肌骨骼瘤99mTc-MIBI显像

此研究目的是评价临床和放射学特征为原发性或转移性肌骨骼瘤患者 99m Tc- MIBI显像的价值。方法　 84例患者的显像结果与手术及组织学结果作了对照。每例患者作了 99m Tc- MDP三相骨显像和动态及静态 99mTc- MIBI显像 ,用肉眼和定量分析评价 99m Tc- MIBI显像 ,在 99m Tc- MIBI显像中提取感兴趣区 ,计算病灶与邻近或对侧正常区域 (L / N )计数比值 ,用 Mann- Whitney检验测定恶性和良性肿瘤摄取比值间的差异。结果　 99m Tc- MDP摄取增加对骨恶性肿瘤不是特异的 ,发现 99m Tc- MIBI显像良性肿瘤 (L / N=1.2 2± 0 .4 3)和…     

肺亲肿瘤显像鉴别良恶性病变的观察

71例诊断为肺部肿瘤的患者,进行了~(99m)Tc-MIBI~(99m),Tc-Glu~(99m),Tc-HMPAO,肺亲肿瘤显像。检出率各为77.8％,50％,80％;准确率各为90.8％,58.3％,和80％;特异性各为70％,14.3％,0％。SPECT显像对肺小肿瘤检出率明显高于平面显像,~(99m)Tc-MIBI检出最小肿物为1.5cm。纵隔淋巴转移,锁骨上淋巴转移部位可清楚显示,注射后2小时延迟SPECT显像比早期SPECT显像更易揭示肺恶性病变,~(99m)Tc-MIBI对5例肺癌合并陈旧结核病人的病灶能清晰显示而结核病灶未见显影。结果证明在肺部疾病中~(99m)Tc-MIBI是有亲肺癌特征,并有可能用于肺良恶性病变的鉴别诊断。     

99Tcm-替曲膦心肌灌注显像在冠心病诊断的应用及治疗决策的作用

目的 评价99Tcm-替曲膦(99Tcm-Tetrofosmin)心肌灌注显像在冠心病诊断的应用及治疗决策的作用.方法 73例临床初步诊断冠心病患者行99Tcm-替曲膦心肌灌注显像,第一日行99Tcm-替曲膦静息心肌灌注显像,次日行99Tcm-替曲膦负荷(运动负荷或药物负荷)心肌灌注显像,一周内行冠状动脉造影(Coronary arteriongraphy,CAG).对99Tcm-替曲膦心肌灌注显像阴性者36例、99Tcm-替曲膦心肌灌注显像心肌灌注显像阳性者37例与其CAG结果对比,得出99Tcm-替曲膦心肌灌注显像对胸闷、胸痛等不同症状患者心肌缺血程度的初步评测及其在治疗决策中的作用.结果 99Tcm-替曲膦心肌灌注显像提示未见缺血的36例患者中,在其CAG结果中发现冠状动脉病变2支以上者3例(狭窄程度最大值不超过75％,狭窄程度均值为71.42％±3.78％),单支病变者8例(狭窄程度最大值不超过75％,狭窄程度均值为63.75％±6.94％),25例患者CAG提示冠状动脉未见狭窄,予以对症药物治疗或临床密切观察.99Tcm-替曲膦心肌灌注显像提示明显心肌缺血26例,在其CAG结果中发现冠状动脉病变2支以上者8例(狭窄程度均值为78.75％±11.34％),单支病变者14例(狭窄程度均值为78.93％±5.94％),上述22例患者均进一步行球囊扩张术和(或)支架植入术;4例患者CAG提示未见明显狭窄.99Tcm-替曲膦心肌灌注显像提示轻度心肌缺血者11例,对应其CAG结果发现冠状动脉病变2支以上者5例(狭窄程度最大值不超过80％,均值为70.91％ ±8.31％),单支病变者5例(狭窄程度最大值不超过80％,狭窄程度均值为68.00％±8.36％),1例患者CAG提示冠状动脉未见狭窄,均进行药物治疗.结论 99Tcm-替曲膦心肌灌注显像对冠心病进行诊断、治疗方案的选择有重要的临床应用价值.     

