肝受体显像剂~(99m)Tc-NGA一步法冻干药盒的研制

本文报道了肝受体显像剂~(99m)Tc-NGA一步法冻干药盒的制备,在探讨各种标记条件对放化纯影响的基础上,建立了最佳标记方案和质控方法。资料表明,此药盒无菌无热原,无毒副反应,操作简便快速,有效期>3个月,~(99m)Tc-NGA产率>95％,体外稳定性>4小时,动物显像和临床试用满意。     

胆汁淤积型肝炎~(99m)Tc-EHIDA与~(99m)Tc-MIBI肝胆显像对比研究

目的探讨~(99m)Tc-MIBI肝胆动态显像是否可用于婴儿肝炎综合征和先天性胆道闭锁的鉴别诊断,为临床诊治提供依据。方法随机抽取34例~(99m)Tc-EHIDA SPECT肝胆动态延迟显像肠道不显影而最终临床诊断为胆道闭锁的患儿作为观察组,10例同期临床诊断为肝炎综合征的患儿作为对照组,在行~(99m)Tc-EHIDA肝胆显像后次日行~(99m)Tc-MIBI肝胆显像;对比分析~(99m)Tc-EHIDA与~(99m)Tc-MIBI肝胆显像在婴儿先天性胆道闭锁及婴儿肝炎综合征的影像特征。结果 34例观察组和10例对照组~(99m)Tc-MIBI肝胆显像均出现肠道显影,且肠道放射性分布出现时间较早,提示肠道放射性并非来自肝胆排泄而是肠道自身的摄取。结论对于~(99m)Tc-EHIDA SPECT肝胆显像肠道未出现放射性核素影像的黄疸患儿,~(99m)Tc-MIBI肝胆显像对于婴儿肝炎综合征和先天性胆道闭锁的鉴别诊断价值有限。     

~(99m)锝-双半胱乙酸和~(131)碘-邻碘马尿酸肾脏功能测定及显像的对比研究

应用~(99m)锝-双半胱乙酸(~(99m)Tc-EC)和~(131)碘-邻碘马尿酸(~(131)I-OIH)进行肾脏功能测定及显像自身对比检查研究。结果显示:正常组和异常组~(99m)Tc-EC肾图与~(131)I-OIH肾图的各项分析指标均呈高度相关(P<0.01),~(99m)Tc-EC肾图的高峰时间、半排时间较~(131)I-OIH肾图延长,15min残留率增加,肾脏指数下降,其余分析指标无明显统计学意义。在肾脏显像方面,两者图像基本相同,仅时相不同,两种显像剂分泌聚集时相接近,但~(99m)Tc-EC排泄时相延迟。~(99m)Tc-EC的核素性能优良,所获图像质量优于~(131)I-OIH,除肾脏、膀胱显像外,未见甲状腺等其它组织器官显像。     

运动~(99m)Tc-CPI心肌SPECT显像在冠心病诊断中的初步应用

~(201)Tl心肌灌注显像已成为冠心病临床诊断、预后及疗效评价的重要无创作手段,但由于~(201)Tl的核性质及价格等方面的原因,限制其更广泛的临床应用。 ~(99m)Tc标记的甲酯异丙基异腈(~(99m)Tc-Carbomethoxy isopropyl isnoitrile,~(99m)Tc-CPI)是~(99m)Tc标记的异腈类化合物中较有希望的一个心肌显像剂,除了~(99m)Tc的核性质适宜和价格低廉外,还具有肺、肝清除较快、心肌图像清晰等优点,国内外初步临床应用结果比较满意。文献     

