^99Tc^m—MIBI乳房亲肿瘤显像诊断原发性乳腺部及腋淋巴结转移

目的 探讨＾９０Ｔｃ＾ｍ－甲氧基异丁基异腈（ＭＩＢＩ）乳房亲肿瘤显像鉴别诊断乳房肿瘤良恶性及诊断腋淋巴结转移的临床价值。方法 ４６例乳房肿块病人,其中２７例恶性肿瘤,１９例良性病变,在手术前１５ｄ内进行＾９９Ｔｃ＾ｍ－ＭＩＢＩ乳房亲肿瘤显像。病变乳房对侧肘前静脉注射＾９９Ｔｃ＾ｍ－ＭＩＢＩ ７４０ ＭＢｑ后５ｍｉｎ,分别采集俯卧位两侧乳房后斜位图像及仰卧位胸部前位图像。乳房内和（或）腋窝区出现异常     

^99Tc^m—MIBI与^99Tc^m—MDP骨显像诊断骨良恶性病变的比较

目的 对比分析＾９９Ｔｃ＾ｍ－甲氧基异丁基异腈（ＭＩＢＩ）和＾９９Ｔｃ＾ｍ－亚甲基二膦酸盐（ＭＤＰ）对骨良恶性病变的诊断价值和疗效评估。方法 ６１例临床拟诊骨良性病变患者分别进行２项骨显像,其中６例恶性肿瘤患者分别进行化疗前后显像,显像后均经手术,病理检查对比分析。结果 ＾９９Ｔｃ＾ｍ－ＭＩＢＩ显像;７３％恶性肿瘤病灶肉眼见中、高度ＭＩＢＩ浓聚,６０％良性病灶肉眼未见ＭＩＢＩ聚集,恶性病灶部位与对     

^99mTc—DTPA肾显像在早期诊断SLE肾损害和观察早期治疗效果中的应用

本文报道了４５例ＳＬＥ患者~（９９ｍ）Ｔｃ－ＤＴＰＡ肾显像结果，并通过分析ＧＦＲ及~（９９ｍ）Ｔｃ－ＤＴＰＡ肾图定量指标且与血ＣＲ、血ＢＵＮ、血、尿β２－ｍ和尿旦白等生化指标的比较显示，~（９９ｍ）Ｔｃ－ＤＴＰＡ肾显像及其肾图分析在早期诊断ＳＬＥ肾损方面具有显著意义。以Ｃ段下降半排时间（Ｃ＿（１／２））最敏感。ＧＦＲ在判定肾损害程序以及治疗效果方面较有意义。我们认为，~（９９ｍ）Ｔｃ－ＤＴＰＡ肾显像及其肾图分析比单纯ＧＦＲ检查及其它生化检查优越，值得临床推广。     

99Tc^m（V）—DMSA显像诊断卵巢良恶性肿瘤的价值

目的 探讨＾９９Ｔｃ＾ｍ（Ｖ）－二巯基十丁酸钠（ＤＭＳＡ）显像鉴别诊断卵巢良恶性肿瘤的临床价值。方法 对２４例临床疑卵巢肿瘤的患者进行＾９９Ｔｃ＾ｍ（Ｖ）－ＤＭＳＡ显像,并与手术病理结果进行对照。结果 ２４例卵巢肿瘤患者经病理证实卵巢恶性肿瘤１５例,良性肿瘤９例。１５例卵巢恶性肿瘤,＾９９Ｔｃ＾ｍ（Ｖ）－ＤＭＳＡ显像阳性１４例,假阴性１例;９例良性肿瘤,显像阴性７例,假阳性２例。＾９９Ｔｃ＾ｍ（Ｖ     

