不同注射方法注射显像剂对放射性药物剂量准确性和辐射防护的影响

目的探讨不同注射方法注射显像剂对放射性药物剂量准确性和辐射防护的影响。方法选取2014年1月~12月在我院进行正电子发射计算机断层-X线计算机体层成像(PET-CT)检查的180例患者,随机分为对照组和研究组,每组90例。研究组采用改良注射法。对照组采用直接注射法。均采用18 F-FDG作为显像剂,剂量(7.2±0.2)mci。分别采用活度计测量注射器和针头内残留放射性药物的残留放射性活度,记录接触放射性显像剂时间。结果研究组注射后注射器内的残留放射性活度低于对照组,有显著性差异(P0.05);两组接触放射性显像剂时间比较无显著性差异(P0.05)。结论改良注射法可以减少注射器和针头内药物的残留量及残留放射性活度,保障成像质量的同时不会增加注射人员接触辐射的时间,有利于医护人员的健康。     

单光子发射型计算机断层显像剂注入剂量准确性的分析

目的研究探讨在单光子发射型计算机断层(SPECT)检查前注射放射性显像剂时,不抽回血与抽回血两种直接注射方法对注射器内的放射性显像剂残留量的影响。方法对114例患者注射99mTc-标记化合物,将其分为抽回血组(57例)和不抽回血组(57例)。测量抽回血和不抽回血两种情况下,注射器内放射性残留量。结果不抽回血时,注射器内放射性显像剂残留放射性活度(3.39±0.57)mCi,均明显高于抽回血组的(1.49±0.29)mCi,两组间差异有显著性意义(P=0.000,双侧)。结论在使用直接注射法注射SPECT显像剂时,抽回血能显著减少注射器内放射性显像剂残留放射性活度。     

PET/CT检查采用不同静脉注射法注射18F-FDG显像剂的准确性和辐射防护影响

目的探讨PET/CT检查采用不同静脉注射法注射18F-FDG显像剂的准确性和辐射防护影响。方法选取2017年6—7月在我院接受检查的的70例PET/CT受检者为研究对象,随机将其等分为观察组和对照组,观察组患者采用改良直接注射法,对照组患者采用三通管注射法,显影剂均采用18F-FDG(7. 2±0. 2) m Ci,比较两组患者注射器内残留药物放射性活度,同时,采用活度计测量记录其放射性显影剂时间。结果观察组患者注射器内残余药物放射性明显低于对照组,差异有统计学意义(P 0. 05);但两组患者放射性显像时间比较,差异无统计学意义(P 0. 05)。结论对于PET/CT检查者采用改良直接法,可有效降低注射器内18F-FDG显像剂的残余量和放射性活度,与三通管注射法相比注射剂量精准,但临床操作中遭受残余药物辐射时间不会增加,值得临床推广应用。     

全身骨显像剂注射方法对剂量准确性和辐射防护的影响

目的研究单光子发射型计算机断层成像术(SPECT)全身骨显像患者采用不同注射方法注射显像剂对放射性药物剂量准确性和辐射防护的影响。方法 按随机数字表,将行SPECT全身骨显像的100例患者分为两组,每组50例。其中研究组采用抽回血注射法,对照组采用头皮针注射法,显像前2～3h两组均注射99mTC-亚甲基二磷酸盐(MDP)作为显像剂,剂量20mci(740MBq),体积0.5ml。A、B两组注射后均立即用Χ-Υ辐射仪测量注射器及针头内残留放射性药物的残余辐射量,用活度计测量残留放射性药物的残余放射性活度,并记录静脉注药时间。结果研究组注射后注射器内的残余放射性活度及残余辐射量均低于对照组,差异有统计学意义(P<0.01);研究组注药时间短于对照组,差异也有统计学意义(P<0.01)。结论抽回血注射法与头皮针注射法相比,既减少了注射器内放射性药物的残留量和残余放射性活度,保证了成像质量,也缩短了注射人员接触射线的剂量和时间,有利于辐射防护。     