放射性核素~(99m)TC闪烁显像对乳腺癌淋巴结转移预判断研究

目的观察放射性核素~(99m)TC对乳腺癌淋巴结转移闪烁显像效果,探讨~(99m)TC闪烁照相在乳腺癌术前淋巴结转移预判断中的作用。方法 71例病理证实的乳腺癌患者术前采用~(99m)TC扫描闪烁显像,对淋巴结显影情况进行记录,依据显像结果进行术中淋巴结清扫,对术中清扫淋巴结及~(99m)TC闪烁显像进行对比,分析~(99m)TC扫描闪烁显像对淋巴结转移预判断的准确率。结果 71例乳腺癌患者~(99m)TC闪烁照相显影54例,病理证实淋巴结阳性59例,~(99m)TC闪烁照相显影准确率91.5%,内乳组淋巴结准确率100%,腋下组淋巴结准确率91.1%。结论放射性核素~(99m)TC闪烁照相能够准确预判断乳腺癌患者的淋巴结转移情况,为乳腺癌的淋巴结清扫提供依据。     

~(99m)T_c-PMT肝肿瘤显像的临床研究(摘要)

~(99m)T_c-5-PMT(~(99m)T_c-N-吡哆-5甲基色安酸)于1982年首由日本学者M.Kato Azulne提出作为优良的肝胆显像剂。1984和1985年,日本长谷川义尚首先报告将~(99m)T_c-PMT用于肝细胞癌及其转移灶的阳像,取得了令人鼓舞的结果。我院亦于1984性显年6月开始用~(99m)T_c-PMT进行肝肿瘤显像,到1988年10月底止共作了308例次,其中131例经手术病理证实。131例中,原发性肝癌104例,肝细胞腺瘤3例,肝海绵状血管瘤12例,继发性肝癌5例,肝囊肿2例,胆管细胞癌、肝脂肪变性、新生肝、肝手术疤痕及肝硬化各1例。研究结果证明~(99m)T_c-PMT延迟显像诊断原发性肝癌的灵敏度为61.6％,将异性为95.8％。特别适用于原发性肝癌的定位诊断,和原发性肝癌转移灶及AFP阴性病人的定位和定性诊断。本法     

~(99m)TcSC显像在移植肾排异反应中的应用

以~(99m)Tc-硫化锝胶体(~(99m)TcSC)为示踪剂,对48例患者进行肾显像,结果表明,20例无肾脏疾患的非肾移植对照组均不显像;28例同种异体移植肾表现为不同程度的~(99m)TcSC 蓄积,14例排异反应组的移植肾蓄积值(91.94±14.36%)明显高于10例正常功能移植肾的~(99m)TcSC 蓄积值(54.81±11.47%),P<0.01;以蓄积值超过70%为异常,可诊断为排异。该法的灵敏度、特异性及准确性分别为92.3%、92.85%及92.59%。     

胰腺B细胞显像剂~(99)Tc~m-DTPA-NGN2在小鼠体内的分布

目的 研究胰腺B细胞显像~(99)Tc~m-DTPA-NGN2在小鼠体内的分布规律,为~(99)Tc~m-DTPA-NGN2用于临床胰腺B细胞显像及胰腺癌的核医学显像做基础.方法 正常小鼠42只,分为7组,每组6只,尾静脉注射~(99)Tc~m-DT.PA-NGN2 3.7 MBq后5、15、30 min和1、2、4、6 h放血处死,取心、肝、脾、肺、脑、肾、肌肉、骨、小肠、胃、胰腺和血液等组织或器官,称重并测量其放射性,计算每克组织百分注射剂量率(%ID/g).同时,取正常小鼠5只,尾静脉注射~(99)Tc~m-DTPA-NGN218.5 MBq后相同时间进行显像.结果 ~(99)Tc~m-DTPA-NGN2 主要经肾脏代谢,脑内未见摄取,各组织、器官的百分注射剂量率在1 h内均迅速下降,胰腺的百分注射剂量率随时间的延长逐渐上升,在1～2 h内保持较高水平.显像结果与生物分布实验结果一致,随时间的延长胰腺显影逐渐清晰,在1～2 h内均可清晰观察胰腺组织.结论 ~(99)Tc~m-DTPA-NGN2可能是一种较好的胰腺B细胞显像剂,在胰腺B细胞的功能显像和胰腺癌显像的应用中值得进一步研究.