肝断层及平面显像在肝占位性病变鉴别诊断中的意义──与B超、CT比较

本文对９２例临床可疑肝占位性病变患者进行了肝胶体及血池断层与平面显像，计算了肝血流灌注指数，并对照同期的病理及肝动脉造影资料，探讨了核素显像、ＣＴ及Ｂ超的诊断价值。研究表明，三种方法对肝癌及肝囊肿的诊断准确性无显著性差异（Ｐ＞０．０５），但断层显像对肝血管瘤的诊断（９３％）明显优于ＣＴ（８４％）和Ｂ超（８０％）；平面肝显像难以发现直径３ｃｍ以下的病变，对肝占位灶的检出率明显低于断层显像（Ｐ＜０．０５）。联合肝、胆道系统显像有助于降低假阳性率，其价值有待进一步探讨。     

甲状旁腺功能亢进的定位诊断

比较了８５例临床诊断为甲状旁腺功能亢进的患者使用（２０１）Ｔｌ／（９９ｍ）Ｔｃ双核素减影技术、（９９ｍ）Ｔｃ－ＭＩＢＩ和Ｂ型超声做病灶术前定位的结果。术中共发现９９个病灶，双核素显像检出４９个病灶，Ｂ超发现６７个病灶，灵敏度分别为５０％和６７％。其中８例患者用（９９ｍ）Ｔｃ－ＭＩＢＩ检查的灵敏度为６７％（６／９）；对异位甲状旁腺病灶核素显像的灵敏度为８４．６％（１４／１７），Ｂ超为４１％（７／１７）。     

应用多种脑功能显像剂的脑膜瘤显像特征

目的探讨应用多种脑功能显像剂进行脑膜瘤显像的特征表现及诊断脑膜瘤的互补作用。方法对２１例脑膜瘤病人（良性１８例，恶性３例）进行了脑血流显像、９９ｍＴｃ乙撑双半胱氨酸二乙酯（ＥＣＤ）、９９ｍＴｃＤＴＰＡ和（或）９９ｍＴｃ甲氧基异丁基异腈（ＭＩＢＩ）脑显像。分析病灶的显像特征和计算放射性摄取比值（Ｔ／Ｎ）。病人均有ＣＴ或ＭＲＩ检查。结果１６／２０例肿瘤部位动脉期有放射性异常增高。１７／１９例９９ｍＴｃＥＣＤ显像表现为形态规整、边缘光滑的卵圆或圆形内凹缺损，１例为额顶叶受压变平，仅１例无异常发现；１７／１７例９９ｍＴｃＤＴＰＡ、１４／１４例９９ｍＴｃＭＩＢＩ显像表现为均匀的放射性浓聚，形态与９９ｍＴｃＥＣＤ显像所示缺损区吻合。３种显像剂的Ｔ／Ｎ值互不相关，仅９９ｍＴｃＥＣＤ的Ｔ／Ｎ值恶性病变显著低于良性病变。结论９９ｍＴｃＥＣＤ结合９９ｍＴｃＤＴＰＡ或９９ｍＴｃＭＩＢＩ脑显像能明确脑膜瘤的诊断，９９ｍＴｃＥＣＤＴ／Ｎ值能否提示脑膜瘤的良恶性尚待积累资料     

乳腺肿块~(99m) Tc-MIBI双时相显像与X线钼靶对照研究

目的：探讨~(９９ｍ)ＴＣ－ＭＩＢＩ双时相乳腺显像和乳腺钼靶的联合应用对提高患者术前诊断准确性的价值。材料和方法：对疑为乳腺癌的 ３４名患者术前行钼靶检查和~(９９ｍ)Ｔｃ－ ＭＩＢＩ双时相乳腺显像。乳腺钼靶：双乳分别行轴位（头足位）和侧位摄片。乳腺双时相核素显像采用平面显像行正位、双侧斜位、俯卧位时双侧乳腺侧位。所有病例均于两项检查后两星期内行手术获得病理诊断。结果：~(９９ｍ)Ｔｃ－ ＭＩＢＩ乳腺双时相显像示：乳腺的早期和延迟显像一致。恶性病变早期和延迟相的平均Ｔ／Ｎ值分别为１８０±０．６８、１．６４±０．４２,两者Ｐ＞０．０５。~(９９ｍ)Ｔｃ－ＭＩＢＩ乳腺双时相显像敏感性为８８％,特异性为７６％,准确性为８２％。钼靶检查：良性病变诊断的８例中,一例为恶性病变（浸润性导管癌）;病变性质无法确定的１４例中,６例为恶性病变（浸润性导管癌３例,浸润性腺癌２例,鳞癌１例）;恶性病变诊断的１２例中２例为良性病变。钼靶检查病变性质无法确定的１４例中,乳腺双时相显像诊断正确为１２例。结论：~(９９ｍ) Ｔｃ－ＭＩＢＩ乳腺双时相显像和钼靶检查对乳腺肿块的诊断和鉴别诊断中有各自的特点。在临床实践中合理的诊断程序有助于提高诊断准确率,减少不     

