86例肺结节病67Ga显像分析

目的探67Ga显像非典型或典型“熊猫脸”征象对肺结节病的诊断价值。方法回顾性分析86例经病理检查证实为肺结节病患者的67Ga全身显像资料，与185例非结节病患者67Ga显像结果对照。结果86例肺结节病患者中表现为泪腺和腮腺摄取放射性，呈典型“熊猫脸”征象并伴有纵隔和(或)肺门淋巴结肿大者39例，占45．3％；表现为泪腺或腮腺摄取放射性，呈非典型“熊猫脸”征象并伴有纵隔和(或)肺门淋巴结肿大者18例，占20．9％。所有表现为泪腺和(或)腮腺有放射性摄取、伴有纵隔和(或)肺门淋巴结肿大者均经病理检查确诊为结节病。在非结节病患者中未出现该征象。结论67Ga显像非典型与典型“熊猫脸”征象有同样的诊断价值，在伴有纵隔和(或)肺门淋巴结肿大时是诊断结节病的可靠征象。     

^67Ga显像对结节病的临床研究

对２４例结节病（４例活动期，２０例非活动期）患者进行了＾６７Ｇａ显像，并测定了血清血管紧张素转化酶（ＳＡＣＥ），进行了肺功能及ＣＴ或Ｘ线检查。４例活动期结节病患者中有３例表现为双侧肺门对称性放射性浓聚，似“八”字状；其中２例患者因双侧泪腺和腮腺＾６７Ｇａ摄取增高，呈特殊的“熊猫”面容。４例活动期结节病患者其病灶对＾６７Ｇａ摄取明显增多，相当于３＋；２０例非活动期患者中８例（４０％）＾６７Ｇａ显像异     

18F-FDG符合线路显像与67Ga显像诊断结节病的对比研究

目的 对比分析^18F-脱氧葡萄糖(FDG)符合线路显像(FDG显像)和^67Ga显像对结节病的诊断和疗效监测的价值。方法 17例结节病患者行^18F-FDG显像，其中11例行^67Ga显像。以目测法判断纵隔和肺门淋巴结放射性摄取程度，明显超过周围肺组织本底水平者为阳性。结果 11例未治疗的结节病患者^18F-FDG显像均阳性，其中7例行^67Ga显像者影像特征与^18F-FDG显像相似；^18F-FDG、^67Ga显像均阳性的2例患者，治疗后X线片示病灶吸收，再次显像均为阴性；^18F-FDG显像本底较低且显像效果较好。3例已治疗者X线片示病灶吸收，^18F—FDG显像均阴性，其中2例行^67Ga显像也阴性。3例临床诊断为结节病者，^18F-FDG显像阳性，其中2例^67Ga显像也阳性(1例治疗后2种显像仍呈阳性，而X线片示纵隔肺门肿大淋巴结缩小)。结论 ^18F-FDG符合线路显像比^67Ga显像效果好,对结节病诊断和治疗效果监测有较好的应用价值。     

67Ga肺显像诊断肺癌及淋巴结转移

笔者分析了 10 8例肺癌患者6 7Ga肺显像结果 ,并与术后病理检查结果对照 ,现报道如下。一、资料与方法1 研究对象。对照组为肺部良性病变患者 4 2例 ,男 2 7例 ,女 15例 ,年龄 2 7～72岁。肺癌患者 10 8例 ,男 82例 ,女 2 6例 ,年龄 2 3～ 82岁 ,其中合并淋巴结转移者 32例。均经病理检查证实。2 方法。静脉注射6 7Ga 枸橼酸钠185MBq,分别于注射后 6 ,2 4 ,4 8和 72h行前位、后位、左侧位及右侧位SPECT显像。以肺部出现异常放射性浓聚区为阳性 ,采用感兴趣区 (ROI)技术分别测量良恶性病变与周围正常肺组织的放射性比值 (T N) ,显像阴…     

67Ga炎症显像的操作指南

介绍了67Ga炎症显像的适应症,并指导核医学医师掌握67Ga-枸橼酸盐炎症显像的操作过程及对显像结果进行解释、报告.     