Abstract：

Objective To evaluate the biodistribution and imaging of technetium-99m labeled Nateglinide: ~(99)Tc~m-DTPA-Nateglinide (~(99)Tc~m-DTPA-NGN2) in mice. Methods Forty-two healthy Kunming mice were divided into 7 groups. Five minutes, 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours,and 6 hours after the injection of 3.7 MBq ~(99)Tc~m-DTPA-NGN2, these mice were sacrificed by cutting the carotid. Selected tissues (heart, liver, spleen, lung, brain, kidney, muscle, bone, intestine, stomach, pancreas and blood) were excised and weighed, and the radioactivity was measured. The biodistribution of radiotracer in each tissue sample was calculated as a percentage of the injected dose per gram of wet tissue weight (%ID/g). Another 5 mice were imaged after the injection of 18.5 MBq ~(99)Tc~m-DTPA-NGN2 at the same time. Result ~(99) Tc~m-DTPA-NGN2 is metabolized mainly from kidney, brain doesn't uptake ~(99) Tc~m-DTPA-NGN2, the %ID/g of the selected tissues were decreased rapidly in 1 hour, and the radioactivity in pancreas kept stable from 1 hour to 2 hours after injection. The pancreas visualized clearly 1 hour after injection. Conclusion ~(99) Tc~m-DTPA-NGN2 can be clearly visualized in pancreas in mice, and maybe it's promising in imaging pancreatic tumor and in evaluating the function of pancreatic B cell.     

99mTc-MIBI脑SPECT对脑胶质瘤的诊断价值

目的探讨~(99m)Tc-MIBI脑显像对脑胶质瘤的诊断价值。方法对59例脑胶质瘤患者、9例正常人、6例脑脓肿患者进行~(99m)Tc-MIBI脑SPECT显像。判断病灶有无异常摄取并根据感兴趣区(ROI)计算肿瘤/非肿瘤比值(T/NT),计算~(99m)Tc-MIBI脑显像对脑胶质瘤诊断的灵敏度、特异性、准确率。T/NT比值在胶质瘤、脑脓肿及正常组之间的比较采用t检验。结果59例脑胶质瘤患者中,51例显像为阳性,诊断灵敏度86.4%、特异性66.7%、准确率82.4%。15例非胶质瘤受检者有5例阳性。脑胶质瘤组T/NT比值为2.6±1.2,明显高于正常组的1.1±0.2(t=3.6199,P<0.001)和脑脓肿组的1.5±0.5(t=2.1327,P<0.05)。结论用~(99m)Tc-MIBI脑SPECT诊断脑胶质瘤灵敏度高,可以有效地鉴别良恶性病变。99m     

SPET和PET在探测冠心病心肌缺血与心肌存活的应用价值

单光子发射型断层显像仪[single-photon emission(computed)tomograph,SPET,SPECT]和正电子放射型断层显像仪(positron emission tomo-graph,PET)是当前核医学临床检查的高级精密设备,它们与超声、X线CT、磁共振成像(MRI)共同构成四大影像技术。SPET显像的主要原理是测量发射单光子(如γ射线)的核素标记化合物在人体内的分布,如~(99m)锝(~(99m)Tc)及其标记化合物。PET显像的主要原理是测量发射正电子的核素(~(18)F,~(11)C,~(13)N,~(15)O)在体内的分布,正电子在衰变过程中,产生湮没辐射,同时发射两个能量为511KeV方向相反(180°)的γ光子,采用符合线路探测器(coincidence detector),即PET可以准确探测。 SPET用于冠心病的诊断,主要包括:核素心肌灌注断层显像和核素心室造影,后者可以了解心室功能和局部室壁运动。目前国际上应用较多的心肌灌注显像剂有~(201)Tl、~(99m)Tc-甲氧异腈(~(99m)Tc-MIBI)、~(99m)Tc-替曲膦(~(99m)Tc-tetrofosmin)以及~(99m)Tc-替肟锝(~(99m)Tc-teborox-ime)。其中~(201)Tl应用时间最长,优点是注射一次即可获得运动(exercise)和再分布(redistribution)的图像,但半衰期偏长(73h),能量偏低;而~(99m)Tc-MIBI显像的优点是半衰期短(6h)、对病人的辐射剂量低,可投给较大剂量以改善图像     