^99mTc—MIBI显像诊断自主功能性甲状腺结节

报告２０例自主功能性甲状腺结节显像的诊断意义，９例＾９９ｍＴｃＯ＾－４显像示正常甲状腺组织完全被抑制的病例，８例＾９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）显像正常甲状腺组织显影清晰；１１例正常甲状腺组织不全抑制的病例，＾９９ｍＴｃ－ＭＩＢＩ显像８例显影较＾９９ｍ－ＴｃＯ４显像清晰，３例未见变化。虽然＾９９ｍＴｃ－ＭＩＢＩ显像与ＴＳＨ刺激试验显像的原理不同，但它能使功能受抑制的正常甲状腺组织显像，能     

99Tcm(Ⅴ)-DMSA显像诊断卵巢良恶性肿瘤的价值

目的探讨９９Ｔｃｍ（Ⅴ）二巯基丁二酸钠（ＤＭＳＡ）显像鉴别诊断卵巢良恶性肿瘤的临床价值。方法对２４例临床疑卵巢肿瘤的患者进行９９Ｔｃｍ（Ⅴ）ＤＭＳＡ显像,并与手术病理结果进行对照。结果２４例卵巢肿瘤患者经病理证实卵巢恶性肿瘤１５例,良性肿瘤９例。１５例卵巢恶性肿瘤,９９Ｔｃｍ（Ⅴ）ＤＭＳＡ显像阳性１４例,假阴性１例;９例良性肿瘤,显像阴性７例,假阳性２例。９９Ｔｃｍ（Ⅴ）ＤＭＳＡ诊断卵巢恶性肿瘤的灵敏度为９３３３％,特异性为７７７８％,阳性预测值为８７５０％,阴性预测值为８７５０％,假阳性为１４２９％,假阴性为６６７％,准确性为８７５０％。结论９９Ｔｃｍ（Ⅴ）ＤＭＳＡ显像在鉴别卵巢良恶性肿瘤方面具有重要的临床价值。     

放射性核素阴囊闪烁显像诊断精索静脉曲张

放射性核素闪烁显像是诊断精索静脉曲张的一种非侵袭性方法,目前对该方面的研究已从定性、半定量向定量方向发展,可对精索静脉曲张的诊断、分级、预测手术效果提供帮助。     

Enhanced detection of reversible myocardial hypoperfusion by technetium 99m-tetrofosmin imaging and first-pass radionuclide angiography after nitroglycerin administration

Background  Reversal of ischemia after myocardial infarction by revascularization is worth-while only if viability exists in a sufficiently large portion of the left ventricle. Methods and Results  To determine myocardial hypoperfusion reversibility and its influence on segmental and global function, we studied 50 patients after myocardial infarction. Three technetium 99m-tetrofosmin scintigraphies were performed: 1 at rest, 1 after 0.6 mg sublingual nitroglycerin (NTG), and 1 after injection at peak stress. First-pass multigated radionuclide angiography was obtained at rest and after NTG. Each patient also underwent a stress redistribution-reinjection thallium-201 scintigraphy. During stress ^99mTc-tetrofosmin, 104 segments had normal uptake, 51 showed moderately reduced uptake, and 186 had severely reduced uptake. Of these 186 segments, 33 (18%) improved at rest, and 41 (22%) improved only after NTG. Fifty-nine (79%) of these segments with improved uptake were also found to have reversible defects on ²⁰¹Tl imaging. In the 26 patients with ventricular dysfunction, a 73% agreement was found between the functional and ^99mTc-tetrofosmin uptake post-NTG improvement, whereas a 69% agreement was found with thallium reinjection. No significant differences were seen between ^99mTc-tetrofosmin and ²⁰¹Tl imaging. Conclusion  Nitroglycerin administration during ^99mTc-tetrofosmin scintigraphy improves the detection of myocardium with reversible hypoperfusion in patients with a previous myocardial infarction.     

