缺血前的最大左室压力的比值及最大左室压力变化速率的比值在曲美他嗪各实验组均明显大于对照组 (P均 <0 0 0 1)。另外 ,曲美他嗪各组再灌注心律失常的总发生率 ,尤其是室速的发生率均明显小于对照组 (P均 <0 0 1)。【结论】曲美他嗪预处理对离体缺血再灌注鼠心有保护作用。     

曲美他嗪对大鼠缺血再灌注心肌线粒体的保护作用

目的探讨曲美他嗪(trimetazidine,TMZ)对缺血再灌注损伤(RI)心肌线粒体的保护作用及其机制.方法50只雄性SD大鼠随机分为假手术组、等渗盐水组和药物组(TMZ 5 mg/kg组及TMZ 10 mg/kg组)共四组,假手术组只剖胸,不结扎冠状动脉.余三组制作RI模型,缺血前分别静脉注射TMZ(5 mg/kg或10 mg/kg)或等量等渗盐水,在缺血30 min及再灌注40 min时测定RI区心肌线粒体丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-PX)及总钙浓度,并通过电镜观察心肌超微结构改变.结果与假手术组相比,等渗盐水组及药物组线粒体中的MDA及总钙显著增高(P＜0.01),SOD、GSH及GSH-PX显著降低(均P＜0.01);与等渗盐水组比较,药物组的MDA及总钙水平显著降低(P＜0.05,P＜0.01),SOD、GSH及GSH-PX显著增高(P＜0.05,P＜0.01).结论TMZ能减轻缺血再灌注心肌线粒体的脂质过氧化损伤,其机制可能是通过提高线粒体内GSH含量及SOD、GSH-PX活性,增强其抗氧化能力,并通过减轻线粒体内钙聚积在细胞水平提供心肌保护作用.     

缺血预处理对缺血再灌注心肌细胞凋亡的影响

目的 :观察缺血预处理 (ischemicpreconditioning ,IPC)对体外循环中缺血再灌注心肌细胞凋亡的影响 ,评价其对心肌的保护作用。 方法 :在猫体外循环 (cardiopulmonarybypass,CPB)模型的基础上随机分成 3组 :组 1(单纯CPB组 ,n =18)和组 2 (主动脉阻断组 ,n =18)于CPB开始 4 5min后阻断主动脉 ,6 0min后开放主动脉使心脏恢复再灌注 90min ;组 3(IPC组 ,n =18)于主动脉阻断前进行IPC(阻断升主动脉 5min后开放 10min ,并重复 3次 ) ,余处理与组 2相同。应用Annexin Ⅴ /PI联合染色、流式细胞仪检测心肌细胞膜磷脂酰丝氨酸的外翻 ,比较IPC处理组及单纯缺血再灌注组体外循环过程中 4 5、10 5、195min时间点心肌细胞坏死和凋亡的数量。 结果 :组 2于主动脉阻断 6 0min及再灌注 90min时心肌细胞坏死率分别为(2 .6 75± 0 .4 2 4 ) %及 (5 .32 7± 0 .5 13) % ,而组 3则分别为 (1.317± 0 .2 92 ) %和 (3.112± 0 .32 8) % ,两组主动脉阻断 6 0min时 ,均未检出凋亡心肌细胞 ,但在再灌注 90min时 ,组 2和组 3的心肌细胞凋亡率分别达 (2 .32 7± 0 .6 73) %和 (0 .94 3± 0 .14 6 ) %(P <0 .0 1)。IPC处理组缺血再灌注期间坏死及凋亡的心肌细胞明显减少。 结论 :IPC不仅能减少体外循环缺血再灌注导致的心肌细胞坏     

猪缺血再灌注损伤与心肌细胞凋亡的实验研究

目的探讨猪心肌梗死不同区域细胞凋亡的分布。方法滇南小耳猪10只,随机分为两组,每组5只。(1)假手术组(S组),在X线的监控下,经右股动脉置入冠状动脉球囊导管至左前降支,不行冠脉封堵心肌缺血;(2)缺血再灌注组(I/R组),冠脉球囊扩张阻断冠脉血流60min致心肌缺血,撤除球囊恢复冠脉灌注。再灌注72h,行猪心肌末端标记法(TUNEL法)检测凋亡细胞及免疫组化法检测Bcl-2和Bax的蛋白表达。结果再灌注后72h,S组未发生心肌梗死及心肌细胞凋亡,I/R组在心肌梗死区、边缘区、非梗死区的心肌组织均存在细胞凋亡现象,梗死区和边缘区的心肌细胞凋亡指数(AI)明显高于非梗死区,且相应区域的Bax蛋白表达及Bax/Bcl-2比值均较非梗死区增加(P<0.05)。结论猪心肌缺血再灌注损伤后心肌梗死区、梗死边缘区、非梗死区均存在心肌细胞凋亡现象,细胞凋亡主要分布在梗死区和边缘区。     