~（99m）Tc－NGA肝受体显像的临床观察

用９９ｍＴｃ－ＮＧＡ在健康人（１２例）、原发性肝癌（１２例）和肝硬变（１０例）患者中进行肝动态及静态显像研究。结果表明：（１）９９ｍＴｃ－ＮＧＡ肝放射性－时间曲线对肝功能状态具有很高的敏感性。（２）静态显像可提供与放射性胶体相似的肝脏影像。     

The Value of In-Phase and Opposed-Phase T1-Weighted Breath-Hold FLASH Sequences for Hepatic Imaging

Tl--weighted(TlW)sequencesareconsideredtobeanintegralcomponentofacomprehensiveMRexaminationoftheliver.TheTlWSEsequenceiscurrentlyperformedinconventionalMRexaminationoftheliverfordetectionandcharacterizationoffocallesions.However,conventionalSEMRI-isproblem-aticdueto1ongdurationofdataacquisition(theor-derofminute)andphysicalmotionartifactscausedbyrespiratorymotionandgastrointestinalperistalsisandsoon.WithdeveIopmentofthehardwareandsoftwareoftheMRIsystem,theuseofGREtech-niqueshasbecomei…     

SPECT肝脏断层图像上正常结构影像的特点和识别

本文报道了判读46例肝实质、肝血池SPECT断层显像的体会,分析了肝脏SPECT图像中六个正常结构的特点,包括肾脏压迹、门静脉及分枝、下腔静脉、镰状韧带、肝静脉、胆囊窝,其中肝内、外血管结构在肝实质断层和肝血池断层上有良好对应关系。作者认为,肝血池断层显像对于识别肝实质影像上正常血管影像很有价值。     

320排CT的低对比剂4D DSA对移植肝动脉并发症的观察

目的 探讨320排CT的低对比剂4D DSA对肝移植后肝动脉并发症的临床应用价值.方法 回顾性分析2008年11月至2009年1月中山大学器官移植中心15例肝移植病例,患者均采用TOSHIBA 320排CT-Aquilion One扫描机,造影剂流速6 ml/s,总剂量50 ml,动态容积扫描模式,利用4D DSA成像软件,测量纯肝动脉的强化峰值时间、CT值.选取最佳纯肝动脉期的图像,进行容积(VR),最大密度投影(MIP),多层面重建(MPR)图像重建.结果 肝动脉的强化峰值时间为20(10.0～24.2)s,强化CT峰值为373(310～440)HU.肝动脉吻合口假性动脉瘤2例,肝动脉吻合口轻度、中度狭窄各为3例、4例,肝动脉吻合口闭塞、重度狭窄各1例,肝动脉吻合口未见异常4例.其中肝动脉闭塞、重度狭窄者伴有肝门部侧支动脉形成,伴有肝动脉分支局限性与节段性狭窄、肝动脉-门静脉瘘及肝动脉迂曲、肝内动脉小分支开放各4例,其他包括9例伴有肝内动脉小分支稀疏,3例供受体肝动脉管径粗细不一致,1例移植肝血管瘤,呈"挂果征",脾动脉瘤、脾动脉瘤样扩张各1例.结论 320排CT低对比剂的4D DSA成像可获得准确的纯动脉期肝动脉图像,对于肝移植术后肝动脉病变的诊断具有安全、无创、准确的优点,可作为肝移植术后对肝动脉并发症进行随访的有效手段.     

肝脏假性肿瘤病变的CT表现与血供特点的相关性

目的:探讨肝内假性肿瘤病变的CT特征及其与血供特点的相关性.方法:回顾性分析35例患者共48个经临床证实为肝脏假性肿瘤病变的CT影像特征,根据病变的部位及其所在部位血供特点将假性肿瘤病变归类,并分析CT影像特征与血供特点的相关性.结果:48个肝内假性肿瘤病变可按出现部位血供特点及表现分为5类:(1)胆管旁静脉丛引起的假性病变20个;(2)胆囊静脉丛引起的假性病变6个;(3)镰状韧带旁静脉引起的假性病变7个;(4)肝包膜血管引起的假性病变10个;(5)肝内小动静脉开放引起的假性病变5个.结论:肝内假性肿瘤病变的形成与肝内血供有密切的相关性,在特定的部位可形成较特异的CT影像表现,认识假性肿瘤病变的影像表现,有助于提高肝脏肿瘤病变的确诊率,降低误诊率.     

