面部海绵状血管瘤的~(99m)Tc-RBC显像诊断与~(32)P胶体介入注射治疗

目的:探讨面部海绵状血管瘤的99mTc-RBC显像及32P胶体介入注射治疗的临床价值.方法: 海绵状血管瘤患者31例,依据瘤体表面面积分为A、B两组,行32P胶体介入多点位注射治疗,所有患者治疗前后均行99mTc-RBC血管瘤显像,先后采集动脉血流灌注相,早期血池相及延迟血池相图像.结果: 31例患者的动脉血流灌注相,早期血池相无放射性分布,而延迟相持续放射性浓聚.瘤内注射治疗后,一次治愈率为70.97%(22/31),其中A组治愈率为83.33%(15/18),B组治愈率为53.85%(7/13),经过第二次治疗,总治愈率为87.10%(27/31).治疗后再次显像,原放射性浓聚程度变淡,范围缩小或完全消失.结论: 99mTc-RBC显像对海绵状血管瘤的定性诊断与32P胶体介入注射治疗的疗效判定具有临床价值,32P胶体介入治疗疗效确切,方法简便,瘤体越小治疗效果越佳.     

90Sr敷贴及平阳霉素注射治疗皮肤血管瘤的疗效观察

  目的 评价90Sr敷贴+平阳霉素治疗皮肤血管瘤的治疗效果。方法 皮肤血管瘤218例，瘤体243个（单纯性血管瘤108个，海绵状血管瘤74个，混合性血管瘤61个 ）； 随机分为两组：90Sr敷贴治疗组127个，平阳霉素（PYM）组116个。90Sr敷贴治疗组剂量300 ~ 600 cGy／次，2次／周，4次为1疗程；PYM治疗组平均每次用量3 ~ 4 mg，7 ~ 10 d后重复。结果 两组总治愈率分别为91.34 %及88.79 %；其中单纯性血管瘤90Sr敷贴治疗与PYM注射治疗两者治愈率分别为98.41 %及82.22 %，海绵状血管瘤两者治愈率分别为80.66 %及95.35 %，混合性血管瘤两者治愈率分别为87.88 %及89.29 %。结论 对于单纯性血管瘤可首先考虑90Sr敷贴治疗，而 对于海绵状血管瘤则应首先考虑PYM治疗；混合性血管瘤两种方法均可选择，但PYM注射加90Sr敷贴治疗为佳。     

放射性核素显像在巨大肝血管瘤诊断与鉴别诊断中的意义

目的:评价放射性核素显像诊断巨大肝血管瘤的临床应用价值.方法:肝内巨大占位病变23例病人37个病灶,同时行肝胶体断层和肝血池断层显像.手术病理证实为肝巨大血管瘤24个病灶.结果:核素显像诊断巨大肝血管瘤都有典型表现:肝血池延迟相放射性过度填充,明显高于正常肝组织.结论:肝胶体断层显像联合肝血池断层显像诊断巨大肝血管瘤有良好诊断价值,对巨大肝血管瘤与肝癌有重要的鉴别诊断意义.     

