核医学显像在急诊医学中的应用

目的:探讨核素显像在急诊显像中的应用价值。材料和方法:105 例患者接受急诊核素显像。A 组78 例行急诊心肌显像;B 组5 例行急诊脑显像;C 组15 例行急诊胃肠道出血显像;D 组7 例行急诊大血管显像。结果:78 例急诊心肌显像中,阳性74 例,阴性4 例;5 例急诊脑显像全部阳性;15 例胃肠道出血显像中,6 例阳性;7 例大血管显像全部阳性。结论:核素显像在急诊医学中能发挥重要作用。     

99mTc-RBC显像对胃肠道出血的定位诊断价值探讨

目的：探讨胃肠道出血核素显像的价值。材料和方法：回顾性分析了52例胃肠道出血的^99mTc-RBC核素显像检查,常规作体内标记法,先途径动态血流灌注显像。然后于注射后10,20,30min,1和2h作静态显像,自1999年2月开始加作24h延迟显像。结果：（1）52例核素显像的阳性率为53.8%(28/52),定位准确率为82.1%(23/28).(2)52例中,血流灌注动态显像早期以及静脉显像的定位准确率分别是94.1%(16/17)和72.2%(13/18);11例24h的延迟显像中,发现出血者7例,定位准确者4例.(3)22例阳性显像中,大便隐血(OB)试验阴性7例,阳性3例,强阳性12例;阴性显像14例中,OB阴性11例.强阳性3例,(4)核素显像阳性与BUN/Cr阳性之间未见相关性.结论:为了提高^99mTc-RBC显像对小肠出血点定位的灵敏度和准确性.应注意观察早期动态血流灌注显像和一系列静脉显像.对于出血的预测,显像前的大便隐血试验、BUN/Cr不如核素显像准确。     

^99Tc^m-MIBI／^90Tc^mO4-显像减影法在甲状旁腺腺瘤术前定位诊断中的价值

目的本研究比较^99Tc^m-MIBI／^90Tc^mO4-显像减影法与其他影像方法对术前甲状旁腺瘤定位诊断的价值,并探讨腺瘤大小、重量、血PTH及血钙对此核素显像的影响。方法回顾性分析了17例病理证实为甲状旁腺腺瘤患者,术前均行此核素显像及B超,其中15例行CT,10例行MRI检查。结果核素显像的灵敏度为70．59％,高于B超（58．82％）、CT（66．67％）及MRI（50．00％）。在核素显像阳性组（n=12）之腺瘤重量明显大于阴性组（n=5）,差异具有统计学意义（P〈0．05）;组间腺瘤最大径、血清PrrH及血钙无统计学差异。结论^99Tc^m-MIBI／^90Tc^mO4-显像减影法在术前甲状旁腺腺瘤的定位诊断中具有重要价值。     

冠心病患者~(201)Tl和~(99)Tc~m-MIBI双核素心肌灌注显像

目的　探讨静息2 0 1 Tl 负荷99Tcm 甲氧基异丁基异腈 (MIBI)双核素心肌SPECT显像在冠心病诊断中的价值。方法　对 36例冠心病患者行2 0 1 Tl负荷 延迟再分布心肌SPECT显像 ;常规潘生丁药物负荷高峰时 ,静脉注射2 0 1 Tl111～ 14 8MBq ,15min后进行心肌显像。对 2 3例冠心病患者和 9例正常人行静息2 0 1 Tl负荷、99Tcm MIBI双核素心肌SPECT显像 ,静息状态注射2 0 1 Tl111～ 14 8MBq ,注射后5min给予潘生丁药物负荷 ,高峰时注射99Tcm MIBI 92 5MBq。 1h后行双核素显像。结果　 36例冠心病患者2 0 1 Tl负荷 延迟再分布心肌显像的阳性率为 83 33% ,2 3例冠心病患者双核素心肌显像的阳性率为 10 0 % ,两组阳性率比较差异有显著性 (χ2 =4 2 6 7,P =0 0 4 3)。 9例正常受检者均为阴性。结论双核素心肌显像对冠心病的检出率较高 ,省时、安全并可获得高质量图像 ,对冠心病诊断有较高临床价值。     