Scanning electron microscopic observation: three-dimensional architecture of the collagen in hepatic fibrosis rats

Background In the process of hepatic fibrosis, the accumulation of collagen fibers is strongly related to the hepatic function. The aim of this study was to investigate the three-dimensional architecture of the collagen network in the liver of rats with hepatic fibrosis. Methods Healthy adult male Wistar rats （n=32） were randomly divided into a control group （n=16） and a hepatic fibrosis group （n=16）. In the control group, the rats were treated with peanut oil while the rats in hepatic fibrosis group were treated for 10 weeks with 60% CCI4 diluted in peanut oil. The quantity of collagen fibers was detected by Western blotting; distribution of the collagen was detected by sirius red staining and polarized microscope; the three-dimensional architecture of collagen in the liver was observed under the scanning electron microscope after fixed tissues were treated with cell-maceration using NaOH. Statistical analysis was performed using the u test. Results The quantity of collagen fibers increased significantly in the hepatic fibrosis group. With the aggravation of hepatic fibrosis, collagen fibers gradually accumulated. They interlaced the reticulation compartment and formed a round or ellipse liver tissue conglomeration like a grape framework that was disparate and wrapped up the normal liver Iobule. The deposition of collagen fibers was obvious in adjacent hepatic parenchyma, especially around the portal tracts. Conclusion Our experiment showed the collagen proliferation and displays clearly the three-dimensional architecture of collagen fibers in rat liver with hepatic fibrosis by scanning electron microscope. It can provide a morphological foundation for the mechanisms of changed haemodynamics and portal hypertension in hepatic fibrosis.     

磁共振弥散加权成像对肝局灶性病变良恶性的鉴别诊断

目的 探讨磁共振弥散加权成像(DWI)在肝局灶性病变的良恶性鉴剐诊断中的应用价值.方法 收集肝脏局灶性痛变患者106例,其中原发性肝癌34例,肝脏转移瘤16例,海绵状血管瘤33例,肝囊肿15例,局灶性结节性增生8例.所有病例均行常规磁共振(MRI)扫描和单次激发的自旋回波平面回波成像(SE-EPI)序列的DWI,DWI采用b值为0 s/mm2和500 s/mm2.各组局灶性病灶平均表观弥散系数(ADC)值的比较采用t检验.结果 原发性肝癌、肝脏转移瘤、海绵状血管瘤、肝囊肿和局灶性结节性增生的平均ADC值分别为(1.77±0.60)×10-3mm2/s、(1.74±0.42)×10-3mm2/s、(2.52±0.75)×10-3mm2/s、(3.60±0.69)×10-3nm2/s和(2.09±0.52)x10-3mm2/s,肝囊肿和血管瘤与恶性病变比较,ADC值高且有统计学意义(P<0.01),而恶性肿瘤(原发性肝癌、肝转移瘤)与局灶性结节性增生比较,ADC值的差别不具有统计学意义(P>0.05).结论 DWI和ADC值能够鉴剐常见肝局灶性病变的良恶性,但肝实质性局灶性良恶性病灶之间的ADC值无明显差别,与普通MRI相比,DWI对肝脏实质性病灶性质的鉴别意义有限.     

