PET在中枢神经系统的应用

随着现代医学影像学的发展．人们在对神经系统疾病的诊断方面取得巨大的进展．而且还不断有新技术出现．PET（正电子发射断层，Positron Emission Tomography）的出现将人们带入了一个新的时代——分子影像学时代。PET是将能放出正电子的放射性核素标记示踪剂引入体内，然后探测正电子与电子发生湮灭反应时释放的两个在同一直线上方向相反的两个γ光子，通过计算得到有关血流分布、氧消耗、物质代谢等方面的信息，向人体引入参与体内不同生物代谢活动的各种示踪剂，如碳、氧、氢等，可以获得人体细胞代谢的各种参数，以此评价其功能，是分子影像学研究的重要工具。     

慢性疲劳综合征中枢神经系统机制进展

慢性疲劳综合征（chronic fatigue syndrome，CFS）是美国疾病控制与预防中心（Centre for Disease Control and Prevention，CDC）1988年正式命名的、以持续或反复发作不少于6个月严重疲劳为特征，伴有头痛、睡眠障碍，注意力和记忆下降，抑郁，肌肉骨关节疼痛等多种躯体及精神神经症状。1994年CDC将该标准进行了修订。[第一段]     

慢性疲劳综合征研究现状

慢性疲劳综合征(Chronic FatigueSyndrome,CFS)是以疲劳、低热、咽喉痛、肌痛、关节痛、神经精神症状、免疫学异常和其它非特异性表现为主的综合征.美国全国非卧床病人医疗护理调查结果表明:慢性疲劳是初级诊疗中第七个最常见的症状.最近,美国疾病控制中心(CDC)预测,慢性疲劳将成为二十一世纪人类健康的主要问题之一.因此CFS成为近几年国外医学界研究的重要课题.自30年代后期本病已有50余年的研究历史,曾用许多名称描述,如Akureyri病、Iceland病(冰岛病)、非典型性脊髓灰质炎、良性肌痛性脑脊髓炎(ME)、慢性单核细胞增多症样综合征、慢性Epstein-Barr病毒(EBV)综合征、病毒感染后疲劳综合征和病毒感     

PET脑成像用于诊断帕金森病研究进展

帕金森病(PD)是第二大神经退行性疾病，严重危害患者健康，并给社会和家庭带来巨大负担。PET脑成像技术可无创、精准评估PD患者脑葡萄糖代谢及多巴胺能神经元功能改变，对早期诊断及临床干预具有重要价值。本文介绍PET脑成像用于诊断PD研究进展。     

PET成像中部分容积效应的成因及影响因素

部分容积效应(Partial volume effect,PVE)是影响医学影像设备图像分析的重要因素.PET成像系统有限的分辨率使PVE更加明显,造成大病灶图像边缘模糊,小病灶图像模糊暗淡;在定量分析上使标准化摄取值(SUV)降低,影响对病灶性质的判定及放化疗等治疗效果的评估.本文对PVE的成因、影响因素、实际影响进行初步的探讨. 1 PVE的成因 PVE是由两个效应共同作用下形成的,即点源扩展及组织分数效应.点源扩展是PET分辨率较低造成的[1],组织分数效应主要和PET采集图像信号的方式有关[2],下面进行详细的叙述.     

慢性疲劳综合征

慢性疲劳综合征霍万户慢性疲劳综合征（ｃｈｒｏｎｉｃｆａｔｉｇｕｅｓｙｎｄｒｏｍｅ：ＣＦＳ）目前在欧美以及日本的新闻媒体称之为“第二爱滋病”。群众和医学界对此都很关注。如美国近年连续召开国际性的慢性疲劳综合征（下略称ＣＦＳ）的专题学术会议探讨其病因、诊...     

列表模式采集在18F-FDG PET/CT采集时长优化中的初步应用

目的:探讨应用列表采集模式优化18F-FDG PET/CT采集时长的可行性.方法:共22例常规接受PET/CT检查患者入选本研究.患者按照7.4 MBq/kg的标准注射显像剂,显像仪器为西门子Biograph 64 PET/CT.选择肝脏作为靶器官,先行CT扫描,然后行180 s列表模式PET采集.通过设置不同的采集时间长度参数对原始数据重建静态图像,获得40～180 s间8个时长条件下的PET图像.选择肝脏最大层面、无病灶区域勾画直径为4 cm的感兴趣区,测量感兴趣区的SUVmax及SUVmean.所有统计分析使用SPSS16完成.结果:SUVmax与SUVmean均呈现出随采集时间增加而降低的变化趋势,在采集时长≥80 s的情况下,各组间SUVmax与SUVmean均无显著差异,与常规PET/CT采集获得图像亦无显著差异.结论:优化的采集时长在保证图像质量基础上显著提高了检查效率.列表模式采集能够动态反映采集时长与图像质量间的关系,可以作为确定18F-FDGPET/CT最优采集时长的有效方法.     