^99Tc-MDP骨三相扫描在骨肉瘤诊断中的临床价值

目的：探讨^99Tc-MDP骨三相扫描在骨肉瘤病人中的显像特点和应用价值。方法：回顾了我院2006年4月～2007年1月经穿刺活检及手术病理诊断为骨肉瘤的24例患者，男12例，女12例，最小年龄11岁，最大50岁，平均年龄20．6岁，所有患者都使用GE公司的Hawkeye SPECT进行^99Tc-MDP骨三相扫描，图像经Entegra工作站处理。在血流灌注相，利用感应区技术（ROI），就肿瘤血流灌注开始时间、最高计数率、计数率达高峰时间、快速灌注持续时间、计数率-时间曲线斜率、曲线下面积与健侧进行比较，行两样本均数比较t检验。并计算计数率一时间曲线斜率比值、曲线下面积比值。另外计算血池相计数与对侧比值、延迟相计数与对侧比值（T／NT）及两样本均数比较配对t检验。观察结果延迟相的显像特点。结果：58．3％发生在股骨的（14／24），其中股骨下9例；37．5％发生在胫骨（9／24），其中胫骨上7例；发生在腓骨仅1例；累及2块骨头以上为5例。未发现远处部位转移。肿瘤血流灌注平均开始时间、计数率达高峰时间、快速灌注持续时间、最高计数率、计数率-时间曲线斜率、曲线下面积分别为（3．04±1．94）s，（13．43±3．98）s，（10．52±3．06）s．（958．26±469．24）counts／s，99．15±61．02，（49797±25157．24）counts，健侧分别为（4．70±3．25）s，（18．26±5．69）s，（13．57±4．57）s，（270±160．51）counts／s，23．22±19．20，（13403±8821．95）counts，两者相比均有统计学意义（P〈0．05），两者斜率比值为6．03±4．68，曲线下面积比值为4．99±3．62。血池相计数与对侧比值、延迟相计数与对侧比值分别为3．34±1．53，6．02±3．12，两者相比具有统计学意义（P〈0．05），延迟显像，放射性异常高度浓聚，核素分布均匀41．7％，不均匀者58．3％，病变内出现放射性稀疏、缺     

99mTc-MDP骨三相扫描在骨肉瘤诊断中的临床价值

目的:探讨99mTc-MDP骨三相扫描在骨肉瘤病人中的显像特点和应用价值.方法:回顾了我院2006年4月-2007年1月经穿刺活检及手术病理诊断为骨肉瘤的24例患者,男12例,女12例,最小年龄11岁,最大50岁,平均年龄20.6岁,所有患者都使用GE公司的Hawkeye SPECT进行99mTc-MDP骨三相扫描,图像经Entegra工作站处理.在血流灌注相,利用感应区技术(ROI),就肿瘤血流灌注开始时间、最高计数率、计数率达高峰时间、快速灌注持续时间、计数率-时间曲线斜率、曲线下面积与健侧进行比较,行两样本均数比较t检验.并计算计数率-时间曲线斜率比值、曲线下面积比值.另外计算血池相计数与对侧比值、延迟相计数与对侧比值(T/NT)及两样本均数比较配对t检验.观察结果延迟相的显像特点.结果:58.3%发生在股骨的(14/24),其中股骨下9例;37.5%发生在胫骨(9/24),其中胫骨上7例;发生在腓骨仅1例;累及2块骨头以上为5例.未发现远处部位转移.肿瘤血流灌注平均开始时间、计数率达高峰时间、快速灌注持续时间、最高计数率、计数率-时间曲线斜率、曲线下面积分别为(3.04±1.94)s,( 13.43±3.98)s,(10.52± 3.06)s,(958.26±469.24)counts/s,99.15±61.02,(49797±25157.24)counts,健侧分别为(4.70±3.25)s,(18.26±5.69)s,(13.57±4.57)s,(270±160.51)counts/s,23.22±19.20,(13403±8821.95)counts,两者相比均有统计学意义(P﹤0.05),两者斜率比值为6.03±4.68,曲线下面积比值为4.99±3.62.血池相计数与对侧比值、延迟相计数与对侧比值分别为3.34±1.53,6.02±3.12,两者相比具有统计学意义(P﹤0.05).延迟显像,放射性异常高度浓聚,核素分布均匀41.7%,不均匀者58.3%,病变内出现放射性稀疏、缺损者占54.2%,另外软组织可见侵犯并有不均匀放射性浓聚.结论:99mTc-MDP骨三相扫描为骨肉瘤的诊断提供了丰富的信息,具有较高的临床价值.     