^99mTc-DTPA-半乳糖人血清白蛋白在不同小鼠肝损伤模型中肝功能显像的应用

目的明确肝显像剂99mTc-DTPA-半乳糖人血清白蛋白(99mTc-GSA)在3种不同类型肝细胞损伤小鼠模型中不同的摄取和生物分布情况。方法3种小鼠模型分别为肝硬化、淤胆性肝损伤和肝肿瘤模型。肝硬化模型用腹腔内注射CCl4完成(每48小时腹腔注射0.4 ml 10?l4,共48 d);淤胆性肝损伤模型以结扎胆总管72 h建立;肝肿瘤模型用H22肿瘤细胞株种植肝包膜下10 d建立。各模型组小鼠和正常对照组小鼠均以0.1 ml(0.37 MBq)99mTc-GSA(2μg)注射尾静脉,5 min后断头处死,取出各重要器官或组织(肝脏、心脏、肺脏、肾脏、脾脏、胃、血液、骨骼、肌肉、肠道)称量,测定其放射性计数。同时血清学及肝脏病理学检查验证肝脏损伤。结果3个模型组和对照组中99mTc-GSA在小鼠肝脏均有显著浓聚(均>40%ID.g-1),但与对照组(90.05±10.55)%ID.g-1相比,肝损伤模型组的浓聚度均显著下降(P<0.001)。病理检查结果和建立模型时预期的病变相符;血清肝功能显示肝硬化模型组的损伤[天冬氨酸转氨酶为(235.3±14.7)U/L]轻于淤胆性肝损伤模型以及肝肿瘤模型[天冬氨酸转氨酶分别为(841.3±68.7)和(1 060.3±208.3)U/L];但肝硬化模型的浓聚度(72.20±2.13)%ID.g-1较淤胆性肝损伤模型(56.72±5.92)%ID.g-1及肝肿瘤模型(42.80±6.05)%ID.g-1显著增高(P<0.001)。结论99mTc-GSA在肝脏有显著浓聚,其浓聚程度与肝功能受损情况呈负相关。99mTc-GSA可能成为临床上反映肝功能的显像剂,如与三维扫描技术相结合,有希望建立评估肝脏区段功能的三维成像系统。     

~(99m)Tc-DTPA肾动态显像对2型糖尿病患者肾功能的评价

目的　探讨99mTc -二乙三胺五乙酸 (99mTc -DTPA)肾动态显像对 2型糖尿病患者肾功能的评价 ,为临床治疗和预后判断提供依据。方法　将 68例 2型糖尿病患者根据尿蛋白定性和定量结果分成无蛋白尿组 3 2例 (尿蛋白阴性 ,2 4h尿蛋白 <0 .5 g) ;蛋白尿组 3 6例 (尿蛋白阳性 ,2 4h尿蛋白≥ 0 .5 g)。并与正常对照组 2 3例进行99mTc -DTPA肾动态显像评价 ,比较获得肾小球滤过率 (GFR)、肾功能曲线峰时 (min)、2 0min残留率 (% )等参数。结果　无蛋白尿组GFR明显高于正常对照组 (P <0 .0 1) ;蛋白尿组GFR明显低于正常对照组 (P <0 .0 1)。两组 2型糖尿病患者肾功能曲线峰时、2 0min残留率均较正常对照组延长 (P <0 .0 1或 0 .0 5 )。结论　99mTc -DTPA肾动态显像可诊断 2型糖尿病肾病早期的GFR高滤过状态 ,并了解肾功能的受损程度 ,为临床治疗和随访提供依据。     

Three-dimensional reconstruction of digitized human liver: based on Chinese Visible Human

Background Comparing with two dimensional （2D） imaging, both in diagnosis and treatment, three dimensional （3D） imaging has many advantages in clinical medicine. 3D reconstruction makes the target easier to identify and reveals the volume and shape of the organ much better than 2D imaging. A 3D digitized visible model of the liver was built to provide anatomical structure for planing of hepatic operation and for realizing accurate simulation of the liver on the computer. Methods Transverse sections of abdomen were chosen from the Chinese Visible Human dataset. And Amira software was selected to segment and reconstruct the structures of the liver. The liver was reconstructed in three-dimensions with both surface and volume rendering reconstruction. Results Accurately segmented images of the main structures of the liver were completed. The reconstructed structures can be displayed singly, in small groups or as a whole and can be continuously rotated in 3D space at different velocities. Conclusions The reconstructed liver is realistic, which demonstrates the natural shape and exact position of liver structures, tt provides an accurate model for the automated segmentation algorithmic study and a digitized anatomical mode of viewing the liver.