99TCm-MIBI联合67Ga心肌显像诊断小儿病毒性心肌炎

目的　探讨99Tcm 甲氧基异丁基异腈 (MIBI)心肌灌注显像联合6 7Ga心肌显像诊断小儿病毒性心肌炎 (VMC)的价值。方法　 78例VMC患儿 ,其中急性期 (<6个月 ) 4 5例 ,慢性期 (>6个月) 33例 ,分别行99Tcm MIBI心肌灌注显像和6 7Ga心肌显像。结果　 4 5例急性期患儿中 31例(6 8 9% ) 99Tcm MIBI心肌灌注显像出现不同程度的放射性分布异常 ,38例 (84 4 % ) 6 7Ga心肌显像示心脏部位异常放射性浓聚 ;33例慢性期患儿中 2 3例 (6 9 7% ) 99Tcm MIBI心肌灌注显像阳性 ,6 7Ga心肌显像仅10例 (30 3% )阳性。急性期两者结果差异无显著性 (P >0 0 5 ) ;慢性期两者差异有显著性 (P <0 0 5 )。结论　99Tcm MIBI心肌灌注显像联合6 7Ga心肌显像对诊断小儿VMC及观察病情演变有较高价值。     

高分化甲状腺癌放射碘治疗后(131)~I核素显像联合SPECT/CT的诊断价值

目的回顾性比较SPECT/CT和全身131I核素显像联合应用与仅行核素显像对于高分化甲状腺癌放射碘治疗后的新增诊断价值。材料与方法本回顾性研究经单位伦理委员会批准,无需签署知情同意书。研究包括2009年10月—2010年8月经放射碘治疗的高分化甲状腺癌病人147例(男53例,女94例,平均年龄51岁)。每例病人均于放射碘治疗的同一天进行全身核素显像和SPECT/CT检查。全身核素显像中的每个放射性浓聚灶,根据甲状腺床内、淋巴结和远隔转移的摄取情况分为阳性和不能确定。采用常规McNemar检验对全身核素显像与SPECT/CT的检查结果进行比较评价。结果 SPECT/CT清晰地确定了甲状腺床内全身核素显像不能确定的全部5个"高摄取"病灶的起源(正常甲状腺残余组织或淋巴结转移)。对于核素显像诊断为转移淋巴结的108个放射性浓聚灶,其中的24个(22.2%)SPECT/CT改变了原来的结论(P<0.0001)。在SPECT/CT检查中,85个全身核素显像阳性的病灶中有1个证实为阴性(假阳性);在20个全身核素显像不能确定的病灶中,13个证实为阳性,7个证实为阴性。SPECT/CT检查还纠正了3个核素显像为假阴性的病灶。对于远隔转移灶,52个病灶中有24个(40%)的诊断结论被SPECT/CT修正(P<0.0001)。在SPECT/CT检查中,32个全身核素显像诊断为阳性的病灶中有1个被证实为阴性;20个全身核素显像不能确定的病灶中,11个证实为阳性,9个证实为阴性。对于全部147例病人,通过SPECT/CT检查改变了9例(6.1%)病人的临床分期和3例(2.0%)病人的治疗方案。结论与全身核素显像相比,SPECT/CT提高了131I在淋巴结转移和远隔转移内浓聚的发现和定位准确性。     