PET/MR的图像融合精度测试研究

目的：运用专用测试体模和Na源在模拟实际临床状态下测试PET/MR一体机（Philips lngenuity TF PET/MR扫描仪）全身3D采集方式的图像融合精度.材料和方法：使用Philips公司提供的测试体模及其配套的Na源,先将Na源分别放置于模型的规定位置对采集和扫描的数据进行融合校准,再将相同的6个Na源分别固定于检查床两测,在检查床负重10 kg和60 kg时分别采集PET/MR图像数据.重建图像后,分别在PET和MR图像的横断层面勾画Na源的轮廓,计算出Na源在PET和MR上的重心位置.对两个位置进行对比,算出差值.结果：检查床负重10 kg时最大偏差出现在上段右侧,为3.01 mm;检查床负重60 kg时最大偏差出现在中段右侧,为4.66 mm.结论：本研究方法可以比较精确地测量PET/MR图像融合精度,并有效地指导PET/MR仪器的验收和质量控制等.     

SPECT及PET成像在自闭症谱系障碍中的研究进展

自闭症谱系障碍（ASD）发病原因尚不明确，SPECT及PET成像可通过无创检测大脑血流量、葡萄糖代谢、蛋白质代谢来研究其神经生物学机制，本文主要对近年来有关ASD的SPECT及PET成像研究进行综述。     

慢性疲劳综合征研究新进展

近年来慢性疲劳综合征已引起医学界的广泛关注。从慢性疲劳综合征发病原因、发病机制和干预措施方面综述了最新研究进展。     

慢性疲劳综合征研究新进展

近年来慢性疲劳综合征已引起医学界的广泛关注.从慢性疲劳综合征发病原因、发病机制和干预措施方面综述了最新研究进展.     

Prefrontal cortex oxygenation during incremental exercise in chronic fatigue syndrome

This study examined the effects of maximal incremental exercise on cerebral oxygenation in chronic fatigue syndrome (CFS) subjects. Furthermore, we tested the hypothesis that CFS subjects have a reduced oxygen delivery to the brain during exercise. Six female CFS and eight control (CON) subjects (similar in height, weight, body mass index and physical activity level) performed an incremental cycle ergometer test to exhaustion, while changes in cerebral oxy-haemoglobin (HbO2), deoxy-haemoglobin (HHb), total blood volume (tHb = HbO2 + HHb) and O2 saturation [tissue oxygenation index (TOI), %)] was monitored in the left prefrontal lobe using a near-infrared spectrophotometer. Heart rate (HR) and rating of perceived exertion (RPE) were recorded at each workload throughout the test. Predicted VO2peak in CFS (1331 +/- 377 ml) subjects was significantly (P < or = 0.05) lower than the CON group (1990 +/- 332 ml), and CFS subjects achieved volitional exhaustion significantly faster (CFS: 351 +/- 224 s; CON: 715 +/- 176 s) at a lower power output (CFS: 100 +/- 39 W; CON: 163 +/- 34 W). CFS subjects also exhibited a significantly lower maximum HR (CFS: 154 +/- 13 bpm; CON: 186 +/- 11 bpm) and consistently reported a higher RPE at the same absolute workload when compared with CON subjects. Prefrontal cortex HbO2, HHb and tHb were significantly lower at maximal exercise in CFS versus CON, as was TOI during exercise and recovery. The CFS subjects exhibited significant exercise intolerance and reduced prefrontal oxygenation and tHb response when compared with CON subjects. These data suggest that the altered cerebral oxygenation and blood volume may contribute to the reduced exercise load in CFS, and supports the contention that CFS, in part, is mediated centrally.     