18F-氟代脱氧葡萄糖PET/CT与增强CT在结直肠癌区域淋巴结转移诊断价值对比分析

目的 对比分析18F-氟代脱氧葡萄糖(18F-FDG) PET/CT与增强CT诊断结直肠癌区域淋巴结转移的临床运用价值.方法 回顾性分析2011年3月至2012年12月中山大学附属第一医院40例结直肠癌患者资料,所有患者均1周内行18 F-FDG PET/CT及增强CT检查,最终经病理检查证实.结果 40例结直肠癌患者中,经病理证实20例患者区域淋巴结转移.18 F-FDG PET/CT出现4例假阳性及3例假阴性,18 F-FDG PET/CT诊断结直肠癌淋巴结转移敏感性为85.0％ (17/20),特异性为80.0％(16/20),阳性预测值为81.0％(17/21),阴性预测值为84.2％(16/19),准确性为82.5％(33/40);腹部增强CT出现5例假阳性及8例假阴性,腹部增强CT诊断结直肠癌淋巴结转移敏感性为60.0％(12/20),特异性为75.0％ (15/20),阳性预测值为70.6％ (12/17),阴性预测值为65.2％(15/23),准确性为67.5％ (27/40);两者假阳性及假阴性经McNemar检验差异无统计学意义(P=0.344),两者敏感性及特异性差异亦无统计学意义(P=0.478,P=0.893;x2检验).结论 虽然18F-FDG PET/CT在诊断结直肠癌淋巴结转移方面同增强CT相比有较高的敏感性、特异性及准确性,但差异无统计学意义,因此在临床工作中还需要根据患者情况选择适当的检查方法.     

阿魏酸钠和曲美他嗪联合预处理对心肌缺血再灌注损伤的保护作用

目的观察阿魏酸钠和曲美他嗪联合预处理对体外循环（ECC）心肌缺血再灌注损伤的保护作用。方法30例行心脏瓣膜置换术患者,随机分为曲美他嗪（单纯治疗）组（n=15）;阿魏酸钠和曲美他嗪（联合治疗）组（n=15）。分别于手术前（T0）、术毕（T1）、术后6h（T2）、术后24h（13）检测肌酸激酶同工酶（CKMB）、心肌肌钙蛋白Ⅰ（cTnI）、丙二醛（MDA）、超氧化物歧化酶（SOD）。同时记录心脏复跳、术后正性肌力药物的应用情况。结果CKMB和cTnI两组均明显升高,但T1、T2、T3时联合治疗组低于单纯治疗组（P〈0．05）;MDA两组各时点均较术前明显升高,联合治疗组低于单纯治疗组（P〈0．05）;SOD在术后持续下降,但单纯治疗组在各时点下降更为显著（P〈0．05）;术后多巴胺用量,联合治疗组明显低于单纯治疗组（P〈0．05）。结论阿魏酸钠和曲美他嗪联合治疗可以明显减轻心肌缺血再灌注损伤,具有较好的心肌保护作用,其保护作用优于单纯治疗组。     

终末温血灌注对低温缺血再灌注心肌细胞微管蛋白的影响

目的：研究体外循环低温心肌保护中,采用终末温血灌注(TWBC)对心肌细胞微管蛋白(TB)组分的影响,探讨TWBC心肌保护作用的机制。方法：建立猫体外循环(CPB)模型,随机分为两组：组Ⅰ,间断冷血心停搏液灌注(ICBC);组Ⅱ,先ICBC,主动脉开放前给予TWBC。动态观察不同时间点左心室收缩压峰值(LVSP)、左心室舒张末压(LVEDP)、左心室内压正负相最大变化速率［(±dp/dt)max］及达到最大收缩速率的时间［(t-dp/dt)max］。采用Western杂交技术,检测主动脉阻断(ACC)115、120 min、再灌注5、15、60、120 min时心肌TB含量,进行半定量分析。结果：(1)心脏再灌注120 min内,两组心功能差异显著(P<0.05)。(2)心肌细胞TB含量变化：ACC 120 min、再灌注5min时,两组游离、聚合TB含量差异均非常显著(P<0.01)。结论：TWBC能加速低温心肌保护中细胞TB聚合,有利于再灌注早期心功能恢复。     