双核素门控心肌断层显像对心肌缺血的诊断价值

目的　提高心肌断层显像技术对冠心病诊断的准确性和实用性。方法　采用双核素门控心肌断层显像对 10 3例受检者进行检查 ,患者分为冠心病组 (3 7例 )和非冠心病组 (66例 )。静息注射2 0 1Tl和运动高峰注入99Tcm 甲氧基异丁基异腈 (MIBI) ,40min后一次性进行门控双能峰断层采集。分析比较运动和静息的断层图像 ,以及室壁运动、心肌灌注、室壁增厚度和区域射血分数值等 4个功能图像和左室功能参数 :左室射血分数、舒张末期容积和收缩末期容积 (LVEF、EDV和ESV) ,并以不同角度的“双网图”分析各心壁运动情况。有 3 8例在 2周内进行冠状动脉造影。结果　冠心病组检查阳性 94.6% (3 5 / 3 7例 ) ,阴性 5 .4% (2 / 3 7例 ) ;非冠心病组中检查阳性 10 .6% (7/ 66例 ) ,阴性89.4% (5 9/ 66例 )。冠心病组中双核素门控心肌断层显像提示心肌缺血共 48个节段 ,其中有 3 2个在功能图像上出现室壁运动下降和 (或 )区域LVEF值降低 (66.7% )。冠心病组LVEF(% ) ,EDV(mL)和ESV(mL)分别为 5 2 .3 3± 16.2 6,70 .45± 2 8.12和 3 3 .3 5± 18.86,非冠心病组分别为 61.76± 9.3 8,60 .45± 18.18和 2 3 .3 0± 11.0 9,两组之间比较P <0 .0 1(t=2 .96) ,P <0 .0 5 (t =2 .5 5 ) ,P <0 .0 5 (t =2 .67)。其中 3 8例与冠状     

冠心病患者201Tl和99Tcm-MIBI双核素心肌灌注显像

目的探讨静息201Tl/负荷99Tcm-甲氧基异丁基异腈(MIBI)双核素心肌SPECT显像在冠心病诊断中的价值.方法对36例冠心病患者行201Tl负荷-延迟再分布心肌SPECT显像;常规潘生丁药物负荷高峰时,静脉注射201Tl 111～148 MBq,15 min后进行心肌显像.对23例冠心病患者和9例正常人行静息201Tl负荷、99Tcm-MIBI双核素心肌SPECT显像,静息状态注射201Tl 111～148 MBq,注射后5 min给予潘生丁药物负荷,高峰时注射99Tcm-MIBI 925 MBq.1 h后行双核素显像.结果 36例冠心病患者201Tl负荷-延迟再分布心肌显像的阳性率为83.33%,23例冠心病患者双核素心肌显像的阳性率为100%,两组阳性率比较差异有显著性(χ2=4.267,P=0.043).9例正常受检者均为阴性.结论双核素心肌显像对冠心病的检出率较高,省时、安全并可获得高质量图像,对冠心病诊断有较高临床价值.     

高原地区冠心病患者核素心肌显像和冠状动脉造影的对比

目的：探讨核素心肌显像和冠状动脉造影在冠心病诊断中的临床意义，并与平原地区资料相比较，探讨高原地区缺氧环境中核素心肌显像在临床中的应用价值。方法：核素心肌显像：采用单光子发射计算机体层摄影（SPECT），根据充盈缺损部位确定缺血或梗塞部位。冠状动脉造影：采用经右股动脉穿刺，冠状动脉管径狭窄≥50％时判断为冠状动脉造影结果阳性。结果：核素心肌显像对冠心病的诊断敏感性为95．2％，特异性为77.8％，阳性预测值为97．6％，阴性预测值为77．8％。结论：核素心肌显像对冠心病的诊断有较大价值。     

腺苷与运动负荷心肌灌注显像诊断不典型胸痛心肌缺血的临床价值

目的评价腺苷和运动负荷心肌灌注显像诊断不典型胸痛患者心肌缺血的价值。方法不典型胸痛患者67例行腺苷负荷心肌灌注显像，81例行运动负荷心肌灌注显像，结果分别与冠状动脉（简称冠脉）造影比较，得到显像诊断冠心病心肌缺血的灵敏度、特异性和准确性。结果腺苷负荷心肌灌注显像组67例中，23例冠脉造影有狭窄病变，腺苷负荷心肌灌注显像检出可逆性灌注异常即诊断心肌缺血16例，44例冠脉造影阴性者中，腺苷心肌灌注显像正常41例。腺苷负荷心肌灌注显像诊断冠心病心肌缺血的灵敏度为70％，特异性93％，准确性85％。运动负荷心肌灌注显像组81例中，31例冠脉造影阳性，运动负荷心肌灌注显像检出心肌缺血22例，50例冠脉造影阴性者中，运动负荷心肌灌注显像正常48例。运动负荷心肌灌注显像诊断冠心病心肌缺血的灵敏度为71％，特异性96％，准确性86％。结论腺苷或运动负荷心肌灌注显像出现可逆性灌注异常对诊断不典型胸痛患者冠心病心肌缺血有重要意义。     

