枇杷清肺饮加减治疗肺经风热型寻常性痤疮临床疗效

目的探讨枇杷清肺饮加减治疗肺经风热型寻常性痤疮的临床疗效。方法选取自2016年10月至2018年5月辽宁中医药大学附属第二医院皮肤科收治的100例肺经风热型寻常性痤疮患者为研究对象。根据随机数字表法将患者分为A、B两组,每组各50例。A组给予常规治疗;B组给予枇杷清肺饮加减进行治疗。比较两组患者中医症状积分及临床疗效。结果 B组患者治疗后各项中医症状积分显著优于A组,两组比较,差异有统计学意义(P<0.05)。B组有效率为90.0%(45/50),显著优于A组的80.0%(40/50),两组比较,差异有统计学意义(P<0.05)。结论枇杷清肺饮加减治疗具有疏散风热、消肿散结的功效,可有效改善肺经风热型痤疮患者的临床症状,缩小皮损面积。     

通络活血针刺法治疗卵巢早衰临床疗效观察

目的观察通络活血针刺法治疗卵巢早衰的临床疗效。方法选取武警陕西省总队医院自2014年1月至2016年12月收治的60例卵巢早衰患者为研究对象。采用随机数字表法将患者分为A、B组两组,每组各30例。A组患者进行口服克龄蒙治疗,B组患者在A组治疗基础上加用通络活血针刺法治疗。两组均连续治疗3个月,停药后观察3个月,并于治疗前及停药后3个月监测血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平,观察并记录两组患者的治疗疗效及中医症状积分变化情况。结果 B组治疗总有效率为90.0%(27/30),明显高于A组的63.3%(19/30),组间比较,差异有统计学意义(P<0.05)。停用药物3个月后,两组的中医症状积分与未治疗前比较均明显下降(P<0.05),两组间比较,差异也有统计学意义(P<0.05);两组血清FSH、LH水平均低于治疗前,两组间比较,差异无统计学意义(P>0.05);血清E2水平明显高于治疗前,两组间比较,差异有统计学意义(P<0.05)。结论针刺在改善卵巢早衰患者E2水平及中医症状方面均有一定的疗效,在改善FSH方面尚待于进一步研究。     

硝苯地平联合羟苯磺酸钙对早期2型糖尿病合并高血压患者血管内皮功能及血液流变学影响

目的探讨硝苯地平控释片联合羟苯磺酸钙对早期2型糖尿病(T2DM)合并高血压患者血管内皮功能保护作用及血液流变学的影响。方法选取自2011年1月至2018年10月收治的80例T2DM合并高血压患者为研究对象。按照随机分组原则将患者随机分为A组与B组,每组各40例。A组给予降压+降糖+改善循环等治疗;B组在A组基础上给予羟苯磺酸钙治疗。比较两组患者的空腹血糖(FBG)、餐后2 h血糖(2 h PGB)、收缩压(SBP)、舒张压(DBP)、血管舒缩张因子[一氧化氮(NO)、内皮素-1(ET-1)、血管内皮生长因子(VEGF)]浓度及其血流介导的肱动脉内皮依赖性血管舒张功能(FMD)、硝酸甘油所介导的非内皮依赖性血管舒张功能(NMD)、血液流变学指标,并评估临床疗效,记录治疗过程中不良反应。结果两组患者治疗后FBG、2 h PGB、SBP、DBP均较治疗前降低,差异有统计学意义(P<0.05)。B组治疗后NO、VEGF高于A组,ET-1低于A组,差异均有统计学意义(P<0.05)。B组治疗后FMD、NMD均高于A组,差异有统计学意义(P<0.05)。B组治疗后血液流变学指标均低于A组,差异均有统计学意义(P<0.05)。B组有效率为92.5%(37/40),显著高于A组的60.0%(24/40),两组比较,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论在早期未发生微血管病变的T2DM合并高血压患者在降糖、降压的治疗基础上,加用羟苯磺酸钙能很好的改善血管内皮功能,改善血液流变学,提高临床疗效,且安全可靠。     