结节病18F-氟代脱氧葡萄糖PET/CT的影像诊断及误诊分析

目的 分析总结结节病18F-氟代脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)正电子发射断层显像/计算机体层摄影(positron emission tomography/computed tomography,PET/CT)的图像特征,为提高该病正确诊断率以及减少误诊提供一定的参考依据.方法 收集整理23例结节病患者的影像资料,归纳总结结节病的18F-FDG PET/CT图像特征,并对误诊病例进行讨论分析.结果 ①累及淋巴结:所有病例都伴有纵隔与肺门淋巴结受累并且表现为双侧对称分布,锁骨上窝、颈部、腋窝以及腹股沟淋巴结也多为双侧受累并对称分布,而腹部和盆腔淋巴结以肝门区及腹膜后累及居多.所有受累淋巴结的放射性摄取呈不同程度增高,最大径均不低于1.0 cm.②累及结外脏器:18例肺部累及者主要表现为肺内散在的结节影及斑片状实变影,放射性摄取多数呈不同程度增高,最大标准化摄取值(standard uptake values,SUVmax)值0.9～5.5;5例胸膜累及者主要呈局部增厚或小结节样改变;3例肝脾累及者中1例表现为肝脾内稍低密度影伴放射性摄取增高,另外2例脾脏的放射性分布呈弥漫性增高;3例骨骼累及者局部可见18F-FDG浓聚灶,相应部位并无骨质破坏;3例皮肤及皮下累及者可见全身皮疹或皮下小结节;2例心包累及者以心包肥厚为主要表现.③5例误诊,主要被误诊为淋巴瘤及肺部肿瘤.结论 纵隔及双肺门淋巴结对称性肿大伴18F-FDG高摄取是结节病PET/CT显像的典型表现,部分病例容易被误诊为淋巴瘤及肺部肿瘤,加深对该病PET/CT影像表现及鉴别要点的认识有助于提高诊断准确率.     

银杏叶提取物后处理对兔心肌缺血-再灌注损伤的影响

目的探讨银杏叶提取物（EGb761）后处理对兔心肌缺血-再灌注损伤的保护作用。方法 32只兔随机分为假手术组（S组,开胸后仅行左冠脉套线而不阻断160 min）、缺血-再灌注组（IR组,行左冠状动脉前降支阻断40 min,再灌注120 min）、缺血后处理组（IPC组,结扎冠状动脉前降支40 min,再通30 s,结扎30 s,重复3次,再灌注120 min）和EGb761后处理组（E组,开放左冠状动脉即刻1 min内予以静脉推注EGb761 100mg/kg,再灌注120 min）。分别于左冠前降支阻断前20 min（T1）、左冠前降支阻断20 min（T2）、左冠前降支阻断40 min（T3）、心肌再灌注1h（T4）和心肌再灌注2 h（T5）抽取颈内动脉血测定血清肌钙蛋白（IcTnI）含量。再灌注末抽血离心测定超氧化物歧化酶（SOD）、丙二醛（MDA）,测定梗死面积。结果和IR组相比,IPC组和E组再灌注各个时间点cTnI均降低（P〈0.05）;IPC组和E组梗死面积均小于IR组（P〈0.05）;IPC组和E组血清中SOD的活性高于IR组,MDA的含量低于IR组（P〈0.05）。结论银杏叶提取物后处理具有类似缺血后处理的心肌保护作用,其机制可能是通过减少氧自由基的生成,增强心肌抗氧化能力有关。     

18F-FDG PET/CT在原发性骨肉瘤诊断中的影像学特征

目的：探讨18F-FDG PET/CT显像在骨肉瘤诊断中的影像学特征.方法：对在2005年1月至2011年5月在本院就诊经病理检查确诊的原发性骨肉瘤患者行18F-FDG PET/CT全身显像,采用感兴趣区（ ROI）技术计算肿瘤病灶的SUVmax,同时分析同机CT扫描图像的影像学特点,着重研究肿瘤新生骨及软组织肿块特点.结果：10例原发性骨肉瘤患者的原发病灶均位于干骺端,其中位于股骨下端6例,肱骨上端2例,股骨颈和胫骨上段各1例,1例发现有“跳跃性转移灶”.同机CT影像表现为骨质破坏、肿瘤骨、骨膜反应或骨膜三角和软组织肿块.其中,肿瘤骨对18F-FDG呈低摄取,而非癌骨区或软组织肿块对18F-FDG摄取明显增高.“跳跃性转移灶”呈明显18F-FDG高摄取.结论：18F-FDG PET/CT实现了对原发性骨肉瘤解剖结构改变和代谢变化的优势互补,对骨肉瘤的诊断及治疗提供了依据.     

Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary

Background  Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP, including detecting the occult primary tumor and effecting on disease therapy.

Methods  One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients, the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350–425 MBq of ¹⁸F-FDG.

Results  In 24.8% of patients, FDG PET/CT detected primary tumors that were not apparent after conventional workup. In this group of patients, the overall sensitivity, specificity, and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%, 87.7%, and 87.2%, respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%, 47 of 149) patients underwent a change in therapeutic management.

Conclusions  FDG PET/CT is a valuable tool in patients with CUP, because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases, and optimized the mangement of these patients.

     

Assessment of myocardial perfusion by positron emission tomography in patients with end-stage coronary artery disease treated with percutaneous myocardial revascularization

Background Reportedly, patients with persistent refractory angina due to end-stage coronary artery disease （CAD） not amenable to traditional revascularization techniques have experienced symptomatic relief following laser revascularization, either surgical transmyocardial revascularization （TMR） or percutaneous myocardial revascularization （PMR）. In spite of several hypotheses （i.e., channel patency, placebo effect, denervation, neoangiogenesis）, the mechanism of action and the benefit remains controversial. Methods A prospective trial utilizing positron emission tomography （PET） was conducted as an attempt to correlate quantified myocardial blood flow （MBF） to clinical improvement following PMR. Thirteen consecutive patients with angina class 〉11 in spite of maximal medical treatment underwent PMR with a holmium：yttrium-aluminum-garnet （Ho：YAG） laser. MBF at rest and under hyperemia was assessed by [13N]ammonia PET at baseline, 3 and 6 months following PMR. Results Mean angina class and exercise tolerance time improved at 6 months compared with baseline （P 〈0.001）. The clinical results were accompanied with an improvement in hyperemic MBF （P=-0.05） and a reduction in minimal coronary resistance （MCR; P 〈0.05） in PMR-treated segments. Opposite effects, reduced hyperemic MBF and increased MCR, were observed in nontreated segments. The increase in MCR in nontreated segments revealed the favorable therapeutic impact achieved in PMR-treated segments. Conclusion The results of this trial utilizing a quantitative technique to quantify myocardial perfusion link clinical improvement post-PMR to neoangiogenesis and consistently improved microcirculation.     

Combination of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging is an optimal way to evaluate rheumatoid arthritis in rats dynamically

Background Rheumatoid arthritis （RA） is a chronic,systemic autoimmune inflammatory disorder.Many methods have been used to observe the progress of RA.The purpose of this study was to observe the progress of RA in rats with 18F-fluorodeoxyglucose （FDG） positron emission tomography/computed tomography （PET/CT）,magnetic resonance （MR） imaging and arthritis score,and analyze the relationships among different methods in evaluation of RA.Methods Sixteen healthy Sprague Dawley （SD） rats about 8-week old were randomly assigned to a RA group and a control group.Bovine type Ⅱ emulsified incomplete Freud＇s adjuvant was used to induce arthritis in the RA group.Arthritis score of the rats in two groups were recorded,and 18F-FDG PET/CT,MR imaging were performed both on the corresponding rats every 3 days.All the rats were sacrificed at week 5,and histopathological examination was performed on rat knees stained with haematoxylin and eosin.Results The arthritis score and the standard uptake value （SUV） of knee joints in RA rats increased with the progression of arthritis gradually.Both peaks of arthritis score and SUV appeared at 21 days after the first immune injection,then the arthritis score and SUV of knee joints decreased slowly.The arthritis scores of knee joints in RA rats were positively correlated with their SUV changes.The MR images were confirmed by the histopathological studies.Conclusion PET/CT can detect the earliest molecular metabolism changes of RA,and MR imaging can follow up the dynamical anatomical changes of RA,all of which indicated that PET/CT and MR imaging may be applied as useful tools to monitor the progress of RA.     