Negative Endoskopie sowie Mehrzeilendetektor-CT bei Patienten mit akuter unterer Gastrointestinalblutung

PURPOSE: To evaluate the clinical use of (99m)Tc red blood cell imaging (RBC imaging) in patients presenting with acute lower gastrointestinal (GI) bleeding and negative endoscopy and multislice computed tomography (MSCT) findings. PATIENTS AND METHODS: In 31 consecutive patients with acute lower GI bleeding in whom the endoscopy findings were negative or the procedure was not feasible, dual-phase MSCT of the abdomen was performed [collimation 4x1 mm (arterial phase), 4x2.5 mm (venous phase)]. MSCT was followed by a (99m)Tc red blood cell scan in patients in whom no active bleeding was visible by CT. Images were created within 24 h after administration of the tracer, depending on the clinical symptoms. The results of the imaging modalities were correlated with clinical course and surgical treatment. RESULTS: In 20 of 31 patients MSCT showed no active bleeding and a (99m)Tc red blood cell scan was performed. In 8 of 20 patients RBC imaging was also negative. Of these eight patients five were stable and did not require further diagnostic work-up; in the other three bleeding persisted and these patients required surgical treatment. In 12 of 20 patients active bleeding was demonstrated using a (99m)Tc red blood cell scan. Of 12 patients with positive RBC scintigraphy findings, 8 underwent surgery, where the site of bleeding was confirmed. CONCLUSION: In patients with acute lower GI bleeding with negative or nondiagnostic endoscopy or MSCT findings, (99m)Tc red blood cell imaging is a useful tool in an emergency algorithm, improving the overall bleeding detection rate.     

Imaging with 99mTc ECDG targeted at the multifunctional glucose transport system: feasibility study with rodents

PURPOSE: To evaluate the feasibility of technetium 99m ((99m)Tc) ethylenedicysteine-deoxyglucose (ECDG) imaging in tumor-bearing rodents. MATERIALS AND METHODS: ECDG was synthesized by means of reacting ethylenedicysteine with glucosamine, with carbodiimide as the coupling agent. Hexokinase assays were performed at an ultraviolet wavelength of 340 nm. To determine whether blood glucose level could be altered, ECDG or glucosamine was injected into six rats. In a separate study, ECDG followed by insulin was administered to three rats. To determine biodistribution, lung tumor cells were intramuscularly injected into the hind legs of 18 nude mice. The animals were then injected with (99m)Tc ECDG or fluorine 18 ((18)F) fluorodeoxyglucose (FDG) (0.037-0.074 MBq per mouse). Radioactivity was measured in tissue excised from the animals. Scintigraphy was performed in three groups: in group 1 to demonstrate that different-sized tumors could be imaged after (99m)Tc ECDG administration, in group 2 to ascertain whether tumor uptake of (99m)Tc ECDG was perfusion related, and in group 3 to demonstrate that tumor uptake of (99m)Tc ECDG occurred by means of a glucose-mediated process. RESULTS: ECDG was positive for phosphorylation at hexokinase assay. Blood glucose level increased with ECDG injection and decreased with insulin administration. Tumor-to-brain tissue and tumor-to-muscle tissue ratios of (99m)Tc ECDG uptake were higher than those of (18)F FDG uptake. Scintigraphic results demonstrated the feasibility of (99m)Tc ECDG imaging. CONCLUSION: There are similarities between (99m)Tc ECDG uptake and (18)F FDG uptake in tumors, and study findings supported the potential use of (99m)Tc ECDG as a functional imaging agent.     