小针刀联合神经妥乐平对腰椎间盘突出症术后残余神经痛炎性因子水平及腰部功能影响

目的探讨小针刀联合肌肉注射神经妥乐平对腰椎间盘突症(LDH)术后残余神经痛炎性因子水平及腰部功能影响。方法选取自2015年3月至2016年3月于承德医学院附属医院行腰椎融合术后的残余神经痛患者80例为研究对象。将患者随机分为A、B两组,每组各40例。A组患者单纯给予肌肉注射神经妥乐平治疗,B组患者给予小针刀联合肌肉注射神经妥乐平治疗。比较两组患者的治疗总有效率、治疗前后视觉模拟评分(VAS)、日本矫形外科腰痛评分(JOA)及血清炎性细胞因子的水平。结果 B组治疗总有效率为95.0%(38/40),显著高于A组的75.0%(30/40),两组比较,差异有统计学意义(P<0.05)。两组患者治疗前VAS评分及JOA评分比较,差异无统计学意义(P>0.05)。治疗后B组患者的VAS评分显著低于A组,JOA评分显著高于A组,两组比较,差异有统计学意义(P<0.05)。治疗前两组患者血清炎性细胞因子水平比较,差异均无统计学意义(P>0.05)。治疗后B组患者血清炎性细胞因子水平显著优于A组,两组比较,差异有统计学意义(P<0.05)。结论小针刀联合肌肉注射神经妥乐平治疗LDH术后残余神经痛患者疗效显著,能够显著改善患者的腰部功能,降低患者血清炎性细胞因子水平。     

阿奇霉素联合BiPAP无创呼吸机治疗慢性阻塞性肺疾病合并肺源性心脏病临床效果观察

目的探讨阿奇霉素联合BiPAP无创呼吸机治疗慢性阻塞性肺疾病合并肺源性心脏病的临床效果。方法选取凉山彝族自治州第一人民医院自2016年5月至2017年12月收治的80例慢性阻塞性肺疾病合并肺源性心脏病患者为研究对象,将患者随机分入A组和B组,每组各40例。A组患者在常规治疗基础上应用阿奇霉素,B组患者在A组基础上接受BiPAP无创呼吸机治疗。比较两组患者的治疗有效率、急性加重次数、肺功能相关指标、血气相关指标、脑尿钠肽水平及不良反应发生率。结果治疗后,A组有效率为80.0%(32/40),B组有效率为95.0%(38/40),差异有统计学意义(P<0.05)。B组急性加重次数为(2.26±0.36)次,少于A组的(3.17±0.41)次,差异有统计学意义(P<0.05)。两组患者治疗3、6个月后,B组的第一秒钟用力肺活量占预计值百分比、第一秒钟用力肺活量占用力肺活量比值、最大呼气峰流速均高于A组,差异有统计学意义(P<0.05)。治疗后,两组患者的氧分压、血氧饱和度均高于治疗前,且B组高于A组,差异有统计学意义(P<0.05);两组患者的二氧化碳分压均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗6个月后,B组脑尿钠肽水平明显低于A组,差异有统计学意义(P<0.05);与治疗前比较,A组和B组治疗6个月后的脑尿钠肽水平均明显降低,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿奇霉素联合BiPAP无创呼吸机治疗慢性阻塞性肺疾病合并肺源性心脏病临床效果显著,可改善患者肺功能,缓解心力衰竭症状。     

皮内针干预在血液透析合并高血压患者中临床应用

目的探讨皮内针干预治疗血液透析合并高血压的方法及临床疗效。方法选取自2015年1月至2016年7月在辽宁中医药大学附属第二医院血液净化室行维持性血液透析(MHD)的60例患者为研究对象。将所有患者随机分为A组(n=30)和B组(n=30)。A组行常规西医治疗,B组在A组基础上给予皮内针干预治疗。所有患者分别于治疗前、后测量血压,观察并比较两组患者血压达标率及血压变化情况。结果 A组中2例患者失访,B组中3例患者失访。B组血压达标率为40.7%(11/28),显著高于A组的14.8%(4/27),两组间比较,差异有统计学意义(P<0.05)。B组治疗后收缩压及舒张压均显著低于A组,两组间比较,差异均有统计学意义(P<0.05)。结论在常规透析和降压药物治疗的基础上,采用皮内针疗法能有效降低血液透析合并高血压患者的血压,从而提高血压达标率。     