正电子发射断层显像中子宫和卵巢生理性摄取的特点

目的了解正电子发射断层显像(PET)中女性子宫和卵巢生理性摄取的特点和规律。方法对247例女性受试者共进行了288次PET检查,其中恶性肿瘤164例,良性病变44例,正常39例,均无盆腔病变。分析比较子宫和卵巢摄取18F-脱氧葡萄糖(FDG)的高低与所处月经周期时段的关系。结果月经规律患者116例,共行131次PET检查,其高、中度子宫内膜摄取多出现在月经早期或中期,呈倒置椎形,尖端指向膀胱后方;一侧或双侧卵巢摄取常在月经中期出现,多呈卵圆形,位于膀胱后上方两侧;月经来潮后期和增殖早期无明显子宫或卵巢摄取的可能性最大,分别为86%和80%。17例(19次PET)月经明显不规律、112例(136次PET)停经和2例尚未开始来月经者均无子宫、卵巢高摄取。结论子宫和卵巢对18F-FDG的生理性摄取随月经周期而变化,正确认识可避免误诊,通过选择检查时机可减少其影响。     

11C-methionine and 18F-fluorodeoxyglucose positron emission tomography/CT in the evaluation of patients with suspected primary and residual/recurrent gliomas

Background  ¹⁸F-fluorodeoxyglucose (FDG) is the most widely used radiotracer in tumor imaging, but its use for brain gliomas and recurrence is limited by the high ¹⁸F-FDG uptake in normal brain tissue. ¹¹C-methionine (MET) has low uptake in the normal brain tissue, providing potential advantages over ¹⁸F-FDG. The aim of the study was to investigate the diagnostic value of ¹¹C-MET compared to ¹⁸F-FDG positron emission tomography and computed tomography (PET/CT) in patients with suspected primary and residual/recurrent gliomas.

Methods  Eighty paired PET/CT scans using ¹¹C-MET and ¹⁸F-FDG were performed on 44 newly diagnosed patients with suspected gliomas and 36 post-operative patients with suspected residual/recurrent tumors. PET/CT results were evaluated by visual and semiquantitative analysis. The sensitivity, specificity and accuracy for detection of gliomas and residual/recurrent tumors were calculated using visual analysis. Tumor to contralateral normal gray matter (T/G) ratio was calculated for semiquantitative analysis.

Results  Final pathology of the 44 newly diagnosed patients included 26 gliomas (14 high-grade and 12 low-grade tumors) and 18 non-glioma benign lesions. Residual/recurrent gliomas were verified in 28 patients and excluded in 8/36 post-operative patients by subsequent histopathologic examination and/or clinical follow-up for more than six months. The sensitivity, specificity and accuracy of ¹¹C-MET PET/CT were 88.5%, 83.3% and 86.4% for gliomas and 96.4%, 87.5% and 94.4% for residual/recurrent gliomas, respectively. The sensitivity, specificity and accuracy of ¹⁸F-FDG PET/CT were 50.0%, 88.9% and 65.9% for gliomas and 46.4%, 100.0% and 58.3% for residual/recurrent gliomas, respectively. ¹¹C-MET had a higher sensitivity than ¹⁸F-FDG (83.3% vs. 33.3%, P=0.031) in low-grade gliomas, but had no significant difference in sensitivity from ¹⁸F-FDG for high-grade gliomas (92.9% vs. 64.3%, P=0.219). ¹¹C-MET T/G uptake ratios in high-grade gliomas, low-grade gliomas and benign lesions were 1.94±0.53, 1.78±0.61 and 1.06±0.34, respectively. ¹⁸F-FDG T/G uptake ratios in high-grade gliomas, low-grade gliomas and benign lesions were 1.05±0.37, 0.66±0.14 and 0.63±0.17, respectively.

Conclusions  ¹¹C-MET PET/CT is superior to ¹⁸F-FDG PET/CT in detecting and delineating gliomas and residual/recurrent tumors, especially low-grade gliomas and residual/recurrent lesions present in gray matter, but its role in non-invasive grading of the tumors is limited.

     

Imaging of atherosclerotic aorta of rabbit model by detection of plaque inflammation with fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography

Background  Atherosclerotic plaque rupture is the primary mechanism of thrombosis which plays a key role in the onset of acute coronary syndromes. Detection of these plaques prone to rupture (vulnerable plaque) could be clinically significant for prevention of cardiac events. It has been shown that high metabolism cells have a high uptake of fluorine-18 fluorodeoxyglucose (¹⁸F-FDG). The objective of this study was to investigate the correlation of FDG uptake and the immuno-histochemistry parameters of plaques, and the effect of atorvastatin on vulnerable atherosclerotic plaque in a rabbit model.