口腔颌面部126例海绵状血管瘤缝扎硬化的疗效分析

目的　观察瘤体分区缝扎硬化治疗颌面部血管瘤的疗效及不良反应。方法　采用瘤体周围及分区交叉缝扎加瘤腔内注射平阳霉素的方法,治疗颌面部海绵状血管瘤12 6例。平阳霉素术后可重复注射1～6次。结果　随访观察6～3 6个月,治愈98例,基本治愈2 6例,有效2例,无无效病例。临床治愈率(包括治愈和基本治愈)为98 4%。结论　分区缝扎硬化治疗海绵状血管瘤操作简便、安全可靠,治愈率高,特别对于唇部、舌前部、颊部易于阻断血流处治疗效果好,具有较好的治疗应用价值。     

胃镜引导瘤体内介入放射性药物^32P—胶体治疗胃食道癌的应用体会

对19例中晚期胃食道癌,采用由胃镜引导下瘤体内介入放射性药物~(32)P-胶体内照射治疗。经过2~4次治疗完全缓解7例(36.84%7/19),部分缓解9例(47.36%,9/19),无变化1例(5.26%,1/19),有效率为84.10%(16/19);生存期:随访19例至1997年3月底。存活2~5个月2人(10.52%),1年以上17人(89.47%)。作者认为,瘤体内介入放射性药物~(32)P-胶体内照射治疗胃食道癌,方法简便,使用安全,无明显副作用,并对治疗方案,操作方法及治疗敏感性等问题进行了讨论。     

^32P-磷酸铬-聚L乳酸降解粒子植入体内分布及其对免疫功能的影响

目的：探讨32P-磷酸铬-聚L乳酸（32P-CP-PLLA）粒子植入H22淋巴转移模型的靶向浓聚及对淋巴转移治疗的潜能和间质植入SD大鼠对其免疫功能的影响。方法：KM小鼠模型50只,随机分为2组,瘤体内分别植入1枚32P-CP-PLLA和注入胶体32P-磷酸铬（32P-CP）。给药后不同时间点处死,观察荷瘤鼠体内生物分布及影像学检查,病理学检查。SD大鼠20只,74 MBq/只,γ相机韧致辐射显像,流式细胞仪动态检测血清CD3、CD4、CD8表达水平。结果：体内生物分布示植入32P-CP-PLLA粒子在瘤体内未发生移位。MR扫描示粒子椭圆形低信号区。γ相机韧致辐射显像示植入粒子组放射性分布持续局限浓聚于植入点。SD大鼠肝脏粒子组免疫力3 d开始降低,7 d最低,14 d恢复正常。肌肉粒子组大鼠免疫力14 d略降低,其余时间正常。肝脏32P-CP组免疫力3 d时降低,7 d降到最低,持续30 d恢复正常。结论：32P-CP-PLLA粒子组织靶向定位明显优于32P-CP,对淋巴转移治疗具有一定的潜能。32P-CP-PLLA植入肌肉组织对机体免疫功能无明显影响,植入肝脏免疫功能一过性轻度降低;同等活度的32P-CP肝脏间质注射可引起机体免疫功能明显损伤,持续约4周左右。     

三种不同方法治疗儿童混合性皮肤血管瘤的疗效观察

目的：观察应用激素、90Sr皮肤敷贴器或／加药物介入法治疗儿童混合性皮肤血管瘤的临床疗效.方法：对200例儿童混合性皮肤血管瘤的患者,分别采用激素、90Sr皮肤敷贴或／加药物介入法治疗.混合性血管瘤68例采用90Sr皮肤敷贴治疗,根据年龄大小和治疗反应决定个体化剂量；56例混合性血管瘤采用口服强的松激素治疗；混合性血管瘤76例先行平阳霉素瘤体内注射,待深部瘤体消退后,浅表性表皮病变再行β射线敷贴治疗.结果：β射线敷贴治疗儿童混合性血管瘤治愈率为57．35％,有效率为80．88％；β射线敷贴器加平阳霉素注射治疗儿童混合性血管瘤治愈率为81．58％,有效率为94．74％；而单纯激素治疗混合性血管瘤治愈率为30．36％,有效率为64．29％.结果表明采用90Sr皮肤敷贴器或／和平阳霉素治疗儿童血管瘤的方法,其疗效明显优于单纯激素治疗.两组疗效比较有非常显著差异（P〈0．01）.结论：90Sr皮肤敷贴器或／加平阳霉素药物介入疗法是治疗儿童皮肤混合性血管瘤较为有效的方法.     