血必净联合乌司他丁治疗感染性休克临床效果观察

目的观察血必净联合乌司他丁治疗感染性休克的临床效果。方法选取长沙市第一医院自2016年6月至2018年6月收治的98例感染性休克患者为研究对象,按照随机数字表法将患者分为A组和B组,每组49例。在常规的化痰、止咳、吸氧、维持水电解质/酸碱平衡、适量糖皮质激素等治疗基础上,A组患者接受血必净治疗,B组患者接受血必净联合乌司他丁治疗。比较两组患者血流动力学指标、炎症因子指标以及存活率。结果与治疗前比较,两组患者治疗后的氧合指数、平均动脉压升高,心率降低,差异有统计学意义(P<0.05);治疗后,B组患者的氧合指数、平均动脉压、心率均低于A组,差异有统计学意义(P<0.05)。两组患者治疗后的白细胞介素-6、超敏C反应蛋白、肿瘤坏死因子-α水平均低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。A组、B组患者治疗30 d后的存活率分别为83.67%(41/49)、91.84%(45/49),两组存活率比较,差异无统计学意义(P>0.05)。结论血必净联合乌司他丁治疗感染性休克可维持患者血流动力学稳定,显著改善炎症因子水平。     

低分子肝素对肺源性心脏病伴呼吸衰竭患者呼吸机治疗影响研究

目的探讨低分子肝素对肺源性心脏病伴呼吸衰竭患者呼吸机治疗的影响。方法选取南京大学医学院附属鼓楼医院自2016年1月至2018年7月收治的95例肺源性心脏病伴呼吸衰竭患者为研究对象。按照随机数字表法,将患者分入A组(n=45)和B组(n=50)。A组患者接受常规处理和呼吸机治疗,B组患者在A组基础上联合低分子肝素钙进行治疗,两组均连续治疗1周。比较两组临床有效率,治疗前后的血气和炎症指标,以及不良反应发生情况。结果治疗后,B组有效率92.0%(46/50)高于A组的75.6%(34/45),差异有统计学意义(P<0.05)。治疗后,A组和B组二氧化碳分压均明显低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗后,A组和B组氧分压均明显高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。A组和B组治疗前后pH值比较,差异均无统计学意义(P>0.05)。治疗后,A组和B组C反应蛋白、降钙素原、白细胞介素-6均明显低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论低分子肝素对肺源性心脏病伴呼吸衰竭患者呼吸机治疗有积极影响,可改善患者血气和炎症指标,且安全性好。     

冠状动脉内注射小剂量重组尿激酶原治疗急性ST段抬高型心肌梗死临床效果观察

目的探讨冠状动脉内注射小剂量重组尿激酶原治疗急性ST段抬高型心肌梗死的临床效果。方法选取徐州医科大附属沭阳县人民医院自2018年1月至2019年2月收治的86例急性ST段抬高型心肌梗死患者为研究对象。根据治疗方法不同,将患者分入A组和B组,每组各43例。A组患者接受常规治疗,B组患者在常规治疗基础上联合冠状动脉内注射小剂量重组尿激酶原治疗。比较两组患者的治疗有效率,术后4、8、12、24 h和术后1、3个月6个时间点的心肌酶、心电图QT离散度、血浆B型脑钠肽、左室射血分数,心肌梗死溶栓(TIMI)血流分级,ST段回落和再通情况,以及主要不良心血管事件发生率。结果 B组治疗有效率为95.4%(41/43),高于A组的76.7%(33/43),差异有统计学意义(P<0.05)。治疗后,两组患者心肌酶、心电图QT离散度、血浆B型脑钠肽在术后4、8、12、24 h和术后1、3个月这6个时间点呈逐渐下降趋势,各时间点比较,差异均有统计学意义(P<0.05);且B组低于A组,差异有统计学意义(P<0.05)。治疗后,两组患者左室射血分数在术后4、8、12、24 h和术后1、3个月这6个时间点呈逐渐上升趋势,各时间点比较,差异均有统计学意义(P<0.05);且B组高于A组,差异有统计学意义(P<0.05)。B组TIMI血流分级2～3级所占比例为95.4%(41/43),高于A组的79.1%(34/43),差异有统计学意义(P<0.05)。B组患者ST段回落≥50%者所占比例为81.4%(35/43),高于A组的60.5%(26/43),差异有统计学意义(P<0.05);B组ST段完全回落者所占比例为55.8%(24/43),高于A组的34.9%(15/43),差异有统计学意义(P<0.05);B组再通者所占比例为76.7%(33/43),高于A组的55.8%(24/43),差异有统计学意义(P<0.05)。B组主要不良心血管事件发生率为7.0%(3/43),低于A组的18.6%(8/43),差异有统计学意义(P<0.05)。结论冠状动脉内注射小剂量重组尿激酶原治疗急性ST段抬高型心肌梗死的临床效果显著,可有效改善患者心功能和心肌灌注,减少出血风险,降低主要不良心血管事件发生率。     