99mTc-ENS ventilation scintigraphy: preliminary study in human volunteers

Exogenous natural surfactant (ENS) labeled with (99m)Tc ((99m)Tc-ENS, 900-1110 MBq), a new radiopharmaceutical for ventilation scintigraphy, was nebulized during 3 min to five volunteers. For comparative purposes, (99m)Tc-diethylenetriamine pentaacetic acid (DTPA) was studied in the same way. (99m)Tc-ENS images were of at least the same quality as (99m)Tc-DTPA images. However, in smoking volunteers, the (99m)Tc-DTPA images show some areas that seemed to be not well-ventilated, although these areas appeared well-ventilated when the study was performed with (99m)Tc-ENS. These results suggest that (99m)Tc-ENS can be used for ventilation scintigraphy to allow the observation of some areas that cannot been visualized using (99m)Tc-DTPA as ventilation agent.     

Is there a role for (99m)Tc-anti-CEA monoclonal antibody imaging in the diagnosis of recurrent colorectal carcinoma?

AIM: To evaluate the usefulness of immunoscintigraphy with an anti-CEA monoclonal antibody fragment labelled with (99m)Tc for early detection of colorectal recurrence in patients with rising serum CEA levels. METHODS: Fifty-one consecutive patients (27 women, 24 men) with colorectal cancer (mean age 68.9+/-10.2 years) and rising CEA levels (16.2+/-18.2 ng/ml) were prospectively studied. Two immunoscintigraphy studies were performed in 8 patients (n=59). Immunoscintigraphy was performed after i.v. injection of 925 MBq of anti-CEA monoclonal antibody. Planar images of the thorax, abdomen and pelvis, as well as SPECT of the abdomen and pelvis were obtained at 4 and 24 hours after injection. In all cases an abdominal CT scan was previously performed. Findings were validated by histopathological analysis (28 cases) or by imaging and clinical follow-up of at least 6 months following the immunoscintigraphy (31 cases). RESULTS: Forty-one patients did not show recurrence during follow-up. We found 18 cases with confirmed diagnosis of extrahepatic abdominal or pelvic diseases, 11 cases with liver metastases, 9 in the thorax and 2 in the bone. In patients with pelvic and extrahepatic abdominal disease, immunoscintigraphy was positive in 18 cases (14 true positive, 4 false positive). From the 14 true positive only 7 cases had been detected by CT. Immunoscintigraphy was negative in the remaining 41 cases (37 true negative, 4 false negative). Therefore, the sensitivity and specificity for immunoscintigraphy in extrahepatic abdominal and pelvic disease were 78% and 90%, respectively. CT results showed a lower sensitivity of 61% (p<0.05) and specificity of 83%. Liver metastases were detected by CT in 9 cases, but only 2 of these were identified using immunoscintigraphy. CONCLUSION: Scintigraphy with anti-CEA monoclonal antibody fragment labelled with (99m)Tc is superior to CT for the detection of pelvic and extrahepatic abdominal recurrence of colorectal cancer, while CT is more sensitive in the detection of liver and lung metastases. Immunoscintigraphy has a limited usefulness in the detection of distant metastases, but it may be helpful in the diagnosis of suspected colorectal recurrence in patients with non-conclusive CT findings, when FDG-PET is not available.     

Protein-losing enteropathy: diagnosis with (99m)Tc-labeled human serum albumin scintigraphy

PURPOSE: To investigate the diagnostic value of technetium 99m-labeled human serum albumin (HSA) scintigraphy in a group of patients suspected of having protein-losing enteropathy (PLE). MATERIALS AND METHODS: After intravenous injection of 740 MBq of freshly prepared (99m)Tc HSA, serial images of the abdomen were obtained from 10 minutes until 24 hours after injection. A (99m)Tc HSA scan was considered positive for PLE if there was visible tracer exudation in the gut. The diagnosis was established on the basis of standard clinical and biopsy findings. RESULTS: Thirty-nine scans were obtained: 27 scans in 26 suspected cases of PLE and 12 scans in control subjects with no known gastrointestinal disease. Twenty-five of the 26 studies in patients suspected of having PLE showed (99m)Tc HSA activity in the bowel. Among the 25 studies with positive findings, seven demonstrated PLE only on images obtained 24 hours after injection. In the control subjects, no activity was seen in the bowel. CONCLUSION: (99m)Tc HSA with serial scanning for up to 24 hours is reliable and useful for imaging PLE. Sites of protein loss may also be demonstrated. This imaging method is convenient, easy to perform, and yields results within 24 hours.     