67 Ga显像诊断口腔颌面部良恶性肿块的临床研究

67Ｇａ 枸橼酸 (Ｃｉｔ)对淋巴瘤的诊断价值和疗效评价已有报道[1 3 ] ,但极少用于口腔颌面部肿瘤。笔者对 2 5例口腔颌面部肿块患者进行了6 7Ｇａ Ｃｉｔ显像 ,并与术后病理检查结果进行了比较 ,以探讨其诊断价值 ,现报道如下。资料与方法1 研究对象。口腔颌面部肿块患者 2 5例 ,男 12例 ,女 13例 ,平均年龄5 5 7(2 2～ 83)岁 ,均系我院住院患者 ,其中良性肿块 11例 ,恶性肿块 14例。术后均经病理检查证实。以患者病变对侧正常唾液腺为对照。2 研究方法。①患者静脉注射 111～148ＭＢｑ6 7Ｇａ Ｃｉｔ(上海科兴药业公司提供 )后 2 4、48…     

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。     

近年来对~(67)Ga临床应用的认识

６７Ｇａ显像可早期探查淋巴瘤的复发、监测治疗的反应、预测淋巴瘤患者的预后，但在原发性肺癌及转移性淋巴结的探测中，２０１Ｔｌ显像优于６７Ｇａ。６７Ｇａ显像还可用于诊断黑色素瘤。对于ＨＩＶ抗体阳性的病人，６７Ｇａ可用来定位肿瘤或感染灶，尤其对于卡氏肺囊虫肺炎的诊断较为理想，对于不明原因发烧患者，６７Ｇａ显像可帮助寻找病灶，而１１１Ｉｎ－ＷＢＣ用于腹部感染的诊断优于６７Ｇａ。在结节病的诊断中，６７Ｇａ影像具有“熊猫”样面容及肺门“λ型”的特征性表现，具有较高特异性     

结节病在^67Ga显像中的表现

９例活性性结节病患者接受了＾６７Ｇａ显像，其中胸内结节病伴其他脏器受累者６例，单纯胸内结节病２例，泼尼松治疗后＾６７Ｇａ显像阴性１例。结果具有“熊猫“面容者６例，双侧对称性肺门淋巴结肿大（“八字“影像）者７例，同时具有以上两种影像者５例。初步结果显示显同时具有肺门“八字“影像和“熊猫“面容是结节病＾６７Ｇａ显像的特征性表现，具有确定性的诊断价值。     

^67Ga显像评价恶性肿瘤的操作指南

主要介绍＾６７Ｇａ显像对恶性肿瘤特别是淋巴瘤在疾病分期、探测疾病的缓解或进展、预测治疗反应和预后等方面的作用，指导核医学医师掌握＾６７Ｇａ－枸橼酸用于恶性肿瘤的适应症、操作过程及对显像结果进行解释和作出报告。     

Solitary pericardial metastasis detected by 67Ga scintigraphy in a patient with fever of unknown origin

⁶⁷Ga scintigraphy was performed in a patient with fever of unknown origin. Left pneumonectomy had been performed two years previously for carcinoma of the lung. There were no cardiovascular or new pulmonary signs. Four weeks of in hospital investigation did not reveal the cause of the fever. ⁶⁷Ga uptake was localized in the heart and subsequent autopsy demonstrated pericardial metastasis to be the cause of the prolonged fever. Fever of unknown origin is a rare presenting symptom of malignant pericardial involvement and ⁶⁷Ga scintigraphy was crucial in its diagnosis.     

Usefulness of<Superscript>67</Superscript>Ga scintigraphy in extranodal malignant lymphoma patients