Methods  Ten male New Zealand White rabbits were divided into three groups as follows: (1) normal control group (n=2, C group): the animals were fed a standard diet at 120 g/d and were given water ad labium; (2) atherosclerosis group (n=4, As group): animals were fed with high fat diet for 5 months after aortic endothelia damage; (3) treatment group (atherosclerosis + atorvastatin, n=4, Statin group): animals were fed with high fat diet for 5 months and then changed into normal chow plus atorvastatin (2.5 mg∙d^-1∙kg^-1) treatment for another 4 months. Then these four rabbits were imaged with fluorine-18 fluorodexyglucose positron emission tomography/computed tomography (PET/CT) and sacrificed for pathohistologic studies. FDG uptake by the aorta was expressed as target-to-background ratio (TBR). Maximal standardized uptake value (SUV) was measured over the thoracic and abdominal aortas. The aortic smooth muscle cell (SMC) number, CD-14 antibody positive cell (macrophage) number and the ratio of the thickness of fibrous cap to the thickness of lipid core (cap-to-core ratio) in atherosclerotic plaques were analyzed.

Results  As group showed significantly higher uptake of FDG than C group (SUVs: 0.746±0.172 vs. 0.286±0.073, P <0.001). After 4 months of atorvastatin treatment and the modification of diet, SUVs decreased significantly (Statin group: 0.550±0.134, compared to As group, P <0.001). However, no marked difference was found in TBR, the number of macrophages, the number of SMC and the cap-to-core ratio in the aortic segments between Statin group and As group. The correlation of aortic FDG uptake with SMC assessed by histopathology was negatively significant (r=–0.57, P <0.001). When aortic FDG uptake was expressed as TBR, it correlated significantly (r=0.69, P <0.001) with the macrophage number, and also correlated significantly (r=–0.78, P <0.001) with the cap-to-core ratio.

Conclusion  ¹⁸F-FDG PET/CT might serve as a useful non-invasive imaging technique for detection of atherosclerotic plaque and potentially permit monitoring of relative changes in inflammation within the atherosclerotic lesion.

     

Fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging of uterine leiomyosarcomas: 2 cases report

Uterine leiomyosarcoma is an uncommon malignant neoplasm of smooth muscle origination and is associated with a poor prognosis. We report two cases of uterine leiomyosarcoma that presented with pulmonary metastases. 2-deoxy-2-(¹⁸F)fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) was performed to identify the primary carcinoma and found the focus located in the uterus. The follow-up magnetic resonance imaging (MRI) confirmed the diagnosis was uterine leiomyosarcoma.

     

18F-氟代脱氧葡萄糖正电子发射断层成像/CT与同机CT对弥漫大B细胞淋巴瘤患者淋巴结及结外病灶的诊断价值对比

目的 比较18F-氟代脱氧葡萄糖电子发射断层成像/CT(18F-FDG PET/CT)与同机CT显像对弥漫大B细胞淋巴瘤(DLBCL)淋巴结及结外病灶的诊断价值.方法 选取48例经病理确诊为DLBCL的患者,行18F-FDG PET/CT全身显像检查,对比分析18F-FDG PET/CT与同机CT对DLBCL患者受累淋巴结和结外病灶的检出率,以及对淋巴结、结外病灶的诊断效能.结果 经手术或活检病理发现,299枚可疑受累淋巴结中确诊受累淋巴结272枚,90处可疑受累结外病灶中确诊受累结外病灶84处.18F-FDG PET/CT对受累淋巴结检出率为86.29%,高于同机CT的74.92%(P<0.05);18F-FDG PET/CT诊断受累淋巴结、受累结外病灶的敏感性、准确度均优于与同机平扫CT图像(P<0.05).结论 18F-FDG PET/CT对DLBCL患者受累淋巴结、受累结外病灶的诊断效能高于同机CT.     

正电子发射计算机断层测定心肌血流量的临床价值

 正电子发射计算机断层（positron emission tomography,PET）技术可以无创伤性绝对定量分析健康人群和多种心血管病患者的局部心肌血流量（myocardial blood flow,MBF）,结果可靠,重现性好。本文主要针对冠脉循环的生理和病理生理学信息及MBF测定对判断冠状动脉微循环功能的独特临床价值作一简要综述。