^99Tc^m—MAA肺显像对深静血栓患者无症状肺栓塞的应用

目的 用^99Tc^m-大颗粒聚合白蛋白（MAA）肺灌注显像研究肾病综合征伴下肢深静脉血栓患者的无症状肺栓塞发病情况。方法 75例肾病综合征伴下肢深静脉血栓而无任何肺部疾病临床症状的患者,均经临床和超声检查证实。所有患者同时进行^99Tc^m-MAA下肢静脉和肺灌注显像,其中45例并行^99Tc^m-MAA肺通气显像。结果 （1）75例患者中有83％（62例）发生下肢Guo窝静脉以下血栓;（2）^99Tc^m-MAA肺灌注显像示61％（46例）患者发生肺栓塞（28例为单侧肺栓塞,18例为双侧肺栓塞）;（3）45例患者^99Tc^m-DTPA肺通气显像未见异常。结论 大部分肾病综合征下肢深静脉血栓患者伴有无症状性肺栓塞;对下肢深静脉血栓患者肺显像应作为常规检查。     

利用放射性核素显像分析肺栓塞病因

目的探讨肺栓塞(PE)患者肺内栓子来源以及下肢静脉病变及其他诱因与PE发病之间的关系。材料和方法对93例临床高度怀疑肺栓塞/下肢静脉病变的患者,应用99mTc-MAA和99mTc-GP,进行肺灌注-通气显像及99mTc-MAA下肢静脉显像。结果肺灌注-通气显像显示86例患者为多发性肺栓塞,7例患者肺灌注-通气显像正常;PE组中,61例有下肢深静脉病变,占70.9％,其中由下肢髂、股静脉血栓引起的PE者46例,占PE合并下肢静脉病变者的75.4％。结论放射性核素肺灌注-通气显像及下肢静脉显像的联合应用可明确PE及其病因诱因的诊断,从而减少临床PE的误漏诊率。     

下肢静脉病变与肺动脉栓塞关系的研究

目的 探讨下肢静脉病变与肺栓塞（PE）发病之间的关系。方法 对50例正常对照者和200例临床高度怀疑PE和下肢静脉病变的患者,行^99Tc^m-大颗粒聚合白蛋白（MAA）和^99Tc^m-葡聚糖酯（GP）双下肢静脉显像和肺灌注/通气显像,其中15例进行了肺动脉造影。结果 对照组下肢静脉显像和肺灌注/通气显像均显示正常,200例患者肺灌注/通气显像示：175例为多发性PE,25例正常。175例PE患者中128例有下肢静脉病变,占73.14%（128/175例）,其中下肢深静脉血栓（DVT）119例,占68.00%（119/175例）;25例非PE者均有下肢静脉病变。153例下肢静脉病变者中检出PE128例,占83.66%(128/153例）。下肢DVT 119例,其中由髂、股静脉血栓引发PE者101例,占84.87%（101/119例）。结论 双下肢静脉显像与肺灌注/通气显像联合应用,有助于PE及其病因的诊断。     

放射性核素显像对下肢深静脉病变和肺栓塞的临床观察

为研究下肢深静脉血栓形成与肺栓塞发病之间的关系，对１７１例临床诊断为下肢静脉病变者，使用９９ｍＴｃ大颗粒聚合白蛋白（ＭＡＡ）进行下肢深静脉和肺灌注显像。其中１０例行Ｘ线下肢静脉造影，１８例肺栓塞患者行ＤＳＡ检查，１５例行ＭＲＩ检查。结果：下肢深静脉及肺灌注显像可见１７１例下肢静脉病变患者中有９８例（５７３％）合并肺栓塞；９８例肺栓塞患者中股静脉以上梗阻为７９例，占８０６％。与ＤＳＡ、ＭＲＩ和Ｘ线下肢静脉造影检查的符合率分别为８８９％、８６７％和９００％。故核素下肢深静脉显像结合肺灌注显像是诊断下肢深静脉血栓和肺动脉栓塞的有效方法。     

核医学专业相关专业知识(四)

一、每题有A、B、C、D、E五个备选答案。请从中选择最佳答案。55.肺毛细血管的直径约为A、5μm B、10μm C、50μm D、100μm E、500μm56.肺灌注显像剂常用99Tcm MAA,其颗粒大小需控制在A、<10μm B、10～60μm C、60～100μm D、100～300μm E、>300μm57.肺栓塞在肺显像中的典型表现为A、灌注显像有缺损区,通气显像正常B、灌注显像正常,通气显像有缺损C、灌注和通气显像均有缺损区D、灌注和通气显像均无缺损区E、灌注和通气显像均正常58.测定肺上皮细胞通透性的理想药物是A、99Tcm EC B、99Tcm DTPA C、99Tcm HAS D、99…     