~(99m)TcO_4~-显像与MRI和CT对比评价腮腺Warthin's瘤的诊断价值

目的:对比分析~(99m)TcO_4~-唾液腺显像与常规MRI和CT在评价腮腺Warthin's瘤中的准确性。方法:对78例临床疑诊腮腺Warthin's瘤的患者进行~(99m)TcO_4~-唾液腺显像,同时对其中61例患者进行腮腺CT或MRI检查(以下简称常规检查组),与病理结果进行对照,分别得出各自的诊断效能。采用受试者工作特征曲线对比分析~(99m)TcO_4~-唾液腺显像组与常规检查组诊断的准确性,并用χ~2检验对比两组的诊断效能。结果:~(99m)TcO_4~-唾液腺显像的灵敏度、特异性、阳性预测值、阴性预测值分别为94.12%、85.19%、92.31%、88.46%,常规检查组的灵敏度、特异性、阳性预测值、阴性预测值分别为28.26%、53.33%、65.00%、19.51%,两者差异有统计学意义(P0.05)。受试者工作特征曲线中~(99m)TcO_4~-唾液腺显像组的曲线下面积为0.929,常规检查组的曲线下面积为0.496。结论:~(99m)TcO_4~-唾液腺显像诊断腮腺Warthin's瘤准确性高,有重要的临床应用价值。     

新型~(99m)Tc-DTPA-GGGRDN-IF7靶向肿瘤血管Anxa1分子探针的制备及SPECT显像

目的制备针对肿瘤血管表面受体Annexin A1(Anxa1)分子探针~(99m)Tc-二乙三胺五乙酸(DTPA)-甘氨酸-甘氨酸-甘氨酸-精氨酸-天冬氨酸-天冬酰胺(GGGRDN)-异亮氨酸-苯丙氨酸-亮氨酸-亮氨酸-色氨酸-谷氨酰胺-精氨酸(IFLLWQR,IF7),进行体外肿瘤细胞(人脑星形胶质细胞瘤U87细胞)实验;探讨~(99m)Tc-DTPA-GGGRDN-IF7在荷瘤小鼠体内的生物学分布规律,并利用单光子发射计算机体层摄像术(SPECT)进行显像研究。方法将100μg DTPA-GGGRDN-IF7溶于10μL二甲基亚砜(DMSO)中,充入氮气保护。加入10μL 1 mg/mL氯化亚锡(SnCl2)溶液(pH 4.0),再加入约111 MBq(3 mCi)Na~(99m)TcO_4,37℃水浴反应30 min,经C_(18)柱淋洗后制备~(99m)Tc-DTPA-GGGRDN-IF7。取样注入分析型高效液相色谱(HPLC)仪分析~(99m)Tc-DTPA-GGGRDN-IF7的放射化学纯度及体外血清稳定性。将U87细胞与~(99m)Tc-DTPA-GGGRDN-IF7共同孵育后,测定放射性计数并计算摄取率。取30只4～5周龄18～20 g荷瘤裸鼠,建立U87荷瘤裸鼠模型,进行~(99m)Tc-DTPA-GGGRDN-IF7的体内分布实验及SPECT显像。结果 ~(99m)Tc-DTPA-GGGRDN-IF7标记产率大于95%,放射化学纯度大于95%。在大鼠血清中37℃保温2 h后性状稳定,放射化学纯度大于92.3%。U87细胞在体外对~(99m)Tc-DTPA-GGGRDN-IF7摄取在60 min时达峰值(6.85%±0.97%),过量的GGGRDN-IF7可以明显降低细胞的摄取。体内分布实验结果显示,药物均在血浆清除较快,肝肾摄取高,主要从肝肾排泄。SPECT显像结果表明,肿瘤部位呈明显放射性浓聚态,注射2 h后肿瘤对~(99m)Tc-DTPA-GGGRDN-IF7摄取值为(3.56±0.44)%ID/g。结论 ~(99m)Tc-DTPA-GGGRDN-IF7合成简便,放射化学纯度高,易于推广;U87细胞对~(99m)Tc-DTPA-GGGRDN-IF7具有较强亲和力;SPECT显像表明肿瘤明显浓聚~(99m)Tc-DTPA-GGGRDN-IF7,体内生物分布理想,靶向性强,有望用于肿瘤显像。     