平阳霉素治疗小儿海绵状血管瘤的疗效分析

目的:评价平阳霉素瘤内注射治疗小儿海绵状血管瘤的临床疗效。方法:回顾性分析234例海绵状血管瘤常规瘤体内注射平阳霉素(注射次数1次-6次)后的临床资料。结果:经过3年随访,治愈168例,基本治愈12例,好转45例,无效9例。总有效率96.15%。结论:平阳霉素瘤内注射治疗海绵状血管瘤疗效高,疗程短,是一种简便、安全的有效方法。     

Technetium-99m Radiocolloid Scintigraphy,Planar and SPECT Red Blood Cell Imaging and Ultrasonography in Diagnosis of Hepatic Hemangioma

Technetium-99m planar sulfur colloid scintigraphy, red blood cell imaging and ultrasonography were performed in eighteen patients of hepatic hemangioma to evaluate their diagnostic utility. Radiocolloid scans detected fourteen hemangiomas in 12 patients as focal hepatic defects but missed 9 lesions smaller than 2.5cm in the other 6 patients, accounting for a 61% sensitivity. All 23 lesions were avascular or normovascular on radionuclide flow study. Serial planar red blood cell scintigraphy showed characteristic gradually increasing focal isotopic accumulation in the 14 hemangiomas which had identifiable cold areas on the radiocolloid study. One of 6 patients with normal radiocolloid scan also showed the typical increasing blood pool pattern of hemangioma, five had normal planar scans till 11/2 hours. SPECT red blood cell imaging in these 5 patients detected an additional seven hemangiomas. All 7 lesions were smaller than 2.5cm. One 1.5cm hemangioma was missed on both planar and SPECT red blood cell imaging. Region of interest ratios in SPECT transaxial images confirmed gradually increasing concentration of labeled red blood cells in the lesions. Ultrasonography detected 22 of the 23 hemangiomas. Ten were hyperechoic, average size 2.25cm. Twelve were of mixed pattern, generally larger, average size 7.2cm. Sonography is useful in the detection of hepatic hemangiomas as a focal mass lesion, but the variable sonographic appearance precludes a definite pathological diagnosis. Technetium-99m red blood cell imaging appears a sensitive technique in detection of hepatic hemangioma, with SPECT being especially useful in locating smaller lesions. The addition of SPECT to planar red blood cell imaging considerably improves the sensitivity of this highly specific technique for an accurate non-invasive diagnosis in hepatic hemangioma.     

Continuous low-dose-rate radiation of radionuclide phosphorus-32 for hemangiomas

The study goal was to clarify the therapeutic effect and the absorbed dose of radionuclide phosphorus-32 for skin hemangiomas and the consequent risk of side effects in these patients. Phosphorus-32 is an β emitter and is used for skin hemangioma treatment. In comparison with the few Gy per minute of the linear accelerators, the dose rate of phosphorus-32 for hemangiomas is much <1 Gy/hour; so, the latter is called low-dose-rate radiation. To achieve the therapeutic dose, continuous hours or days of radiation is necessary. For strawberry hemangiomas, the phosphorus-32 applicator was tightly placed on the lesion site for several hours until reaching therapeutic dose. The absorbed dose was estimated by radiochromic films. The absorbed dose of phosphorus-32 irradiation declined exponentially with a depth from 0 to 2.5 mm. Of the 316 patients with strawberry hemangiomas, the lesion disappeared completely within 3 months after one-time treatment in 259 cases (82%). For cavernous hemangiomas, 370KBq phosphorus-32 colloid was injected into the hemangioma each square centimeter, and the absorbed radiation was estimated by theoretical calculation. Forty-two of the 58 patients with cavernous hemangiomas (72%) had lesions that completely disappeared within 3 months after receiving one to six treatments. Thus, the phosphorus-32 for strawberry hemangiomas and the chromium phosphate-32 colloid for cavernous hemangiomas were clearly efficacious.     

"Variable echo sign" (ultrasonographical alteration of echogenicity) in cavernous hepatic hemangioma.

