99 TcmN-NOEt门控心肌显像的临床应用

目的评价99Tcm-N-乙氧基,N-乙基氨荒酸钠(N-NOEt)门控心肌显像的临床应用价值,并与99Tcm-甲氧基异丁基异腈(MIBI)进行比较.方法 20例受检者分为2组,组1左室射血分数(LVEF)≥50%,共13例,平均年龄(49.9±14.7)岁;组2LVEF<50%,共7例,平均年龄(50.9±12.9)岁.受检者静脉注射99TcmN-NOEt 925 MBq后分别于30和120 min行静息门控心肌断层显像,并计算心/肺(H/L)比值.组2 6例、组1 1例在3 d内行99Tcm-MIBI门控心肌显像,将每例受检者的左室心肌分为9个节段,以常规4分法进行打分.结果组1 30及120 min H/L比值分别为1.47±0.47和1.59±0.53(t=0.31, P>0.05),2次显像的LVEF、舒张末期容积(EDV)和收缩末期容积(ESV)差异无显著性(P>0.05).组2 30和120 min H/L比值分别为0.72±0.11和0.89±0.11(t=2.93, P<0.05),2次显像的LVEF,EDV和ESV间差异无显著性(P>0.05).2组间的H/L比值和LVEF、EDV、ESV差异有显著性.NOEt与MIBI所得LVEF,EDV和ESV值基本一致(P>0.05),但NOEt的不正常节段数(21个)较MIBI(17个)为多,两者的一致性为93.65%, Kappa±s=0.87±0.12,得分分别为2.00±0.84(MIBI)和2.38±0.84(NOEt)(t=1.39, P>0.05).结论①左心功能受损时, 肺摄取99TcmN-NOEt增多.②99TcmN-NOEt与99Tcm-MIBI所测得的LVEF,EDV和ESV基本一致.③99TcmN-NOEt测得的心肌放射性缺损的范围及程度较MIBI广泛而严重.     

~(99)Tc~m-NOET门控心肌灌注SPECT评价冠心病的价值

目的 评价~(99)Tc~m-双(N-乙氧基,N-乙基-二硫代氨基甲酸酯)氮化锝(~(99)Tc~m-NOET)静息门控断层心肌灌注显像对冠心病患者的诊断价值.方法 疑诊为冠心病的45例患者注射925 MBq~(99)Tc~m-NOET后1h用SPECT行静息门控心肌灌注显像,获得舒张未期容积(EDV)、收缩未期容积(ESV)、左室射血分数(LVEF)等心功能参数和舒张末期容积灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图.所有患者在1周内行冠状动脉造影,将冠状动脉狭窄≥50%定为病变血管.根据冠状动脉造影结果将其分为心肌梗死组、心肌缺血组和对照组三组.结果 ~(99)Tc~m-NOET静息门控SPECT诊断冠心病的灵敏度和特异度分别为68.42%和83.33%.心肌梗死组的心功能参数[EDV=(129.32±9.14)ml,ESV=(80.97±9.49)ml,LVEF=(40.15±3.28)%]与对照组[EDV=(80.91±3.12)ml,ESV=(30.12±1.79)ml,LVEF=(63.51±1.04)%]相比,统计学差异有显著性(EDV:F=22.103,ESV:F=32.277,LVEF:F=42.604,均为P＜0.01),心肌缺血组的心功能参数[(EDV=(70.83±3.46)ml,ESV=(25.13±2.85)ml,LVEF=(65.55±2.62)%]与对照组相比,统计学差异无显著性意义.心肌梗死组左室心肌共分为460个节段,其中209个节段局部灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图均异常.局部灌注异常的节段共328个节段.伴有局部射血分数、局部室壁活动和室壁增厚度异常分别有250个、240个和276个节段.局部灌注异常的节段与局部射血分数、局部室壁活动和室壁增厚度异常的节段不完全匹配.结论 ~(99)Tc~m-NOET静息门控心肌灌注显像对冠心病的诊断有较大临床应用价值,所获得的整体心室功能参数在心肌梗死的评价中有优越性,但对心肌缺血的诊断价值不大.心肌梗死中存在有不少的局部灌注与心肌室壁功能异常节段的不匹配,对心肌存活的评价有帮助.     