~(99m)Tc-MIBI双时相联合延迟断层显像在原发性甲状旁腺功能亢进术前定位诊断中的价值

目的探讨~(99m)锝-甲氧基异丁基异腈(~(99m) Tc-MIBI)双时相联合延迟断层显像在原发性甲状旁腺功能亢进(PHPT)术前定位诊断价值。方法选择经病理确诊为PHPT患者62例,其中男性20例,女性42例;年龄21~68岁,平均年龄38.5岁。静脉注射~(99m) Tc-MIBI 370 MBq后行双时相显像,然后再行颈胸部断层显像;同期行颈部超声和计算机断层扫描(CT),所有影像诊断均与术后病理诊断进行比较,对3种检查结果进行分析。结果 ~(99m) Tc-MIBI双时相联合延迟断层显像诊断PHPT 58例,病灶检出率93.55%;其中1例甲状旁腺瘤内伴有囊性变和3例甲状旁腺增生~(99m) Tc-MIBI双时相联合延迟断层显像未被检出。颈部超声诊断PHPT 40例,病灶检出率为64.52%(40/62)。CT诊断PHPT 42例,病灶检出率为67.74%。超声和CT对3例异位甲状旁腺病灶未检出。~(99m) Tc-MIBI双时相联合延迟断层显像对病灶检出率高于超声和CT,与超声、CT相比,差异有统计学意义(χ~2=15.77、13.23,P 0.05)。超声对病灶检出率与CT比较,差异无统计学意义(χ~2=0.144,P 0.05)。结论 ~(99m) Tc-MIBI双时相联合延迟断层显像在术前定位诊断中具有较高的临床价值。     

^99mTc—MIBI鼻咽癌阳性显像的探讨

目的用(~99m)Tc-MIBI来探索鼻咽癌的原发灶和转移灶的诊断.资料与方法 用(~99m)Tc-MIBI断层显像检测21例对照组和41例治疗前鼻咽癌病例,病灶的放射性摄取与头皮比较,由3名以上的医师在不知道任何临床情况下分别阅片.结果41例治疗前鼻咽癌病例中共有36例阳性.特异性为91%,灵敏度为88%.结论用(~99m)Tc-MIBI来探索鼻咽癌的原发灶和转移灶的诊断,是一种灵敏的,值得进一步探讨的影像学方法.     

~(99)mTc标记抗CEA单克隆抗体肠癌放射免疫断层显像的临床研究

本文报告~(99m)Tc标记抗CEA单克隆抗体对12例大肠癌患者作放射免疫显像的临床结果。我们对一种新方法(Schwarz法)进行改良,制备出~(99m)Tc标记抗体.经Seph-adex G25凝胶柱层析法及纸层析法检测标记率为90％～95％,应用前不需进一步纯化。在注射标记物后6h～20h,用SPECT进行     

CAG正常伴心绞痛症状患者行核素心肌灌注显像的临床意义

目的:探讨核素心肌显像在冠状动脉造影(CAG)正常伴心绞痛症状患者中的临床意义。方法:应用99Tcm-MIBI负荷/静息门控心肌灌注断层显像(MPT)分析上述患者显像特点。A组(心血管神经症)15例,B组(原发性高血压)24例,C组(X综合征)20例,D组(Ⅱ型糖尿病)18例。结果:A组有2例3个节段可逆性缺损,评分均为1;B、C、D组均有多节段可逆性或部分可逆性缺损,异常机率明显高于A组(P<0.001),评分为1.12±0.28、1.08±0.36、1.42±0.56,B、C组无明显差异(P>0.05),D组与B或C组有差异(P<0.01)。比较静息LVEF,A组与B、C组无明显差异(P>0.05),D组略低于A组(P<0.01)。结论:MPT可反映CAG正常伴心绞痛患者心肌血流的分布状况,显示病变的范围及程度。     

