分子影像学在心力衰竭中的应用及其进展

心力衰竭是一种复杂的临床症候群,是各种心脏病的终末阶段。其发病率高,5年存活率与恶性肿瘤相仿。分子影像学以心力衰竭过程中特异性分子标志物为靶标,应用分子影像学技术平台,能够无创、可重复、实时地获得体内的动态、定量和可视化的心力衰竭的发生发展过程。本文综述了分子影像学在心力衰竭应用中的一些最新进展。     

同时推量加速调强放疗治疗头颈部恶性肿瘤的临床研究

应用同时推量加速调强放疗技术（SIB－IMART）治疗15例头颈部恶性肿瘤，肉眼靶区（GTV）的平均剂量为70Gy，临床靶区（CTV）的平均剂量为54Gy，脑干、脊髓及腮腺等正常组织的受量均在允许范围之内。结果 13例38天内完成治疗，2例因副作用而中断放疗；皮肤反应I级12例、Ⅱ级3例；粘膜反应Ⅱ级9例、Ⅲ级4例、Ⅳ级2例，咽部及食管I级10例、Ⅱ级3例、Ⅲ级2例；唾液腺副作用明显较传统放疗技术轻，15例中0级3例、I级10例、Ⅱ级2例；口干0级3例、I级9例、Ⅱ级3例，无重度或完全口干病例。放疗结束后疗效达CR者13例，PR者2例，无一例出现病情进展。认为SIB－IMART治疗头颈部恶性肿瘤安全可行，特别是肋腺可受到较好保护，且不同的靶区可以同时实现不同的剂量水平，缩短了治疗时间。     

分子影像学在干细胞促心肌再生研究中的应用

分子影像学能在活体状态下对生物体的细胞和分子水平的生物学过程进行成像、进而进行定性和定量研究.目前,磁共振分子成像、核医学成像和光学分子成像已成功应用于心肌再生的干细胞治疗研究,但每种成像技术都有各自的成像优势和不足.该文主要介绍三种成像手段在心肌再生研究领域中的应用概况及研究成果,便于研究者根据具体的研究目的选择合适的成像手段.     

无创性影像学检查在头颈部血管检查中的应用及评价

目的：已有多种无创性血管成像方法,如超声多普勒、磁共振血管造影以及CT血管造影等用于头颈部动脉狭窄、闭塞的检测,文章对这些无创性影宋体晨头部血管检查中的临床应用进行了评价 。     

影像学技术在门脉高压症诊治中的应用

影像学诊断有直观、准确的优点，尤其是ＣＴ、常规ＭＲＩ、ＭＲＩ血管造影等新影像学方法的建立，使门脉高压症时血流动力学改变的某些动态指标也能够观察或测量。同时，影像学技术还能监测各种治疗前后门脉血流的变化，评价治疗效果；另外，影像学技术在各种介入治疗中也...     

影像学检查在胆石症非手术治疗中的应用

腹部平片，口服胆囊造影，Ｂ超及ＣＴ是临床上用于诊断胆石症的常用影像学检查。本文就其在胆石症非手术治疗中的作用，即对胆石大小和数量的估测，化学成分的预测，对胆囊收缩功能及胆囊管是否开放的评价及对治疗的估计等方面的优缺点作一综述。     

影像学检查在大动脉炎诊断中的应用进展

<正>大动脉炎(takayasu arteritis,TA)是一种慢性、非特异性大血管炎,可导致不同部位动脉的节段性狭窄、闭塞、扩张或动脉瘤形成,并出现相应部位缺血的临床表现。从病程来讲影像学的诊断对于目前TA的血管腔内治疗有极高的应用价值。对手术和腔内治疗都有明确的指导意义。特别是对中晚期的患者血管狭窄或闭塞程度一目了然,对临床医师制定和实施手术有肯定的指导意义。近来随着影像学手段的发展,MRI、超声等方法在观察血管腔的同时还可观察血管壁的     

纳米分子影像学在静脉血栓栓塞中的诊疗研究进展

静脉血栓栓塞(VTE)包括肺栓塞(PE)和深静脉血栓形成(DVT),是全世界最常见的心血管疾病之一,造成了巨大的社会经济负担。临床常以抗血栓治疗为主,由于抗血栓治疗与凝血及溶血系统有关,因此这种治疗方式有极高的出血风险,需要对病程进展进行严格的监控,但现有的手段不能完全满足未来临床精准医疗的需要。分子影像学能反映疾病分子层面的信息,通过影像手段,对血栓靶向纳米探针进行定量监测,对疾病的亚型精准诊断并提供个性化治疗。本综述介绍了近年来纳米分子影像学在VTE中的诊疗研究进展,有望为VTE的诊治提供新的思路。     