可回抽自毁注射器在正电子发射断层显像检查中的应用

[目的]分析正电子发射计算机断层-X线透射计算机断层(PET-CT)检查中使用可回抽自毁注射器对实际注入剂量精确性和成像质量的影响,以及注射操作者发生针刺伤的几率,探索适宜的注射放射性核素的注射器,以提高显像质量,做好注射工作的辐射防护。[方法]选取148例PET-CT检查病人,随机分成两组,试验组采用一次性无菌可回抽自毁注射器,对照组采用普通无菌注射器,分别测量注射后注射器内残留的放射性活度,密切观察扫描仪计数率,记录注射操作人员发生针刺伤的例数。[结果]试验组所使用的可回抽自毁注射器残留放射性活度极微,注射操作人员发生针刺伤的例数均低于对照组,组间差异有统计学意义(P0.05);两组肝脏扫描计数率均较高,组间差异无统计学意义(P0.05)。[结论]使用可回抽自毁注射器注射放射性核素注入剂量精确,方法稳妥,利于显像检查和辐射防护,符合医院感染控制要求。     

可回抽自毁注射器在正电子发射断层显像检查中的应用

[目的]分析正电子发射计算机断层 X线透射计算机断层（PET CT）检查中使用可回抽自毁注射器对实际注入剂量精确性和成像质量的影响,以及注射操作者发生针刺伤的几率,探索适宜的注射放射性核素的注射器,以提高显像质量,做好注射工作的辐射防护。[方法]选取148例PET CT检查病人,随机分成两组,试验组采用一次性无菌可回抽自毁注射器,对照组采用普通无菌注射器,分别测量注射后注射器内残留的放射性活度,密切观察扫描仪计数率,记录注射操作人员发生针刺伤的例数。[结果]试验组所使用的可回抽自毁注射器残留放射性活度极微,注射操作人员发生针刺伤的例数均低于对照组,组间差异有统计学意义（P〈0.05）;两组肝脏扫描计数率均较高,组间差异无统计学意义（P〉0.05）。[结论]使用可回抽自毁注射器注射放射性核素注入剂量精确,方法稳妥,利于显像检查和辐射防护,符合医院感染控制要求。     

兔坐骨神经慢性卡压的高频超声与病理学观察

目的 观察99mTc-DTPA-DG是否进入肿瘤细胞核,验证其用于肿瘤显像的潜在可行性.方法 将体外培养的肺癌细胞Calu-3分为5组:A组为99mTc-DTPA-DG组,B组为18F-FDG组,C组为99mTc-DTPA组,D组为99mTcO-4组,E组为生理盐水组.每组各设3个浓度,即每孔加入放射性药物5、10、20 μCi/0.10 ml,对照组加入同等量生理盐水,每组各设5个复孔.加入各种药物及生理盐水2 h后消化收集细胞,检测各组细胞放射性计数后,分离细胞核,检测细胞核的放射性计数,分离的细胞核涂片行苏木素伊红(HE)染色后镜检.结果 镜检结果显示细胞核计数占细胞总计数的比例达95%.γ测量仪检测显示肺癌细胞Calu-3对99mTc-DTPA-DG和18F-FDG各放射性活度组的摄取均明显高于99mTc-DTPA、99mTcO-4及生理盐水组,差异有统计学意义(P<0.05).细胞核计数结果显示99mTc-DTPA-DG组进入细胞核比率明显高于18F-FDG组(P<0.05).结论 99mTc-DTPA-DG可以进入肿瘤细胞核,故可降低肿瘤诊断的假阳性率,在区分炎症与肿瘤方面有价值,是一种潜在的可用于肿瘤显像的靶向分子显像剂.     

肺癌Calu-3细胞核摄取99mTc-DTPA-DG实验研究

目的 观察99mTc-DTPA-DG是否进入肿瘤细胞核,验证其用于肿瘤显像的潜在可行性.方法 将体外培养的肺癌细胞Calu-3分为5组:A组为99mTc-DTPA-DG组,B组为18F-FDG组,C组为99mTc-DTPA组,D组为99mTcO-4组,E组为生理盐水组.每组各设3个浓度,即每孔加入放射性药物5、10、20 μCi/0.10 ml,对照组加入同等量生理盐水,每组各设5个复孔.加入各种药物及生理盐水2 h后消化收集细胞,检测各组细胞放射性计数后,分离细胞核,检测细胞核的放射性计数,分离的细胞核涂片行苏木素伊红(HE)染色后镜检.结果 镜检结果显示细胞核计数占细胞总计数的比例达95%.γ测量仪检测显示肺癌细胞Calu-3对99mTc-DTPA-DG和18F-FDG各放射性活度组的摄取均明显高于99mTc-DTPA、99mTcO-4及生理盐水组,差异有统计学意义(P<0.05).细胞核计数结果显示99mTc-DTPA-DG组进入细胞核比率明显高于18F-FDG组(P<0.05).结论 99mTc-DTPA-DG可以进入肿瘤细胞核,故可降低肿瘤诊断的假阳性率,在区分炎症与肿瘤方面有价值,是一种潜在的可用于肿瘤显像的靶向分子显像剂.     