伽马刀联合DC-CIK对局部淋巴结转移性食管癌患者免疫功能影响研究

目的探讨伽马刀联合DC-CIK对局部淋巴结转移性食管癌患者免疫功能的影响。方法选取2011年4—6月武警辽宁省总队医院收治的120例局部淋巴结转移性食管癌患者为研究对象,随机分入A组和B组,每组60例。A组患者接受伽马刀治疗,B组患者在A组基础上接受DC-CIK治疗,连续治疗4个周期。比较两组患者治疗后的近期客观有效率、疾病控制率和远期存活率,以及治疗前后的免疫相关指标等。结果治疗后,A组客观有效率为67.3%(37/55)、疾病控制率为90.9%(50/55),B组客观有效率为80.0%(40/50)、疾病控制率为94.0%(47/50),两组比较,差异无统计学意义(P>0.05)。随访1、3、5年时,A组存活率分别为56.4%(31/55)、12.7%(7/55)、1.8%(1/55),B组存活率分别为86.0%(43/50)、32.0%(16/50)、6.0%(3/50),两组比较,差异有统计学意义(P<0.05)。治疗后,两组患者的CD3、CD8、CD56/CD3、CD16/CD3、IgG、IgM、IgA均较治疗前升高,且B组高于A组,差异有统计学意义(P<0.05);CD4、CD4/CD8均较治疗前下降,且B组低于A组,差异有统计学意义(P<0.05)。结论伽马刀联合DC-CIK治疗局部淋巴结转移性食管癌临床效果显著,可改善患者免疫系统功能。     

A case of double cancers with myocardial metastasis mimicking acute myocardial infarction both on an electrocardiogram and on Tc-99m-MIBI myocardial SPECT

We report a rare case of double cancers with myocardial metastasis presenting acute myocardial infarction (AMI)-like findings both on an electrocardiogram (ECG) and on Tc-99m-MIBI myocardial SPECT. The ECG showed abnormal Q-waves and ST-segment elevation in leads V1-V4, and Tc-99m-MIBI SPECT showed a photon deficient area in the anteroseptum. These findings were suggestive of AMI, but the patient had been simultaneously suffering from two adenocarcinomas, which were lung cancer and gastric cancer, and consecutive ultrasonic cardiography (UCG) demonstrated a growing mass lesion in the septal aspect of the left ventricle. After a month he died of severe heart failure. The histological diagnosis of a specimen of the cardiac mass lesion was invasive adenocarcinoma infiltrating to the heart, which revealed that the myocardial metastasis had mimicked AMI. This case shows that it is difficult to distinguish between myocardial infarction and myocardial metastasis with myocardial perfusion SPECT. It is necessary to consider the possibility of myocardial metastasis when a patient with malignancy presents AMI-like findings.     

Automated quantitative coronary computed tomography correlates of myocardial ischaemia on gated myocardial perfusion SPECT

Purpose

Automated software tools have permitted more comprehensive, robust and reproducible quantification of coronary stenosis, plaque burden and plaque location of coronary computed tomography angiography (CTA) data. The association between these quantitative CTA (QCT) parameters and the presence of myocardial ischaemia has not been explored. The aim of the present investigation was to evaluate the association between QCT parameters of coronary artery lesions and the presence of myocardial ischaemia on gated myocardial perfusion single-photon emission CT (SPECT).

Methods

Included in the study were 40 patients (mean age 58.2?±?10.9 years, 27 men) with known or suspected coronary artery disease (CAD) who had undergone multidetector row CTA and gated myocardial perfusion SPECT within 6 months. From the CTA datasets, vessel-based and lesion-based visual analyses were performed. Consecutively, lesion-based QCT was performed to assess plaque length, plaque burden, percentage lumen area stenosis and remodelling index. Subsequently, the presence of myocardial ischaemia was assessed using the summed difference score (SDS ≥2) on gated myocardial perfusion SPECT.