There are few reports describing cavernous hepatic hemangiomas with alteration of ultrasonographical imaging during examinations. We performed ultrasonographic examination of 64 cavernous hepatic hemangiomas and recognized 26 cases (41%) with an alteration of echogenicity during the examinations. We refer to this alteration of echogenicity of cavernous hepatic hemangioma as a "variable echo sign". We performed angiography of the cavernous hepatic hemangiomas with variable echo sign. Most of these imaging patterns showed mild or moderate pooling, suggesting that the alteration of echogenicity might be based on a slow blood flow exchange. We suggest that a variable echo sign is specific to ultrasonographic imaging with cavernous hepatic hemangioma and may be useful to differentiate cavernous hepatic hemangioma from other tumors.     

99^Tc^m-RBC显像对软组织血管瘤的诊断

目的：评价99^Tc^m-RBC显像在诊断软组织血管瘤中的价值。方法：回顾性分析47例行99^Tc^m-RBC血管瘤显像患者的影像资料,47例患者共53个病灶均行彩色多普勒超声检查并经术后病理确诊。结果：99^Tc^m-RBC血管瘤显像诊断软组织血管瘤灵敏度87.5%,特异度100%,阳性预测值100%,阴性预测值72.2%。彩色多普勒超声检查诊断软组织血管瘤灵敏度95.0%,特异度69.2%,阳性预测值90.5%,阴性预测值81.8%。两种方法检测灵敏度无显著性差异;99^Tc^m-RBC血管瘤显像特异性显著高于彩色多普勒超声检查。结论：99^Tc^m—RBC显像对诊断软组织血管瘤有重要价值，而且无创、简便，阳性结果意义更大。     

婴幼儿皮肤血管瘤P-32放射治疗的临床观察

目的：探讨P-32放射治疗婴幼儿皮肤血管瘤的临床效果及不良反应。方法：观察38例婴幼儿P-32放射治疗后的治疗效果及不良反应。结果：P-32放射治疗婴幼儿血管瘤一次治愈率76.3%,有效率100%。治疗中要及时注意皮肤局部损伤情况。结论：P-32放射治疗婴幼儿皮肤血管瘤方法有效,不良反应。     

Natural course of cavernous hepatic hemangioma

Cavernous hepatic hemangiomas are benign liver tumors and present as incidental findings on sonographic examinations, but little is known concerning their natural course. Therefore, we performed a clinical and imaging follow-up of 64 cases of cavernous hepatic hemangioma in 50 patients during an average 18.8 month period. One case presented a symptom of slightly right upper quadrant pain and two cases showed thrombocytopenia. In one of the thrombocytopenia cases, cavernous hepatic hemangioma was resected because of Kasabach-Merrit syndrome. No case increased in size during follow-up, but one case decreased and disappeared. These results suggested that prolonged clinical and imaging follow-up of cavernous hepatic hemangiomas may be needed.     

Cavernous hemangioma of the anus

Vascular tumors of the large bowel can be divided into malignant and benign lesions. The benign lesions can be divided into capillary and cavernous hemangiomas. Large-bowel hemangiomas are rere lesions, with the majority of cases reported in the rectum and rectosigmoid regions. Few cases of isolated anal hemangiomas are found in the literature. A case of an asymptomatic anal cavernous hemangioma, palpable on routine rectal examination and subsequently removed at proctosigmoidoscopy, is described.     

应用锁孔技术显微镜下切除颅内海绵状血管瘤：23例临床经验

背景与目的：锁孔技术是微创神经外科技术之一。本文介绍应用锁孔技术显微镜下切除颅内海绵状血管瘤的临床经验。方法：复习我们于2007～2008年间应用锁孔技术治疗各种颅内肿瘤、动脉瘤、功能性疾病150余例,对其中23例海绵状血管瘤患者进行总结分析。结果：23例中男性13例,女性10例,术后通过做磁共振检查,随访2年以上。（1）所有手术定位准确,顺利找到病灶,并得以全切除,无新的神经功能障碍产生。（2）所有手术均未输血,手术时间短,比常规开颅手术平均缩短1小时左右。（3）随访2年以上,没有一例复发。结论：显微镜下锁孔技术是神经外科常用的微创技术,正确合理的使用,能够明显提高颅内海绵状血管瘤完整切除的成功率。