MRI研究慢性疲劳综合征脑结构及功能进展

2016年WHO国际疾病分类将慢性疲劳综合征(CFS)归为神经系统其他疾病,脑结构及功能异常在CFS发病过程中具有关键作用。MRI有助于观察脑结构及功能变化,为诊断CFS及解析其发病机制提供影像学依据。本文就MRI研究CFS脑结构及功能进展进行综述。     

Traditional chinese medicine for chronic fatigue syndrome

More and more patients have been diagnosed as having chronic fatigue syndrome (CFS) in recent years. Western drug use for this syndrome is often associated with many side-effects and little clinical benefit. As an alternative medicine, traditional Chinese medicine (TCM) has provided some evidences based upon ancient texts and recent studies, not only to offer clinical benefit but also offer insights into their mechanisms of action. It has perceived advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints, although there are some limitations regarding the diagnostic standards and methodology in related clinical or experimental studies. Modern mechanisms of TCM on CFS mainly focus on adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA) axis and serving as an antioxidant. It is vitally important for the further development to establish standards for 'zheng' of CFS, i.e. the different types of CFS pathogenesis in TCM, to perform randomized and controlled trials of TCM on CFS and to make full use of the latest biological, biochemical, molecular and immunological approaches in the experimental design.     

PET及PET/CT对抑郁症的研究现状及进展

抑郁症以显著而持久的心境低落为主要临床特征,严重危害人类健康。目前PET及PET/CT逐渐成为研究抑郁症的有效工具,通过动态观测抑郁症患者脑内物质代谢、局部血流量和受体密度等生理生化改变,为探讨抑郁症的发病机制、病理生理特点及评价治疗反应等提供客观依据。本文对PET及PET/CT在抑郁症研究中的现状及进展进行综述。     

心脏副交感神经正电子显像剂的研究进展

心脏副交感神经正电子显像剂的研发在评估心血管疾病中起着不可估量的作用,正电子发射断层显像能够高灵敏地反映心脏副交感神经的变化。本文旨在介绍烟碱类、毒蕈碱类和乙酰胆碱酯酶类三种心脏副交感神经显像剂的研究新进展。2-¹⁸F-氟-3-(2(S)-甲氧基氮杂环丁烷基)吡啶(2-¹⁸F-F-A-85380)、(R, S)-N-¹¹C-甲基-二苯乙醇酸-3-奎宁环酯(¹¹C-MQNB)和4-¹⁸F-氟苄基-右苄替米特(4-¹⁸F-FDEX)为烟碱类和毒蕈碱类副交感神经显像剂,¹¹C-多奈哌齐(¹¹C-DNP)和N-[¹¹C]甲基-3[[(二甲氨基)羰基]氧基]-2-(2', 2'-二苯基丙氧基甲基)吡啶(¹¹C-MDDP)为乙酰胆碱酯酶类副交感神经显像剂。其中¹¹C-MQNB、2-¹⁸F-F-A-85380研究较为深入,而¹¹C-DNP、¹¹C-MDDP、4-¹⁸F-FDEX是具有良好临床应用潜质的显像剂。     

Measuring substantial reductions in functioning in patients with chronic fatigue syndrome

Purpose.?All the major current case definitions for chronic fatigue syndrome (CFS) specify substantial reductions in previous levels of occupational, educational, social, or personal activities to meet criteria. Difficulties have been encountered in operationalizing ‘substantial reductions.’ For example, the Medical Outcomes Study Short Form-36 Health Survey (SF-36) has been used to determine whether individuals met the CFS disability criterion. However, previous methods of using the SF-36 have been prone to including people without substantial reductions in key areas of physical functioning when diagnosing CFS. This study sought to empirically identify the most appropriate SF-36 subscales for measuring substantial reductions in patients with CFS.

Method.?The SF-36 was administered to two samples of patients with CFS: one recruited from tertiary care and the other a community-based sample; as well as a non-fatigued control group. Receiver operating characteristics were used to determine the optimal cutoff scores for identifying patients with CFS.

Results.?The SF-36 Role-Emotional subscale had the worst sensitivity and specificity, whereas the Vitality, Role-Physical, and Social Functioning subscales had the best sensitivity and specificity.

Conclusion.?Based on the evidence from this study, the potential criteria for defining substantial reductions in functioning and diagnosing CFS is provided.     

Anticardiolipin antibodies in the sera of patients with diagnosed chronic fatigue syndrome

Examination of anticardiolipin antibodies (ACAs) in the sera of patients clinically diagnosed with chronic fatigue syndrome (CFS) using an enzyme‐linked immunoassay procedure demonstrated the presence of immunoglobulin M isotypes in 95% of CFS serum samples tested. The presence of immunoglobulin G and immunoglobulin A isotypes were also detected in a subset of the samples. Future studies will focus on elucidating whether alterations to mitochondrial inner membranes and/or metabolic functions play a possible role in the expression of ACAs. J. Clin. Lab. Anal. 23:210–212, 2009. © 2009 Wiley‐Liss, Inc.