Imaging of HER2/neu expression in BT-474 human breast cancer xenografts in athymic mice using [(99m)Tc]-HYNIC-trastuzumab (Herceptin) Fab fragments

OBJECTIVE: To evaluate the ability of trastuzumab (Herceptin) Fab, labelled with (99m)Tc through introduced hydrazinenicotinamide (HYNIC) functionalities, to image HER2/neu-overexpressing human breast cancer xenografts in athymic mice. METHODS: Fab fragments were produced by immobilized papain digestion of trastuzumab immunoglobulin G (IgG), followed by purification by ultrafiltration. The immunoreactivity of trastuzumab Fab was evaluated by receptor-binding assays against HER2/neu-positive SK-BR-3 human breast cancer cells. Trastuzumab Fab fragments were labelled with (99m)Tc following modification with HYNIC N-hydroxysuccinimide ester. Biodistribution and tumour imaging studies were performed in athymic mice bearing subcutaneous HER2/neu-overexpressing BT-474 human breast cancer xenografts following intravenous injection of 1.1 or 25 MBq of [(99m)Tc]-trastuzumab Fab (30 microg), respectively. The specificity of tumour uptake was assessed by comparison with that of [(99m)Tc]-labelled irrelevant anti-CD33 HuM195 Fab. RESULTS: Trastuzumab Fab was pure and exhibited preserved immunoreactivity towards SK-BR-3 cells (K(d) = 1.6 x 10(-8) M). Modification with HYNIC diminished its receptor-binding affinity fourfold. [(99m)Tc]-trastuzumab Fab localized avidly and specifically in BT-474 xenografts, achieving a tumour uptake of 10.7% of the injected dose (ID) per gram and a tumour to blood (T/B) ratio of 3 : 1 at 24 h. The tumour uptake and T/B ratio for [(99m)Tc]-trastuzumab Fab were significantly higher than those for control [(99m)Tc]-HuM195 Fab (2.6% ID x g(-1) and 0.9 : 1, respectively; P<0.05). Tumours were imaged as early as 2 h post-injection of [(99m)Tc]-trastuzumab Fab, but were more clearly visualized at 6 and 24 h post-injection. CONCLUSIONS: [(99m)Tc]-HYNIC-trastuzumab Fab localized specifically in HER2/neu-overexpressing human breast cancer xenografts in athymic mice, allowing imaging of the tumours within the useful lifetime of the radionuclide.     

Feasibility of dual-isotope coincidence/single-photon imaging of the myocardium.

Hybrid PET scanners offer the possibility of obtaining myocardial viability information from coincidence imaging of the positron emitter (18)F-FDG and perfusion measurements from a single-photon tracer-potentially simultaneously. This new approach is less costly and more readily available than dedicated PET and offers potential for improved FDG resolution and sensitivity compared with SPECT with 511-keV collimators. Simultaneous imaging of the coincidence and single-photon events offers the further advantages of automatic image registration and reduced imaging time. However, the feasibility of simultaneous coincidence/single-photon imaging or even immediately sequential imaging is unknown. In this study, the potential of using standard low-energy high-resolution (LEHR) collimators with hybrid PET to obtain coincidence and SPECT data was assessed. METHODS: Phantom and human studies were performed to investigate the effect of LEHR collimators on FDG coincidence imaging with a hybrid PET system, the effect of the presence of (99m)Tc during FDG coincidence imaging with LEHR collimators, and the effect of the presence of FDG during (99m)Tc SPECT imaging. RESULTS: FDG images were somewhat degraded (a measure of myocardial nonuniformity increased 10%) with LEHR collimators. With 148 MBq (4 mCi) (99m)Tc present during FDG imaging of a phantom, image quality was maintained and the number of detected coincidences changed by <5%. With (99m)Tc/(18)F whole-body ratios of 7:1, crosstalk from (18)F photons accounted for the majority of counts in the (99m)Tc SPECT images and resulted in severe artifacts. The artifacts were decreased with a simple crosstalk correction scheme but remained problematic. CONCLUSION: (99m)Tc/(18)F ratios of at least 9:1 and state-of-the-art reconstruction and crosstalk correction are likely to be required to perform immediately sequential coincidence/single-photon imaging of the myocardium with clinically useful results. Additional challenges remain before simultaneous imaging of coincidence events and single photons can be realized in practice.     