门控心肌SPECT显像三种定量分析软件测定左心室容积和射血分数的比较

目的研究定量门控心肌断层显像（QGS）、爱莫瑞心脏工具箱（ECToolbox）和四维模型心肌断层显像（4D-MSPECT）3种定量分析软件所测左心室射血分数（LVEF）、舒张末期容积（EDV）和收缩末期容积（ESV）的相关性以及与左心室造影之间的相关性。方法临床疑诊或确诊冠心病患者212例均行99^Tc^m-MIBI门控心肌SPECT显像，并分别以QGS、ECToolbox和4D-MSPECT软件处理得LVEF1、EDV1、ESV1。其中106例患者行左心室造影，分别测得LVEF2、EDV2、ESV2。比较3种软件之间及其与左心室造影之间的相关性。结果3种软件所测LVEF1、EDV1、ESV1的相关性好，所测LVEF1值的r值为0．89～0．91（P均〈0．001），EDV1、ESV1值的r值为0．97～0．98（P均〈0．001）。对于LVEF1和EDV1，QGS、ECToolbox、4D-MSPECT所测值间的差异具有统计学意义（P〈0．001）。QGS所测值[LVEF1：（59．2±11．4）％、EDV1：（88．8±35．5）ml]低于4D-MSPECT所测值[LVEF1：（64．2±12．6）％、EDV1：（98．1±39．5）ml]，4D—MSPECT所测值又低于ECToolbox所测值[LVEF1：（68．3±12．8）％、EDV1：（108．2±39．0）ml]；而对于ESV1，QGS[（39．0±27．0）ml]、ECToolbox[（37．9±31．4）ml]与4D—MSPECT[（38．7±31．3）ml]所测值之间差异无统计学意义（P=0．92）。门控心肌SPECT显像与左心室造影所测LVEF2、EDV2、ESV2的相关性好，r值分别为0．70～0．80，0．57～0．61和0．87—0．89（P均〈0．001）。结论3种门控SPECT定量分析软件所测值之间及与左心室造影的相关性均较好。     

定量门控~(99)Tc~m-tetrofosmin心肌显像测量左室功能

目的　探讨定量门控 (QG) 99Tcm tetrofosmin心肌显像测量左室功能的临床应用价值。方法　 74例受试者进行了门控99Tcm tetrofosmin心肌显像 ,采用QGSPECT专用分析程序全自动测量左室功能。其中 36例同时进行静息门控心室显像 ,以比较两种方法测量左室功能的相关性。结果　①74例99Tcm tetrofosminQGSPECT全自动定量测定左室功能均获成功。②QGSPECT全自动测量 36例受试者的静息左室射血分数 (LVEF)、舒张末期容积 (EDV)、收缩末期容积 (ESV)分别与静息门控心室显像计算结果显著正相关 (r分别为 0 .85 9,0 .914,0 .95 0 ,P均 <0 .0 0 1) ,重复性好。③心肌缺血组 (n =2 8)静息LVEF与对照组 (n =2 3)比较差异无显著性 ,而心肌梗死组 (n =9)静息LVEF明显低于对照组 (t=6 .33,P <0 .0 0 1)。结论　定量门控心肌显像99Tcm tetrofosmin能准确评价左室功能     

静息门控心肌灌注显像总积分在冠心病诊断中的临床价值研究

目的探讨静息门控心肌灌注显像总积分在冠心病诊断中的临床价值。方法回顾性分析43例冠心病患者,所有患者均行门控心肌灌注显像(GMPI),应用ECTbox软件计算左室舒张末期容积(EDV)、收缩末期容积(ESV)、左室射血分数(LVEF)、每搏输出量(SV),利用半定量分析法得出静息灌注总积分SRS,与上述各指标进行相关性分析,根据SRS的结果将患者分为两组(SRS 10分组、SRS≥10分组),比较两组间左心功能参数差异(均为P 0. 05),并比较各指标在男女之间的差异,最后探讨GMPI在冠心病中的诊断价值。结果 SRS 10与SRS≥10两组间左心功能参数具有明显差异,P 0. 01; SRS及IVEF呈显著负相关,r=-0. 710,SRS与EDV、ESV呈显著正相关,相关系数分别为0. 703、0. 764,与SV呈负相关,r=-0. 415,均为P 0. 01;男性受检者EDV,ESV明显高于女性受检者,而LVEF明显低于女性,男女间差异具有显著性(P 0. 01)。结论门控心肌灌注显像SRS与左室功能呈显著负相关。静息门控心肌灌注显像在冠心病(CAD)的诊断及疗效评估有重要价值。     

门控心肌显像和心血池显像联合检测左心室功能

目的应用99mTC-MIBI门控心肌显像和心血池显像来评价左心室功能.方法30例受检者,静脉注射99mTc-MIBI后,用SPECT行常规体位平面心肌显像,观察分析室壁运动和左心室收缩分数(LVCF).结果99mTc-MI3I门控心肌显像能清楚区分室壁边缘,在判断室壁运动上与心血池显像的完全符合节段达66%.用象素数表现左心室腔面积大小所计算的左心室收缩分数(LVCF)与左心室射血分数(LVEF)明显相关(r=0.09,P＜0.01).结论99mTc-MIBI门控心肌显像和心血池显像在冠心病的检查中具有重要价值,可作为常规检查之一应用于临床.     