分子诊断在血液病中的应用

分子诊断是利用分子生物学和分子遗传学方法检测疾病相关基因和蛋白,并与临床诊断密切结合的一种诊断技术。经过分子杂交、PCR定量和芯片技术3个阶段的发展,分子诊断已经广泛应用于肿瘤和遗传性疾病等相关领域,尤其在严重危害人类健康的恶性血液病领域取得了长足进步,对这些疾病的精细诊断、预后评估和分层治疗均提供了     

现代医学影像学在老年病中的应用和展望

进入21世纪后,我国医学诊断学与介入放射学相结合构成了诊断与治疗兼备的现代医学影像学。以高科技为基础,向广大病员提供先进的诊疗技术为特征的现代医学影像学,在临床医学上不仅占据着重要的地位,而且在未来的医学研究服务体系上也占有很大的比例和很重要的地位。     

PET imaging for thyroid cancers: Current status and future directions

Positron emission tomography–computed tomography (PET/CT) combines both functional and anatomic information and provides in vivo molecular information on biological processes that can be useful at different steps of evolution of thyroid cancers. ¹⁸Fluorodeoxyglucose being highly trapped in rapidly dividing cells makes ¹⁸F-FDG-PET recommended in the staging, prognostic evaluation and follow-up of metastatic and/or of poorly differentiated thyroid carcinomas. ¹⁸F-FDG PET/CT can help in the localization of persistent/recurrent disease. However, its sensitivity depends widely on tumor burden and histology. Iodine 124 (¹²⁴I) is currently under evaluation for diagnosis and pretherapeutic dosimetry planning. PET/CT using ¹⁸F-FDOPA is the most sensitive radiopharmaceutical for localizing persistent/recurrent medullary thyroid carcinoma (MTC). However, its sensitivity depends on calcitonin levels, with a threshold value of around 150 pg/mL. ¹⁸F-FDG PET/CT can also be used in MTC with short calcitonin or CEA doubling time.     

A growing problem--human papillomavirus and head and neck cancers

High-risk human papillomavirus (HPV) are implicated in the development of a subset of head and neck cancers, especially those arising from the lingual or palatine tonsils. HPV-associated cancer of the head and neck represent a different disease entity from those associated with the traditional risk factors of tobacco and alcohol use. There has been as increase in the annual incidence of HPV-related cancers in Europe and USA in the past years. It has now become clear that a subset of the head and neck tumors is a sexually transmitted disease with distinct pathogenesis and clinical and pathological features. Research efforts are now focusing on deintensification of treatment to reduce treatment associated morbidity. The potential application of HPV targeted terapies in HPV associated cancers is an area of active research.     

Clinicopathological study of head and neck cancers in Ilorin, Nigeria

Eighty-nine cases of head and neck cancers were studied over a 5-year period (1997--2001) at the University of Ilorin Teaching Hospital, Nigeria. The most common cancer affecting the head and neck region was carcinoma which constituted 70.8% of all the cases studied. It was followed by the lymphomas and blastomas which accounted for 20.2% and 9%, respectively. The nose/paranasal sinuses were the most common site of primary cancer (18%) followed by thyroid (12.4%), nasopharynx (11.3%) and larynx (4.5%). Other sites include a hypopharynx (3.4%), eye (2.2%), palate (2.2%), tongue (2.2%), skin (1.1%), lip (1.1%), salivary gland (1.1%), oropharynx (1.1%). Cervical lymph node metastasis with unknown primary lesion was seen in 10.1%.The peak age incidence was in the fifth decade of life. The improvement in locoregional control of head and neck cancers over the last decades does not appear to modify the final survival of these patients. It is crucial to understand as accurately as possible the risk factors for these malignancies in order to improve primary prevention.     

Microsatellite instability in double cancers of the esophagus and head and neck

It is generally accepted that patients with squamous cancers of the esophagus are known to have a high risk of concomitant head and neck cancer. However, there have been only a few reports describing microsatellite instability (MSI) in patients with both esophageal squamous cell carcinoma and head and neck cancers. To evaluate the role of genetic instability in carcinogenesis in such patients, we analyzed six microsatellite loci in 21 tumors from 10 patients who had developed primary cancers of both the esophagus and the head and neck. MSI was detected in 6 out of 10 patients. In five patients with double cancer, MSI was observed at the same microsatellite loci in both the esophageal and the head and neck tumors obtained from the same individuals. These data suggest that such patients may have the same underlying defect in the mismatch repair system, providing insight into possible mechanisms for field carcinogenesis.     