联合99mTc-MIBI与99mTcO-4显像鉴别甲状腺结节的临床价值

目的：探讨核医学99mTcO-4与99mTc-MIBI联合显像鉴别甲状腺结节良恶性的临床价值。方法对入选的40例甲状腺结节病例术前行甲状腺99mTcO-4显像、99mTc-MIBI显像,根据结节的99mTc-MIBI与99mTcO-4摄取值,计算99mTc-MIBI /99mTcO-4摄取比值（即M/T值）。根据术后病理,分析M/T值及血清人促甲状腺激素（hTSH）水平与结节良恶性的关系。结果40例中,5例甲状腺结节M/T比值≥2.0,病理结果为恶性结节（乳头状癌、滤泡状癌）,与M/T值存在相关性（P〈0.05）;其余35例为良性结节（腺瘤、囊腺瘤）,M/T值均〈2.0。联合甲状腺99mTcO-4和99mTc-MIBI显像诊断甲状腺恶性结节的灵敏度为100%,特异度为94.3%,准确率为95%。良性结节与hTSH水平增高有关（P〈0.05）。结论联合甲状腺99mTcO-4和99mTc-MIBI显像可对甲状腺结节的良恶性进行鉴别诊断,具有临床应用价值。     

正电子发射断层显像检查中显像剂的两种注射方法比较

目的分析正电子发射计算机断层-X线透射计算机断层(Positron Emission Tomography-X Computer Tomography,PET-CT)检查中12F-2-氟-2-脱氧-D-葡萄糖(18F-2-fluoro-2-deoxy-D-glucose,18F-FDG)两种注射方法对实际注入剂量准确性和成像质量的影响,以及注射操作者受辐射时间的差异,探索适宜的注射操作方法,以提高显像质量,做好注射工作的辐射防护。方法选取进行PET-CT检查的患者150例,随机分成两组,检查前注射18F-FDG,剂量(7.2±0.2)mCi,体积0.5ml。实验组采用间接注射法,对照组采用直接注射抽回血再注射法。分别测量注射后注射器内残留的放射性活度,记录注射操作人员完成每例注射直接接触18F-FDG时间。从PET-CT采集图像观察记录受检者皮肤有无放射性污染及皮下血管外漏情况。结果实验组注射操作人员直接接触18F-FDG时间、药物皮下血管外漏和皮肤放射性污染均低于对照组,组间差异有统计学性意义(P<0.05);而注射器内残留放射性活度均较少,组间差异无统计学意义(P>0.05)。结论间接注射法注入剂量精确、方法稳妥,利于显像检查和辐射防护。     

In vitro characteristics of volume-reduced platelet concentrate stored in syringes

For convenience, small volumes of platelet concentrate (PC) intended for neonatal patients are often dispensed in syringes. The PC, however, may remain in the syringe for up to several hours before the actual transfusion. As there are few data on the effect of such syringe storage on PCs, the in vitro syringe storage properties of small volumes of 1- and 5-day-old units, and volume-reduced units of PC were evaluated. In four separate experiments, PCs were stored in syringes in volumes of 10, 15, or 30 mL for up to 6 hours at 20 to 24 degrees C without agitation. Platelets were evaluated for pH, platelet count, and a variety of biochemical and in vitro functional assays. Results showed that even with the equivalent of a full unit of platelets stored in the syringe for up to 6 hours, the pH did not fall below 6.0. Although there was an increase in lactate production and consumption of glucose, which paralleled the decline in pH, the changes were not greater than those seen in platelets stored up to 5 days in gas-permeable blood bags. Similar results were seen for PCs stored in syringes for 6 hours at 37 degrees C. All of the pH levels recorded at the end of 6 hours of syringe storage were above the minimum required level of pH 6.0. Data from in vitro platelet assays imply that at any time during their shelf life, PCs can be stored in gas-impermeable polypropylene syringes for up to 6 hours and can maintain acceptable storage characteristics; in vivo data are needed to confirm these observations.     