99Tcm-NOET门控心肌灌注SPECT评价冠心病的价值

目的评价99Tcm--双（N-乙氧基,N-乙基-二硫代氨基甲酸酯）氮化锝（99Tcm-NOET）静息门控断层心肌灌注显像对冠心病患者的诊断价值。方法疑诊为冠心病的45例患者注射925MBq 99Tcm-NOET后1h用SPECT行静息门控心肌灌注显像,获得舒张未期容积（EDV）、收缩未期容积（ESV）、左室射血分数（LVEF）等心功能参数和舒张末期容积灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图。所有患者在1周内行冠状动脉造影,将冠状动脉狭窄≥50％定为病变血管。根据冠状动脉造影结果将其分为心肌梗死组、心肌缺血组和对照组三组。结果99Tcm-NOET静息门控SPECT诊断冠心病的灵敏度和特异度分别为68．42％和83．33％。心肌梗死组的心功能参数[EDV=（129．32±9．14）ml,ESV=（80．97±9．49）ml,LVEF=（40．15±3．28）％】与对照组【EDV=（80．91±3．12）ml,ESV=（30．12±1．79）ml,LVEF=（63．51±1．04）％]相比,统计学差异有显著性（EDV：F=22．103,ESV：F=32．277,LVEF：F=42．60：4,均为P〈0．01）,心肌缺血组的心功能参数[（EDV=（70．83±3．46）ml,ESV=（25．13±2．85）ml,LVEF=（65．55±2．62）％1与对照组相比,统计学差异无显著性意义。心肌梗死组左室心肌共分为460个节段,其中209个节段局部灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图均异常。局部灌注异常的节段共328个节段,伴有局部射血分数、局部室壁活动和室壁增厚度异常分别有250个、240个和276个节段。局部灌注异常的节段与局部射血分数、局部室壁活动和室壁增厚度异常的节段不完全匹配。结论99Tcm-NOET静息门控心肌灌注显像对冠心病的诊断有较大临床应用价值,所获得的整体心室功能参数在心肌梗死的评价中有优越性,但对心肌缺血的诊断价值不大。心肌梗死中存在有不少的局部灌注与心肌?     

定量门控99Tcm-tetrofosmin心肌显像测量左室功能

目的探讨定量门控(QG)99Tcm-tetrofosmin心肌显像测量左室功能的临床应用价值.方法74例受试者进行了门控99Tcm-tetrofosmin心肌显像,采用QGSPECT专用分析程序全自动测量左室功能.其中36例同时进行静息门控心室显像,以比较两种方法测量左室功能的相关性.结果①74例99Tcm-tetrofosminQGSPECT全自动定量测定左室功能均获成功.②QGSPECT全自动测量36例受试者的静息左室射血分数(LVEF)、舒张末期容积(EDV)、收缩末期容积(ESV)分别与静息门控心室显像计算结果显著正相关(r分别为0.859,0.914,0.950,P均<0.001),重复性好.③心肌缺血组(n=28)静息LVEF与对照组(n=23)比较差异无显著性,而心肌梗死组(n=9)静息LVEF明显低于对照组(t=6.33,P<0.001).结论定量门控心肌显像99Tcm-tetrofosmin能准确评价左室功能.     

运动99Tcm-MIBI心肌显像左室暂时性扩大诊断冠状动脉病变的价值

目的　探讨定量分析运动99Tcm 甲氧基异丁基异腈 (MIBI)心肌显像左室暂时性扩大诊断冠状动脉 (简称冠脉 ) 3支病变的价值。方法　 76例拟诊冠心病患者 ,平均年龄 (6 1± 8 3)岁。间隔1个月内完成运动 静息99Tcm MIBI心肌断层显像和冠脉造影检查。根据心肌短轴断层影像直径方向剖面曲线 2个峰值点间的距离计算左心腔面积 (LVD) ,以运动 /静息LVD比值 (LVDR)作为判断左心腔暂时性扩大的指标。结果　冠脉造影正常组、冠脉 1支病变、2支病变和 3支病变组LVDR平均值分别为 1 0 1± 0 0 5、1 0 2± 0 0 5、1 0 5± 0 0 4和 1 13± 0 0 6。 76例拟诊冠心病患者中左室暂时性扩大者 2 1例 ,其中 ,有冠脉 3支病变者 19例 (90 % )。LVDR值诊断冠脉 3支病变的灵敏度和特异性分别为 82 %和 94% ,常规分析方法分别为 5 0 %和 91%。其灵敏度显著高于常规分析方法 (χ2 =4 96 ,P <0 0 5 ) ,特异性差异无显著性 (χ2 =1 31,P >0 0 5 ) ,2种分析方法结合 ,灵敏度进一步提高 ,而特异性无显著下降。结论　定量分析运动99Tcm MIBI心肌显像左心腔暂时性扩大可提高其诊断冠脉 3支病变的灵敏度 ,不降低其特异性 ,LVDR值是诊断冠脉 3支病变的 1个新的有用指标。     

~(99)Tc~m-tetrofosmin定量门控心肌断层显像测定左室容积和左室射血分数

目的:对定量门控心肌断层显像(QGS),首次通过放射性核素血管造影(FPRNA)和左心室造影(LVG)测定左室舒张末期容积(EDV)、收缩末期容积(ESV)和左室射血分数(LVEF)的结果进行分析研究。方法:21例患者(男5例,女16例;其中16例冠心病,3例特发性扩张性心肌病,1例心脏淀粉样变性,1例胸痛待查)于静息状态下静脉注射740MBq99Tcm-tetrofosmin进行FPRNA,1h后进行门控心肌灌注断层(GSPECT)显像,每个心动周期分为10帧,资料用CedarsQGS软件自动分析。所有受检者在两周内进行LVG检查。结果:QGS结果重复性很好,明显优于FPRNA。QGS获得…     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.