Impact of targeting insulin-like growth factor signaling in head and neck cancers

The IGF system has been shown to have either negative or negligible impact on clinical outcomes of tumor development depending on specific tumor sites or stages. This review focuses on the clinical impact of IGF signaling in head and neck cancer, the effects of IGF targeted therapies, and the multi-dimensional role of IRS 1/2 signaling as a potential mechanism in resistance to targeted therapies. Similar to other tumor sites, both negative and positive correlations between levels of IGF-1/IGF-1-R and clinical outcomes in head and neck cancer have been reported. In addition, utilization of IGF targeted therapies has not demonstrated significant clinical benefit; therefore the prognostic impact of the IGF system on head and neck cancer remains uncertain.     

Combined fluphenazine and lidocaine for pain relief in head and neck cancers

A successful method of treating intractable neoplastic pain in 12 cases is discussed. A completely new method was tried combining long-acting phenothiazine and lidocaine to achieve long-lasting pain relief. This combination gave pain relief which lasted for weeks. A possible explanation of the mechanism is offered.     

Quadruple cancer,including triple cancers in the head and neck region

Multiple primary tumors are not rare: they are encountered in 3-5% of malignant tumors. They are particularly frequent in the head and neck [20]. They are most often met with secondary malignant tumors; triple tumors occur in only 0.5%, quadruple tumors in 0.3% of malignant tumors. The possibility of developing a second metachronous cancer 5 years after undergoing treatment of the initial head and neck cancer is approximately 22%. Multiple metachronous tumors often appear 3-4 years after the observation of the primary tumor, or even after 5-10 years in the case of laryngeal tumors. The frequency of multiple primary tumors in the head and neck region supports the "field cancerization" theory, according to which the inducing agents (primarily smoking and alcohol consumption) can initiate the tumorous degeneration at a number of sites in the oropharyngeal region. The authors report on a case in whom surgery for bladder tumor was followed 101 months later by tumor development in the region of the head and neck: 3 such tumors were treated within a period of 21 months. The histologic result on the bladder tumor was transitiocellular carcinoma, while the latter ones were squamous cell carcinomas. Three of the tumors were treated effectively (no local recurrence or metastasis developed), but the fourth led to the death of the patient. The literature on multiple tumors of the head and neck is reviewed, and possible etiologic factors are discussed. It is pointed out that, besides primary and secondary prevention, close observation of these patients is required, repeated panendoscopy of the upper aerodigestive tract and genetic examinations are recommended.     

Non-invasive imaging of angiogenesis in head and neck squamous cell carcinoma

Squamous cell carcinoma of the head and neck (HNSCC) is the seventh most common cancer in the United States. Angiogenesis, the process by which new blood vessels are formed, is an essential element at the basis of both tumor growth and metastases. This review discusses pertinent aspects of the role of imaging modalities in assessing angiogenesis and anti-angiogenic therapy in advanced HNSCC.     

消化系肿瘤分子影像诊断的研究进展

消化系肿瘤具有高发病、高死亡的特点,而现有检查手段难以实现早期、准确地诊断.分子影像以分子而非解剖结构为对象,提升检查的灵敏及特异性.消化系肿瘤分子影像涉及的成像方法包括光学内镜、闪烁扫描成像、磁共振、超声等.抗体、多肽、适体等均可作为特异性配体,经显像基团标记成为探针,实现对肿瘤细胞或间质的特异性结合及成像.这类技术不仅用于肿瘤早期诊断,还可协助肿瘤分期,指导治疗.随着新仪器及探针的开发,以及多元化显像模式的发展,分子影像已逐渐完善并从实验室进入临床,使更早期、全面、准确诊断消化系肿瘤成为可能.     

非静脉曲张性消化道出血的内镜治疗

急诊内镜检查已成为治疗上消化道出血首选的止血方法，可及时明确出血原因，并能通过内镜采取多种治疗手段进行现场止血，如药物注射、喷洒、微波、电凝、激光及钛夹等。由于这些先进技术与内镜的完美结合，使急诊内镜下治疗上消化道出血的现场止血率高达80％～90％，显著降低了手术率及死亡率。