Results

Myocardial ischaemia was seen in 25 patients (62.5 %) in 37 vascular territories. Quantitatively assessed significant stenosis and quantitatively assessed lesion length were independently associated with myocardial ischaemia (OR 7.72, 95 % CI 2.41–24.7, p?<?0.001, and OR 1.07, 95 % CI 1.00–1.45, p?=?0.032, respectively) after correcting for clinical variables and visually assessed significant stenosis. The addition of quantitatively assessed significant stenosis (χ ²?=?20.7) and lesion length (χ ²?=?26.0) to the clinical variables and the visual assessment (χ ²?=?5.9) had incremental value in the association with myocardial ischaemia.

Conclusion

Coronary lesion length and quantitatively assessed significant stenosis were independently associated with myocardial ischaemia. Both quantitative parameters have incremental value over baseline variables and visually assessed significant stenosis. Potentially, QCT can refine assessment of CAD, which may be of potential use for identification of patients with myocardial ischaemia.     

川芎嗪对缺血再灌注大鼠心肌细胞凋亡的影响

 目的 观察川芎嗪(Tetramethylpyrazine,TMP)对缺血心肌细胞凋亡以及病理组织学改变的作用.方法 采用大鼠心肌缺血再灌注(Myocardial ischemic reperfusion,MIR)损伤模型,用缺口末端标记技术(TDT-mediated dUTP nick end labeling,TUNEL)法检测MIR过程中不同时间点缺血心肌细胞凋亡的动态变化及川芎嗪对其影响,并采用电镜观察其病理组织学改变进行对照研究.结果 (1)非缺血心肌无TUNEL阳性细胞出现,MIR 60 min大鼠缺血心肌中可见TUNEL阳性细胞,120 min时TUNEL阳性细胞数目最多.(2)与单纯MIR大鼠相比,川芎嗪干预MIR大鼠缺血心肌细胞中TUNEL阳性细胞数明显减少,心肌缺血再灌注60 min时分别为(36.30±8.76)个,张和(24.70±7.15)个/张(P<0.05),120 min时分别为(48.43±23.87)个/张和(10.04±8.11)个,张(P<0.01).(3)电镜结果显示MIR 60 min时,心肌缺血性改变最明显,川芎嗪干预大鼠再灌注组心肌缺血损伤有一定减轻.结论 心肌缺血再灌注可诱导心肌细胞发生凋亡,且随再灌注时间的延长,心肌细胞凋亡数目逐渐增多.川芎嗪干预可使缺血心肌细胞凋亡减少,病理组织学改变亦有减轻.     

心肌灌注断层显像与运动心电图ST段移位检测心肌缺血部位比较

目的　探讨运动心肌灌注断层显像与运动心电图ST段移位检测心肌缺血部位的一致性。方法　心肌灌注异常和ST段移位患者 3 0 2例 ,将ST段移位所在心肌部位与灌注异常部位进行相关性比较。结果　 40例ST段抬高的患者常有心绞痛史 ,并且易为运动诱发 ,运动持续时间较短(P <0 .0 5 )。ST段压低的部位与灌注异常的部位之间存在弱一致性 (Κ =0 .3 6,P <0 .0 1) ;左前降支(LAD)支配节段的灌注异常最常伴有前壁ST段压低 (χ2 =60 6.5 ,P <0 .0 5 ) ;ST段抬高与心肌灌注异常在病变定位上完全一致 (Κ =1.0 0 ,P <0 .0 1)。结论　ST段压低与灌注异常的定位一致性差 ,而ST段抬高则与灌注异常定位显著一致。     

The influence of findings of coronary artery on myocardial salvage in acute myocardial infarction]

201Tl stress myocardial scintigraphy was performed in convalescent patients with acute myocardial infarction, to evaluate the influence of stenosis and collateral circulation of coronary artery in acute phase, on myocardial salvage in chronic phase. In 14 cases of unsuccessful coronary revascularization (complete occlusion), a complete defect of thallium imaging in chronic phase was seen in only one case of four cases with good collateral circulation, while eight of 10 cases with poor collateral circulation. In 16 cases of poor collateral circulation, six cases showed a complete defect, although the target vessel had improved to less than 75% of stenosis. However, in cases of good collateral circulation, no case showed a complete defect when the target vessel had improved to less than 75% of stenosis. The myocardial salvage is quite possible (p less than 0.05), when the coronary angiography in acute phase showed the forward flow (99% or 90% of stenosis) before coronary revascularization and/or good collateral circulation (Rentrop 2 degrees or 3 degrees).     