99Tc(m) labelled HL91 versus computed tomography and biopsy for the visualization of tumour recurrence of squamous head and neck carcinoma

This phase I pilot study reports on (1) the safety and feasibility of 99Tc(m)-HL91, an amine oxime core radioligand that has shown oxygen dependent binding, and imaging; and (2) its usefulness for the visualization of local tumour recurrence of a biopsy proven squamous cell carcinoma of the head and neck (SCCHN) as compared to spiral computed tomogaphy (CT) and biopsy. Nine men (mean age 33 years, range 34-74 years) were prospectively included. For safety measurements, vital signs were recorded and serum chemical analysis carried out, with a complete blood cell count and urine analysis, and an ECG was performed prior to injection of 99Tc(m)-HL91 and repeated during the investigation. Single photon emission computed tomography (SPECT) scans of the head and neck, and of a standard, were performed at 2 h and 4 h post-injection of 740 MBq 99Tc(m)-HL91. Tumour-to-normal tissue background (T/N) ratios and percentage uptake were measured for all 99Tc(m)-HL91 scans. Spiral CT scans were obtained using a Somaton 4+ Siemens scanner within 1 week from the 99Tc(m)-HL91 scans. Based on CT and the 99Tc(m)-HL91 scan findings guided biopsies were performed. No adverse or subjective side effects were noticed. Vital signs, ECG findings, clinical laboratory, blood and urine assays remained stable in all patients. Spiral CT suggested local recurrence in 5/9 patients accompanied by nodal involvement in three, all of which proved positive on biopsy. 99Tc(m)-HL91 scintigraphy was false positive in one patient and true positive (TP) in 3/5 local recurrences and two out of three sites of lymph node involvement depicted by spiral CT. The mean T/N ratios at 2 h and 4 h in TPs were 1.28 (range 1.1-1.66) and 1.40 (range 1.0-1.6), respectively. The corresponding absolute percentages of 99Tc(m)-HL91 lesional uptake at 2 h and 4 h were mu = 0.05% (SD = 0.03%) and mu = 0.048% (SD = 0.035%). The findings suggest 99Tc(m)-HL91 is a safe radioligand and that metabolic binding in a large fraction but not all of local SCCHN recurrences may be expected. The inference that tumour 99Tc(m)-HL91 avidity could be a non-invasive measure of tumour hypoxia deserves however independent confirmation with needle oximetry.     

急诊~(99m)Tc-MIBI心肌显像在不典型急性心肌梗塞诊断及溶栓治疗中的应用(附5例报告)

为探讨急诊９９ｍＴｃ甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像在不典型急性心肌梗塞（ＡＭＩ）诊断及溶栓治疗中的价值，对５例不典型ＡＭＩ患者静脉注射９９ｍＴｃＭＩＢＩ后２小时进行心肌断层显像。结果，５例患者均明确了诊断，其中２例在６小时内进行了溶栓治疗，通过第二次心肌显像，支持临床冠状动脉再通判断。因此，急诊９９ｍＴｃＭＩＢＩ心肌显像对不典型ＡＭＩ的诊断具有特殊的价值；同时，对判断溶栓疗效，估价预后也具有一定的意义。