不同品牌一次性1 ml注射器残余药液的研究

[目的 ]了解不同品牌一次性 1ml注射器死腔容量及残余药量。 [方法 ]收集 5种品牌 6种批号的一次性1ml注射器 ,分成 6组 ,每组随机抽取注射器各 3 0支 ,测定其死腔容量及残余药量。 [结果 ] 6组注射器的死腔容量之间存在差异 (P <0 .0 1) ,且平均死腔容量为 0 .0 45ml～ 0 .0 66ml。[结论 ]不同品牌及针头型号的一次性1ml注射器死腔容量及残余药量不同。临床使用时应先测定其死腔容量 ,以保证使用药物剂量的准确性。     

Potential preanalytical errors in whole-blood analysis: Effect of syringe sample volume on blood gas,electrolyte and lactate values

Background: Arterial blood samples are sensitive to bias because of the physiological properties of blood. Several errors can occur in the preanalytical phase leading to incorrect diagnosis and improper treatment of patients. Collection of a blood specimen, as well as its handling and transport, belong to the key factors to affect the accuracy and good quality of clinical laboratory analysis. Methods: The aim of this study was to validate the effect of different sample volumes on the blood gas, electrolyte and lactate values using 3mL Rapidlyte plastic syringes with filter cap and Rapidlab 865 blood gas analyser. Also, the stability of blood gas analyser parameters with different sample volume was studied. Results: No substantial change in blood gas, electrolyte and lactate parameters was found when the results of 3mL, 1.8mL sample volumes in the 3mL syringes were compared. The sample volume of 1.0mL or 1.5mL in the 3mL syringe is not suitable for the measurement of oxygen tension, especially when accurate results of pO₂ and arterial blood is needed for patient's diagnosis. Conclusions: The minimum sample volume when blood gases, electrolytes and lactate are all measured with the Rapidlab system should be 1.8mL using 3mL Rapidlyte plastic syringe with filtercap. According to this study <1.8mL sample volumes can provide inaccurate results and can impose biases on measurements.     

Use of a large bore syringe creates significantly fewer high intensity transient signals (HITS) into a cardiopulmonary bypass system than a small bore syringe

INTRODUCTION: High intensity transient signals (HITS) have been reported to occur following perfusionist intervention during cardiac surgery. This study investigates the relationship of the syringe bore, injection rate, and HITS created. METHODS: Syringes (10 mL) with a male luer-lock connection (Large Bore) and Abboject 'jet syringes' with a 20 GA needle and male luer-lock connector (Small Bore) were filled with 10 mL of 0.9 N saline. A perfusionist was randomly assigned a set of four similar syringes followed by the other syringe bore. Each of the four syringes was injected into an in vitro saline-primed cardiopulmonary bypass (CPB) system over 5, 10, 15, or 20 sec. Sixteen randomizations of small and large bore syringes were completed at the four injection times (128 injections). HITS in the CPB arterial line were detected with transcranial Doppler (TCD) probes, were recorded for the 2 min following the injection, and were counted independently off-line by two reviewers. RESULTS: The use of a large bore syringe compared to a small bore syringe created significantly fewer HITS (29 +/- 6 versus 145 +/- 17 [mean +/- SEM], p<0.001) introduced into the CPB arterial line. Injection over a longer time produced significantly fewer HITS than shorter injection times (p<0.001). CONCLUSION: Significantly fewer HITS are introduced into the CPB system by using standard syringes and slower injection time.     