乌鲁木齐维吾尔族与汉族前列腺癌骨转移的对比分析

目的 探讨分析乌鲁木齐地区维吾尔族(以下简称维族)与汉族前列腺癌患者骨转移的特点.方法 对25例维族和41例汉族前列腺癌患者用SPECT进行全身核素骨显像,采用放射免疫法分析法检测血清骨钙素水平,采用化学发光免疫分析法检测血清游离前列腺特异抗原(F-PSA)和血清总前列腺特异抗原(T-PSA)水平及其比值(F/T).结果 骨显像阳性率维族为52.0%(13例),汉族为75.6%(31例),差异有统计学意义(P<0.05);汉族患者血清骨钙素水平明显高于维族患者(P<0.05),对于血清F-PSA和T-PSA水平,两民族间无统计学差异(P>0.05),但其比值(F/T)汉族明显低于维族 (P<0.05).结论 乌鲁木齐地区维族与汉族前列腺癌患者骨转移情况可能存在差异,应引起重视.     

肺癌脊柱骨转移的特点和规律的初步探讨

探讨肺癌脊柱骨转移的特点和规律。资料和方法回顾性分析190例病理证实为肺癌、核素骨显像诊断 脊柱骨转移病例的骨显像表现。结果(1)肺癌转移好发部位是胸椎,其次是腰椎。腺癌、早期肺癌及病程短者胸椎转移 率较高,晚期肺癌以腰椎转移为主;(2)腺癌、晚期肺癌及病程长的患者椎体转移范围广,手术较未手术患者椎体转移数 少;(3)病灶常呈圆形或类圆形;(4)肺癌常合并脊柱外骨转移,以胸部骨常见。结论肺癌患者尤其是腺癌,确诊后宜尽 早作骨显像检查,并注意定期随访,以早期发现脊柱骨转移病变,早期治疗,改善患者预后。     

Assessing prognosis after acute myocardial infarction in the thrombolytic era

The use of physiologic testing for prognostication continues to be useful and widely applied in the predischarge evaluation of patients recovering from an uncomplicated acute myocardial infarction in the thrombolytic era. Because patients with abnormal exercise test results are now routinely sent for angiography, there are no randomized trials or experimental confirmation that exercise parameters are still associated with the same prognostic value in the thrombolytic era. Nevertheless, the excellent outcomes in patients treated with thrombolytic therapy and risk stratified with exercise testing provide strong empiric support for the continued use of noninvasive testing of patients without complications after thrombolytic therapy. Reviews of patient cohorts enrolled in trials of thrombolytic therapy show that these patients have a lower incidence of multivessel disease and less evidence of ischemia (ST segment depression or thallium 201 redistribution) compared with prethrombolytic cohorts. For this and other reasons, the sensitivity and specificity of exercise variables for prognosis or detection of multivessel disease are not as strong. The addition of perfusion imaging will enhance the sensitivity for detection of ischemia within or remote from the infarct zone and will provide information regarding viability. Patients who are unable to exercise or those with poor exercise tolerance, an abnormal exercise blood pressure response, inducible ischemia, or nonsustained ventricular tachycardia are candidates for further invasive evaluation and consideration for coronary revascularization. With²⁰¹Tl imaging, evidence for increased pulmonary uptake of the tracer is indicative of high risk and a high probability of an adverse outcome with medical therapy. Low-risk patients are those who achieve their target heart rate or work load without inducible angina, ST segment depression, reversible perfusion abnormalities, or increased lung²⁰¹Tl uptake. Defect size is reflective of infarct size, and patients with extensive areas of nonreversible hypoperfusion are also at high risk for future events even in the absence of ischemia. Finally, pharmacologic stress imaging with dipyridamole, adenosine, or dobutamine has been found to be safe when employed for stress testing soon after uncomplicated infarction.     