Assessment of myocardial viability after myocardial infarction

Conclusions  The data presented above suggest that assessment of myocardial viability after MI, particularly in those patients with severe LV dysfunction, is important for the identification of those with the highest risk, in whom revascularization can be of clinical benefit. There is growing and consistent evidence that patients with relatively large areas of dysfunctional but viable myocardium after MI have improved function, symptoms, and survival with prompt revascularization compared with medical therapy alone. Most importantly, long-term survival with revascularization in these patients is comparable with that achieved with cardiac transplantation. There are several methods available to the clinician with which to investigate the presence of tissue viability, and the evidence suggests that the scintigraphic approaches are the most sensitive. These observations suggest that noninvasive investigation of the amount of ischemic myocardium should be an important component of the diagnostic evaluation of patients with severe LV dysfunction after MI. This approach will likely enhance the often difficult process of selecting patients with poor cardiac function in whom revascularization will likely improve both the quality and quantity of life.     

The impact of sex and myocardial ischemic preconditioning on immunohistochemical markers of acute myocardial infarction

International Journal of Legal Medicine - The immunohistochemical detection of dityrosine, troponins I (cTNI) and T (cTnT), and connexin 43 has been proposed as a tool for the diagnosis of...     

Evidence of acute myocardial infarction on CT

Improvements in CT technology, specifically with respect to the development of multi-row detector CT, have increased the ability to detect acute myocardial ischaemia. This case report details the finding of decreased myocardial enhancement on CT in a patient who complained of acute chest symptomalogy and was diagnosed with acute myocardial infarction, which was subsequently confirmed by cardiac catheterization. Given the variability of the clinical presentation of acute myocardial infarction, greater attention should be paid by radiologists to myocardial enhancement in patients with significant coronary risk factors, as evidence of acute myocardial infarct or ischaemia may be detected.     

Noncardiac findings on dual-isotope myocardial perfusion SPECT

BACKGROUND: This study examined the frequency of reporting noncardiac findings (NCFs), such as malignancies from inspection of raw projection images with dual-isotope single photon emission computed tomography (SPECT) perfusion imaging, which could potentially be of greater clinical importance than myocardial perfusion imaging alone. Dual-isotope (ie, rest thallium 201 and stress technetium 99m sestamibi [MIBI] or Tc-99m tetrofosmin [TET]) SPECT myocardial perfusion imaging combines multipotential tracers for noncardiac purposes (Tl-201 for renal or splenic imaging, inflammation, or lymphoma and MIBI or TET for hepatobiliary imaging and detecting increased mitochondrial number or activity in neoplastic processes). These images are optimally interpreted with cinematic inspection of the raw projection data, but this may not be practiced uniformly in every laboratory. METHODS AND RESULTS: We reviewed 12,526 computer-generated text reports of dual-isotope perfusion SPECT studies from a 6-year period for NCFs. NCFs were categorized by organ and by probability of malignancy: high (eg, focal breast or lung uptake of MIBI or TET), intermediate (eg, lymph node uptake or thyroid abnormalities), or low (eg, filling defects in liver, kidney, spleen, or gall bladder; ascites; or pleural effusions). Confirmatory imaging studies or clinical confirmation for each NCF was sought. There were a total of 207 NCFs identified in 180 reports (1.7% of reports, ranging from 0% to 2.8% of reports of individual interpreters). Of these, 107 NCFs were unsuspected before SPECT; 24% were considered at high probability for malignancy, and 24% were considered intermediate in likelihood of malignancy. Follow-up data were available for 178 NCFs, confirming 88% of these findings, including 82% of breast foci, 62% of lung foci, 86% of hepatobiliary/spleen abnormalities, and 94% of renal abnormalities. The probability of malignancy was highest (82%) in breast or lung foci in which uptake of both Tl-201 and the Tc-99m-labeled agent was present. CONCLUSIONS: In patients referred for evaluation of myocardial perfusion, NCFs are unusual and require systematic and careful inspection of projection images for their detection. With Tl-201, TET, MIBI, or dual-isotope imaging, detecting and reporting NCFs may occasionally result in life-saving early cancer identification.