Stability of dopamine hydrochloride 0.5 mg/mL in polypropylene syringes

OBJECTIVE: To determine the stability of dopamine hydrochloride diluted to 0.5 mg/mL in isotonic glucose infusion and stored in 50 mL polypropylene syringes from two different suppliers. METHODS: Polypropylene syringes containing dopamine hydrochloride 0.5 mg/mL were stored protected from light at 25 degrees C/60% relative humidity for 1 week, at 4 degrees C/ambient humidity for 3 months and at -20 degrees C/ambient humidity for 6 months. Samples were periodically withdrawn and the concentration of dopamine hydrochloride determined using a stability-indicating high-performance liquid chromatography method. The appearance of the solutions with respect to colour, clarity and precipitation was studied and the pH of the solutions measured. RESULTS: The concentration of dopamine hydrochloride in the solutions remained at least 95% of the initial concentration after storage at 25 degrees C for 1 week and at 4 degrees C for 3 months. Variation in dopamine concentration was observed in syringe samples, stored frozen, from two suppliers. The mean concentration was >/=95% for product stored in syringes from Codan and >/=90% of initial concentration when stored in syringes from Braun. In some of the syringes from Braun, the concentration was lower than 90%. The samples in all syringes had to be homogenized after thawing to give a uniform solution. There were no other evident changes in the physical appearance or pH of the solutions during the study. CONCLUSION: Dopamine hydrochloride 0.5 mg/mL in isotonic glucose solution is stable when protected from light for 1 week at 25 degrees C/60% relative humidity and for 3 months at 4 degrees C/ambient humidity in Codan and Braun syringes. The cause of content variability observed in solutions stored frozen in Braun syringes needs further investigation. Braun syringes should not be used if the product is to be frozen. The stability of the frozen product, in Codan syringes is 6 months.     

Improved technique for performing endoscopic ultrasound guided fine needle aspiration of lymph nodes.

BACKGROUND AND STUDY AIMS: Trans-esophageal real-time endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has emerged as an important technique for sampling perigastrointestinal lymph nodes. The purpose of this study was to compare the yield of EUS-guided FNA of mediastinal lymph nodes using different techniques. MATERIALS AND METHODS: A 2 cm mediastinal lymph node was dissected at autopsy. FNA was performed on this lymph node with a 21 gauge needle which is used clinically for EUS-guided FNA (GIP-Mediglobe). FNA of the lymph node was performed for 60 sec, while continuous or intermittent suction was applied with a 10 ml, 20 ml and 30 ml syringe. The pathologist was blinded to the technique used for FNA of the lymph node. The slides were examined and the results recorded independently by two pathologists who were blinded to each other's findings. A similar procedure was repeated in a 2 cm lymph node removed during another autopsy. RESULTS: Pathologic examination revealed metastatic transitional cell bladder carcinoma in the first lymph node, and metastatic non-small cell lung carcinoma in the second lymph node. The cellularity and quality of FNA performed with the 10 ml syringe was better than with the 20 ml or 30 ml syringe. With the 10 ml syringe, continuous suction for one minute provided a better sample than intermittent suction. FNA with a 20 ml or 30 ml syringe was more cumbersome, as it required more physical force. CONCLUSIONS: Our study reveals that continuous rather than intermittent suction with smaller syringes (5-10 ml) provides optimal cellularity in EUS-guided FNA of mediastinal lymph nodes and that use of larger (20-30 ml) syringes does not improve the rate of obtaining a diagnostic specimen.     

Effects of syringe material and needle size on the minimum plunger-displacement pressure of arterial blood gas syringes.

We determined the minimum systolic pressures required for blood to enter and begin to displace the plungers of four brands of 3-ml and 5-ml plastic and glass arterial blood gas syringes by combining samples of each syringe size with three sizes of short-beveled needles--25 gauge, 5/8"; 22-gauge, 1"; and 20-gauge, 1 1/2". We measured pressures by use of an arterial-vessel model that incorporated whole human blood and simulated the conditions of a percutaneous arterial puncture. We concluded that all the arterial blood gas syringes that we studied would self-fill in most clinical situations when they were combined with 20- or 22-gauge needles, but that 22-gauge needles with glass syringes were preferable for persons whose systolic pressures were less than 70 mm Hg, for persons in shock, and for persons undergoing CPR. Only glass 3-ml syringes should be used with 25-gauge needles, as two brands of plastic 3-ml syringes with 25-gauge needles required systolic pressures greater than 158 mm Hg and all brands of plastic and glass 5-ml syringes with 25-gauge needles required systolic pressures greater than 247 mm Hg. Because we found no clinical or statistical differences between 20- and 22-gauge needles, we do not recommend use of the larger 20-gauge needle. The syringe-needle combinations that we do recommend should negate the need for, and the potential trauma of, manual aspiration of the syringe plunger.     