[123I]Mtr-TOCA, a radioiodinated and carbohydrated analogue of octreotide: scintigraphic comparison with [111In]octreotide

Purpose Scintigraphy with maltotriose-[¹²³I]Tyr³-octreotate ([¹²³I]Mtr-TOCA) is compared with [¹¹¹In]DTPA-Phe¹-octreotide ([¹¹¹In]OC) to assess the differences in pharmacokinetics and imaging properties as well as to estimate the therapeutic potential of the corresponding [¹³¹I]Mtr-TOCA.Methods Six patients with somatostatin receptor (sstr)-positive tumours were assessed using a dual-head gamma camera. After injection of 137±28 MBq [¹²³I]Mtr-TOCA, dynamic data acquisition of the upper abdomen (30 min) was performed followed by whole-body scans at 0.5 h, 1 h, 3 h and 20 h as well as by SPECT imaging (tumour) at 2 h. [¹¹¹In]OC scintigraphy was performed by acquiring whole-body scans (4 h, 24 h) and SPECT (24 h). Using a region of interest (ROI) method, tissue and tumour bound activity was assessed and dosimetry performed.Results [¹²³I]Mtr-TOCA shows rapid tumour uptake. Up to 4 h, tumour/organ (tu/org) ratios are stable and generally higher than with [¹¹¹In]OC. From 3 h to 20 h, tu/org ratios increase for spleen, remain stable for liver and decrease significantly for all other tissues. In contrast, with [¹¹¹In]OC, tu/org ratios decrease slightly between 4 h and 24 h for liver, spleen and kidney and increase for all other tissues. On [¹²³I]Mtr-TOCA scintigraphy, a total of 27 lesions are detected, whereas 33 lesions are detected on [¹¹¹In]OC scintigraphy (p=0.50). Effective patient absorbed dose is 1.9±0.9 mSv per 100 MBq [¹²³I]Mtr-TOCA.Conclusion Compared with [¹¹¹In]OC, [¹²³I]Mtr-TOCA enables faster imaging of sstr-positive tumours with a lower radiation burden to the patient. [¹²³I]Mtr-TOCA and [¹¹¹In]OC allow for tumour imaging with almost identical contrast and diagnostic yield. As regards peptide receptor radionuclide therapy, radioiodinated Mtr-TOCA is hampered by limited intratumoural activity retention.     

Value of radionuclide studies in cardiac transplantation

Effective noninvasive evaluation of acute and chronic allograft rejection remains an important challenge in patients with cardiac transplantation. Radionuclide studies have demonstrated utility because of their ease of use, giving relevant information about the pathophysiology of the transplanted heart, along with valuable diagnostic and prognostic indicators. This article focuses on reviewing the pathophysiological changes of the transplanted heart and implications for radionuclide studies.     

双核素显象对甲状旁腺功能亢进病灶定位诊断的价值

总结了85例临床诊断为甲状旁腺功能亢进的患者使用~(201)Tl/(99m)~TC核素减影技术做病灶术前定位的结果,术中外科医生共发现99个病灶,双核素显像检出50个病灶,总的灵敏度仅为50%;对异位甲状旁腺病灶其灵敏度为82%(14/17).     

Regional concordance and discordance between rest thallium 201 and sestamibi imaging for assessing tissue viability: Comparison with postrevascularization functional recovery

Background  

Whether the combined analysis of rest ²⁰¹Tl and sestamibi uptake provides additional information regarding myocardial viability in patients with coronary artery disease is still to be investigated.