99m Tc-MIBI双时相显像定位诊断原发性甲状旁腺机能亢进症

目的评价99m Tc-MIBI双时相显像在原发性甲状旁腺机能亢进症(甲旁亢) 的病灶定位诊断价值.方法对59例甲旁亢患者和25例正常人进行99m Tc-MIBI双时相显像,并与B超、CT检查进行对比分析.结果 59例原发甲旁亢患者(其中甲状旁腺瘤49例、异位甲状旁腺6例、甲状旁腺增生2例、甲状旁腺癌2例)应用99m Tc-MIBI双时相显像法、B 超、CT的诊断灵敏度分别为98.3%、71.4%、83.3%;特异性分别为100%,80.2%,88.5%.结论 99m Tc-MIBI双时相显像对机能亢进的甲状旁腺有较好的诊断价值,是患者术前定位的重要辅助手段.     

甲状腺切除术后应用甲状腺平面显像评估残余甲状腺:与治疗剂量131I扫描的对比

目的:我国常用^99mTc甲状腺扫描评估甲状腺癌术后残余甲状腺大小,本文拟对甲状腺扫描与治疗剂量的¹³¹I扫描进行比较分析。方法:148例（男51,女97）2年内就诊甲状腺癌术后病人入组,年龄（47.0±13.3）岁,2名核医学科医师独立、盲法阅片,采用5分法计分。统计学分析采用秩相关研究,相关系数采用t检验进一步比较。结果:69/148（46.6%）两种显像结果得分一致,79（53.4%）¹³¹I扫描得分高于甲扫。甲扫及¹³¹I扫描评分结果与甲状腺激素水平均相关（P<0.001）,且相关系数间甲扫与T₃、T₄相关程度更高（t₁=-1.933,P=0.028;t₂=-2.788,P=0.003）。结论:^99mTc甲状腺平面显像可作为术后残余甲状腺的评估方法,但¹³¹I扫描显示范围更大,两者与甲状腺激素水平均相关,但甲扫与其相关性可能更高。     

乳腺显像装置的研制及108例乳腺亲肿瘤显像结果分析

目的 提高＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像的对乳腺癌的检出率。方法 采用我们设计的乳腺显像装置作＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像，采用特殊俯卧位检查。其中１０８例的结果与病理资料对照，结果 恶性病变组ＥＣＴ阳性４３／４７；阴性４／４７。良性病变组ＥＣＴ阴性５６／６１；阳性５／６１。＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像对乳腺恶性病变诊断的＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像对乳腺恶性病变诊断     

^99mTcN—NOEt的生物分布研究

研究＾９９ｍＴｃＮ－ＮＯＥｔ的生物分布特征,材料与方法：新西兰兔９只及家狗３只,静脉注射显像剂后进行动态平面伽玛显像,利用感兴趣区技术计算器官放射性活度的主烨,结果与结论：心肌对＾９９ｍＴｃＮ－ＮＯＥｔ摄取较高心／值渐高而心／肝比渐下降;尽管肝脏明显浓像剂,但未见明显的清除,膀胱的放射性渐增多,提示泌尿系也是＾９９ｍＴｃＮ－ＮＯＥｔ生物清除的途径之一。     

Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging

BACKGROUND. The identification of ischemic but viable myocardium by thallium exercise scintigraphy is often imprecise, since many of the perfusion defects that develop in ischemic myocardium during exercise do not "fill in" on subsequent redistribution images. We hypothesized that a second injection of thallium given after the redistribution images were taken might improve the detection of ischemic but viable myocardium. METHODS. We studied 100 patients with coronary artery disease, using thallium exercise tomographic imaging and radionuclide angiography. Patients received 2 mCi of thallium intravenously during exercise, redistribution imaging was performed three to four hours later, and a second dose of 1 mCi of thallium was injected at rest immediately thereafter. The three sets of images (stress, redistribution, and reinjection) were then analyzed. RESULTS. Ninety-two of the 100 patients had exercise-induced perfusion defects. Of the 260 abnormal myocardial regions identified by stress imaging, 85 (33 percent) appeared to be irreversible on redistribution imaging three to four hours later. However, 42 of these apparently irreversible defects (49 percent) demonstrated improved or normal thallium uptake after the second injection of thallium, with an increase in mean regional uptake from 56 +/- 12 percent on redistribution studies to 64 +/- 10 percent on reinjection imaging (P less than 0.001). Twenty patients were restudied three to six months after coronary angioplasty. Of the 15 myocardial regions with defects on redistribution studies that were identified as viable by reinjection studies before angioplasty, 13 (87 percent) had normal thallium uptake and improved regional wall motion after angioplasty. In contrast, all eight regions with persistent defects on reinjection imaging before angioplasty had abnormal thallium uptake and abnormal regional wall motion after angioplasty. CONCLUSIONS. These data indicate that the reinjection of thallium improves the detection of ischemic myocardium and that myocardial regions with improved thallium uptake on reinjection imaging represent viable but jeopardized myocardium.     

唾液腺显像常见影响因素分析

目的 探讨唾液腺显像过程中是否有影响显像结果的因素存在,以确保诊断的准确性.方法 对30例患者进行唾液腺显像,受检者仰卧于检查床上并固定头部.静脉“弹丸”注射99TcmO4-洗脱液5mCi,即刻行前位唾液腺动态显像,每分钟采集1帧图像,连续采集30分钟.在采集到20分钟时,让受检者口含并嚼碎维生素C 400mg,刺激唾液腺的分泌,然后继续按照同样条件采集10分钟,获得唾液显像图像和时间-放射性曲线.分析该30例患者的唾液腺显像图像和时间-放射性曲线结果对诊断准确性影响的相关因素.结果 显像剂注射渗漏、显像过程中受检者体位变动、给予维生素C时间的早晚及感兴趣区（ROI）的勾画等是影响唾液腺显像质量和摄取率、排泌分数等结果的主要因素.结论 唾液腺显像的影响因素很多,建立严格的操作规范和工作流程是确保取得准确结果的前提.     

Simplified scintigraphic methods for measuring gastrointestinal transit times.

To investigate whether simple transit measurements based on scintigraphy performed only 0, 2, 4 and 24 h after intake of a radiolabelled meal can be used to predict the mean transit time values for the stomach, the small intestine, and the colon, a study was conducted in 16 healthy volunteers. After ingestion of a meal containing 111indium-labelled water and 99mtechnetium-labelled omelette, imaging was performed at intervals of 30 min until all radioactivity was located in the colon and henceforth at intervals of 24 h until all radioactivity had cleared from the colon. Gastric, small intestinal and colonic mean transit times were calculated for both markers and compared with fractional gastric emptying at 2 h, fractional colonic filling at 4 h, and geometric centre of colonic content at 24 h, respectively. Highly significant correlations were found between gastric mean transit time and fractional gastric emptying at 2 h (111In: r=0.95, P<0.00001; 99mTc: r=0.96, P<0.00001), between small intestinal mean transit time and fractional colonic filling at 4 h (111In: r=-0.97, P<0.00001; 99mTc: r=-0.89, P<0. 00001), and between colonic mean transit time and geometric centre of colonic content at 24 h (111In: r=- 0.88, P<0.00001). We therefore conclude that reliable regional gastrointestinal transit times can be estimated from scintigraphic images taken 0, 2, 4 and 24 h after intake of radiolabelled markers.     

Comparison of correction techniques for simultaneous 201Tl/99mTc myocardial perfusion SPECT imaging: a dog study