Effects of syringe material, sample storage time, and temperature on blood gases and oxygen saturation in arterialized human blood samples

BACKGROUND: The practice of on-ice storage of arterial-blood samples in plastic syringes for delayed analysis continues, and the effects of storage time and temperature on the measurement of blood-oxygen-saturation values (S(aO2)) have not been adequately described. OBJECTIVE: To determine the effects of syringe material, storage time, and storage temperature on normal arterialized blood gas and S(aO2) values. METHODS: We used a temperature-controlled extracorporeal circuit to "arterialize" 500 mL of fresh, whole human blood at 37 degrees C, and we used certified calibration gases of 12% O2 and 5% CO2 to produce normal blood-gas values. From that arterialized blood we took 90 samples and randomly assigned them to 6 groups, until there were 15 samples in each group. The groups were (1) plastic syringe, analyzed immediately, (2) plastic syringe, stored 30 min at 0-4 degrees C, (3) plastic syringe, stored 30 min at 22 degrees C, (4) glass syringe, analyzed immediately, (5) glass syringe, stored 30 min at 0-4 degrees C, and (6) glass syringe, stored 30 min at 22 degrees C. RESULTS: Compared to the samples that were analyzed immediately, the P(O2) of the samples stored in plastic syringes for 30 min at 22 degrees C and at 0-4 degrees C was significantly higher, with a clinically important magnitude of 11.9-13.7 mm Hg. The P(CO2) of blood stored in glass for 30 min at 0-4 degrees C was significantly lower, although the magnitude of the difference (1.5 mm Hg) was not clinically important. There were no statistically significant differences in pH or oxygen saturation among the 6 groups. CONCLUSION: For accurate arterial-blood-gas results, samples drawn in plastic syringes should be analyzed immediately. If the analysis is going to be delayed, the samples should be drawn and stored in glass.     

Stability of bortezomib 1-mg/mL solution in plastic syringe and glass vial

BACKGROUND: The proteasome inhibitor bortezomib (BTZ), used in antineoplastic chemotherapy, must be diluted in NaCl 0.9% for injection and stored for no more than 3 hours in a syringe or 8 hours in a vial. Better information on its stability could improve storage. OBJECTIVE: To assess the stability of BTZ solution (1 mg/mL) in syringes and vials. METHODS: BTZ 1-mg/mL solutions were prepared by adding sterile NaCl 0.9% to Velcade vials containing 3.5 mg of lyophilized BTZ. Syringes were filled with 1 mL of solution and stored in the dark at 5 degrees C or 60 degrees C; others were not protected from light and stored at 22 degrees C. Velcade vials containing 1 mL of solution were stored at 5 degrees C in the dark. Samples were taken at various times over 23 days and assayed in duplicate. An HPLC method for assaying the stability of BTZ was validated. Appearance and pH were recorded. RESULTS: There was no color change or precipitation in the samples, and the pH was stable. Oxidation, light, and storage temperature all affected the chemical stability of BTZ. The mean concentrations of BTZ in syringes stored for 2, 3, and 5 days at 60, 22, and 5 degrees C were >95% of the initial concentration. The mean concentration of BTZ in vials stored for 5 days at 5 degrees C was >95% of the initial concentration. CONCLUSIONS: BTZ stored refrigerated in vials or syringes and protected from light is chemically stable for 5 days after reconstitution.     

Validation of spirometer calibration syringes

The volume calibration syringe is probably the single most important instrument in pulmonary function laboratories, yet no validation results have been published. In this study a sample of volume calibration syringes was validated. We weighed a 1-L and two 3-L calibration syringes before and after emptying them of water and determined the corresponding volume of gas by using a modified rolling seal spirometer. In this way we established an unbroken calibration chain between a certified weight of water and the corresponding volume of gas. The volume of a spirometer calibration syringe could be verified with an accuracy of ± 15 ml. The modified rolling seal spirometer had an accuracy of ±11 ml at a volume of 1 L and ±13 ml at a volume of 3 L. A sample of spirometer calibration syringes was validated and all syringes except for two small 1-liter syringes all had volumes within the label claimed volume ± 0.5%. Spirometer calibration syringes have a stable stroke volume even after many years of use and storage but have to be calibrated yearly to comply with international standard.