隐匿性肺栓塞—深静脉血栓形成的一种常见后果

作者报导用通气-灌注扫描法诊断58例经静脉造影证实深静脉血栓形成的隐匿性肺栓塞,并与文献所报导的430例无症状肺栓塞患者的扫描结果做了比较。作者用足背静脉造影法将下肢静脉内血栓形成的病人按发病部位分为膝上型和膝下型,并于静脉造影的12小时内行通气-灌注扫描,将~(99m)TC     

急性脑血栓性栓塞的核素显像诊断与疗效判断

目的 评价核素显像对急性肺血栓性栓塞的诊断与疗效评价的价值。方法对１０例临床确诊或可疑为肺栓塞的患者进行核素肺灌注、肺通气、肺血栓灶以及双下肢深静脉显像，４例与肺动脉造影或电子束ＣＴ结果对照。８例患者溶栓后复查肺灌注显像，２例患者昨查肺血栓灶显像，结果 肺灌注显像＋下肢深静脉显像对急性肺栓塞诊断的阳性率为１００％，与Ｘ线检查结果基本一致，溶栓后复查提示肺血流均有明显改善乃至恢复正常。结论 核素显像     

急性肺血栓性栓塞的核素显像诊断与疗效判断(附10例报告)

目的评价核素显像对急性肺血栓性栓塞的诊断与疗效评价的价值。方法对１０例临床确诊或可疑为肺栓塞的患者进行核素肺灌注、肺通气、肺血栓灶以及双下肢深静脉显像，４例与肺动脉造影或电子束ＣＴ结果对照。８例患者溶栓后复查肺灌注显像，２例患者复查肺血栓灶显像。结果肺灌注显像＋下肢深静脉显像对急性肺栓塞诊断的阳性率为１００％，与Ｘ线检查结果基本一致，溶栓后复查提示肺血流均有明显改善乃至恢复正常。结论核素显像对诊断急性肺栓塞以及判断疗效是一种准确、可靠的无创性手段。     

99Tcm-technegas肺通气显像的应用及安全性评价

99Tcm 锝气体 (technegas )为近年来使用的肺通气显像剂 ,其颗粒直径细微(5～ 2 0nm) ,大小均匀 ,末梢气管渗透能力强 ,肺通气显像效果佳。且一旦沉积在肺内 ,2 0min内不被清除 ,亦无重新分布 ,适合进行多角度及断层显像 ,并具有制备方便、价格低廉、应用范围广、能量和半衰期合适的特点。现将其应用状况和安全性简要介绍如下。一、临床应用1.99Tcm technegas显像在肺栓塞 (PE)诊断中的应用。肺血管造影术为诊断PE的“金标准” ,但属有创性 ,并有一定危险性。Bomanji等[1 ] 对 175例可疑PE患者行99Tcm technegas肺通气 灌注 (V Q)显像 …     

肺通气/灌注显像与HCTPA诊断肺动脉栓塞的价值

目的　评价核素肺通气 灌注(V Q)显像、螺旋CT肺动脉造影(HCTPA)及血浆D 二聚体在诊断肺动脉血栓中的作用。方法　临床疑为肺动脉栓塞(PE)患者4 2例,男2 6例,女16例,平均年龄( 4 9 18±16 5 6 )岁,均行核素肺V Q显像、HCTPA及血浆D 二聚体测定。其中32例患者在行肺灌注显像时,选择双足背静脉注射肺灌注显像剂,同时完成双下肢静脉显像。结果　4 2例患者中34例经临床诊断为PE ,肺V Q显像诊断PE的灵敏度、准确性和阳性预测值分别为94 12 %、90 4 8%和94 12 % ,HCTPA分别为85 2 9%、83 33%和93 5 5 % ,D 二聚体分别为5 2 94 %、5 7 14 %和90 0 0 %。32例行下肢深静脉显像的PE患者中2 0例有下肢静脉血栓。结论　肺V Q显像无创、安全、简便,诊断PE的灵敏度、准确性高。核素肺显像诊断亚肺段水平PE的能力明显高于HCTPA。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.