OBJECTIVE: 67Ga scintigraphy has a well-documented role in nodal lymphoma for both disease staging and assessment of treatment response. The objective of the present study was to examine the role of 67Ga scintigraphy in diagnosis and assessment of treatment response, in patients with extranodal malignant lymphoma. METHODS: Seventy-one patients with extranodal malignant lymphoma were studied. Whole body scans in all and SPECT scans in some selected patients were performed 72 hours after injection of 67Ga-citrate. The influence of tumor site, histological classification and tumor size on 67Ga scintigraphy sensitivity was analyzed. Twenty-one of the seventy-one patients also had a second 67Ga scintigraphy to assess response to treatment. RESULTS: The overall 67Ga scintigraphy sensitivity was 83.1% (59/71). The sensitivity was low in patients whose extranodal lymphoma occurred in skin (0/3) and urinary bladder (0/1), as compared to other tumor sites. According to the histological classification of the lesion, the sensitivity was lower in low-grade than in intermediate and high-grade lymphoma. According to the tumor size, the sensitivity was low in lesions less than 2 cm in diameter than those more than 2 cm in diameter. The results changed from positive to negative accumulation in 20 (95.2%) of the 21 patients who had 67Ga scintigraphy to assess the response to treatment. These 20 patients showed a good clinical course. CONCLUSIONS: Although 67Ga scintigraphy did not show positive accumulation in patients with skin and urinary bladder lymphoma, it was helpful to confirm the diagnosis and to evaluate the therapeutic effect in most patients with extranodal malignant lymphoma.     

Accumulation of67Ga citrate in early pregnancy

A 26-year-old pregnant woman complained of chest pain and dyspnea and was diagnosed with malignant lymphoma of the mediastinum. To determine the stage of malignant lymphoma, tumor scintigraphy with 67Ga citrate was performed. 67Ga scintigraphy revealed an abnormal accumulation in the center of the pelvic cavity. An artificial abortion was performed, and the early pregnancy obtained from the abortion showed a prominent uptake of 67Ga citrate ex vivo. 67Ga citrate re-examination, which was performed immediately after the abortion, showed no abnormal accumulation in the pelvic cavity. To our knowledge, this is the first medical report on an aborted tissue investigated ex vivo to determine whether it demonstrated increased uptake of 67Ga citrate.     

Positive gallium-67 citrate scintigraphy in Wiskott-Aldrich syndrome with malignant lymphoma

This case describes the first detection of solid lymphoma lesions by gallium-67 scintigraphy in a 12-year-old patient with Wiskott-Aldrich syndrome. Gallium 67 uptake was found in multiple sites in the patient who had developed an undifferentiated small, noncleaved cell lymphoma. Response to chemotherapeutic treatment is correlated with findings on the gallium scintigraphy follow-up.     

Sarcoidosis of hands

 We present a case of sarcoidosis with soft tissue masses and associated phalangeal erosive changes. Sarcoidosis of the musculoskeletal system presenting as a soft tissue mass has been described previously but is rare. To our knowledge, the combination of soft tissue masses and phalangeal erosions has never been described.     

67Ga scan for evaluating response to therapy in malignant lymphoma

⁶⁷Ga scintigrams in a patient with malignant lymphoma before and after chemotherapy are presented. ⁶⁷Ga did not accumulate in the mostly necrotic mass with some viable cells. Negative uptake of ⁶⁷Ga might reflect necrosis of the tumor; however, it is difficult to detect some residual tumor cells. Therefore, negative uptake of ⁶⁷Ga in the mass seen in X-ray CT may not be totally reliable evidence of eradication of viable tumor cells.     

HPLC法测定枸橼酸钾溶液中枸橼酸钾和羟苯乙酯的含量

目的用HPLC法验证原有测定枸橼酸钾溶液中枸橼酸钾和羟苯乙酯含量的方法,并与原方法进行比对。方法采用Nucleodur C18Pyramid（250 mm×4.6 mm,5μm）色谱柱。梯度洗脱,流动相A：水-磷酸（1000∶1）;流动相B：乙腈。洗脱程序：0~5 min,A100%;5.01~22 min：A70%,B30%;22.1~30 min,A100%;流速1 ml·min^-1,检测波长210 nm。结果以峰面积（Y）对进样浓度（X,μg·ml^-1）进行线性回归,枸橼酸钾回归方程为Y=2.586 X-16.49,r=0.9999,线性范围500.8~5008μg·ml^-1;羟苯乙酯回归方程为Y=0.021 44 X-0.4065,r=0.9999,线性范围2.503~25.03μg·ml^-1;枸橼酸钾回收率为100.2%,RSD为0.15%;羟苯乙酯回收率为99.6%,RSD为1.9%。结论 HPLC法测定结果准确,重复性好,操作简便,优于原方法,可更好的用于枸橼酸钾溶液中枸橼酸钾和羟苯乙酯的含量测定。