We compared two correction methods for simultaneous 201Tl/99mTc dual-isotope single-photon emission computed tomography (SPECT). Both approaches use the information from the third energy window placed between the photopeak windows of the 201Tl and 99mTc. The first approach, described by Moore et al, corrects only for the contribution of the 99mTc to the 201Tl primary 70 keV window. We developed the three-window transformation dual isotope correction method, which is a simultaneous cross-talk correction. The two correction methods were compared in a simultaneous 201Tl/99mTc sestamibi cardiac dog study. Three separate acquisitions were performed in this dog study: two single-isotope and one dual-isotope acquisition. The 201Tl single-isotope images were used as references. The total number of counts, and the contrast between the left ventricular cavity (LVC) and the myocardium, were used in 70 keV short axis slices as parameters for evaluating the results of the dual-isotope correction methods. Three consecutive short-axis slices were used to calculate averaged contrast and the averaged total number of counts. The total number of the counts was 667000+/-500 and 414500+/-400 counts for the dual isotope (201Tl+/-99mTc) and single-isotope (201Tl-only) 70 keV images, respectively. The corrected dual-isotope images had 514700+/-700 and 368000+/-600 counts for Moore's correction and our approach, respectively. Moore's method improved contrast in the dual isotope 70 keV image to 0.14+/-0.03 from 0.11+/-0.02, which was the value in the 70 keV non-corrected dual-isotope image. Our method improved the same contrast to 0.22+/-0.03. The contrast in the 201Tl single-isotope 70 keV image was 0.28+/-0.02. Both methods improved the 70 keV dual-isotope images. However, our approach provided slightly better images than Moore's correction when compared with 201Tl-only 70 keV images.     

3.0T MR前列腺扫描参数的应用

目的比较不同扫描参数对前列腺MRI图像质量及扫描时间的影响。方法应用GE Signa Excite 3.0T MR和8通道体部线圈,对13名健康志愿者中的第一组前7位采用抑脂FSE-XLT2WI、非抑脂FSE-XL T1WI序列和FSE-IR进行前列腺MR成像,对比不同参数图像的信噪比;对第二组后6位志愿者根据图像质量及扫描时间选择适合前列腺MR成像的扫描序列和参数。结果在其它参数相同时采用抑脂FSE-XL T2WI序列、非抑脂FSE-XL T1WI序列、FSE-IR序列,可在较短的扫描时间内获得较高的前列腺图像质量。结论 3.0T MR前列腺成像,通过优化参数可节约扫描时间、提高图像质量。     

99TcmO-4甲状腺静态显像及SPECT/CT同机融合显像对甲状腺"冷结节"良恶性鉴别的诊断价值

目的 探讨99TcmO-4甲状腺静态显像及SPECT/CT同机断层融合显像对甲状腺"冷结节"良恶性鉴别的诊断价值.方法 选取2014年1月至2016年12月99TcmO-4甲状腺静态显像显示为冷结节的患者60例,行SPECT/CT同机断层融合显像,所有患者均行甲状腺手术或穿刺取活检确诊.结果 甲状腺断层融合显像提示冷结节病灶呈低密度35例,等或稍低密度25例,病灶边缘清晰33例,边缘模糊27例,有明显粗大钙化15例,未见明显钙化45例,结节直径大于等于2cm 13例,结节直径小于2cm 47例.等或稍低密度、边缘模糊、无明显粗大钙化灶结节为恶性结节的可能性偏高,低密度结节、边缘清晰、可见粗大钙化灶冷结节为良性结节的可能性偏低,差异均具有统计学意义.结论 99TcmO-4甲状腺静态显像显示冷结节患者,行SPECT/CT同机断层融合显像对鉴别结节良恶性的诊断准确性有很大提高.     

99mTc—HSA（FSA）药盒的制备研究

目的 研制一种快速、简便、可靠的~99nzTc标记的心血池显像剂.方法 用二氧硫脲(FSA)作人血清白蛋白(HSA)还原剂,用放射性直接标记方法制备~99nzTc标记一步法药盒,测定该药盒及其标记产物的~99nzTc-HSA的理化性质、还原蛋白巯基(-SH)数目及生物性能.结果 对还原后的HSA进行了~99nzTc的标记,放化纯度大于95%,标记后室温放置24小时,放化纯度仍大于95%,体外稳定性很好,小鼠体内分布血中浓度高且较稳定.结论 采用该方法制备的药盒明显提高了~99nzTc-HSA在小鼠体内血中浓度,与~99nzTc-二亚乙基三胺五乙酸一人血清白蛋白(~99nzTc-DTPA-HSA)小鼠体内分布数据二者无显著差异,宜于临床进一步研究.