~(99m)Tc-MIBI显像对甲状腺癌诊断的临床研究

目的 研究99mTc-MIBI显像对临床疑似甲状腺癌的诊断价值.方法 对疑似甲状腺癌的45例甲状腺结节患者,应用99mTc-MIBI显像诊断,同时与同期甲状腺彩超、CT诊断和临床病理对照.结果 99mTc04<'->显像诊断甲状腺癌的灵敏度90.24%(37/41),特异度23.53%(13/17);99mTc-MIBI显像诊断甲状腺癌的灵敏度51.22%(21/41),特异度88.24%(15/17).放射性核素显像对甲状腺癌有较好的检出率,甲状腺彩超检查尚可,CT检查及Tg测定意义不大.结论 99mTc-MIBI显像对甲状腺癌诊断有一定的定性诊断价值.     

99mTc-MIBI显像对甲状腺结节良恶性鉴别诊断的价值

目的：评价^99mTc-MIBI(甲氧基异丁基异腈）显像对鉴别甲状腺冷（凉）结节良恶性的临床价值。方法：对35例^99mTc04-显像为冷（凉）结节的患者行^99mTc-MIBI血流灌注显像及静态显像。结果：MIBI显像诊断甲状腺癌的灵敏度为91．3％,特异性为75％。结论：^99mTc-MIBI显像对鉴别甲状腺冷（凉）结节的良恶性具有较高灵敏度及特异性。     

用微波炉法标记^99mTc—MIBI的技术探讨

目的 通过对微波炉法标记99mTc-MIBI的技术探讨,保证此方法的标记质量和标记过程的安全.方法 首先用微波炉对烧杯内的水进行加热实验,观察被加热液体在旋转托盘不同位置的受热状况;再做空白模拟实验,摸索不引起实验瓶破裂的较长加热时间;在此安全加热时间范围内,逐级增加实际加热标记时间,分别用纸层析法做放化纯测定,确定最合适的标记时间.结果 微波炉旋转托盘的中心位置,火力适中、热力均匀;中档火力加热真空瓶中4ml生理盐水,安全加热时间至少70s;实际标记加热40～50s,99mTc-MIBI的放化纯度可达98%以上.结论 微波炉法标记99mTc-MIBI,安全、可靠、高效,值得推广使用.     

Preparation,characterization and biodistribution of a new technetium‐99 m nitrido complex with 2‐methoxyisobutylisonitrile and comparison with 99mTc–MIBI

The preparation of complex ^99mTcN–MIBI was carried out using two alternative procedures that led to the formation of the complex with high radiochemical purity (>90%). The partition coefficient, electrophoresis and cationic resin exchange experiments showed that the ^99mTcN–MIBI is a lipophilic and neutral complex, the structure of this complex is six‐coordinate distorted octahedral, its composition may be [^99mTcNCl₂(MIBI)₃], and the optimized geometry of this complex was calculated by using Gaussian 98 for Window (G98W) program. The biodistribution of ^99mTcN–MIBI shows high myocardial uptake and good target/non‐target ratios in mice at early post‐injection time, for 5 min post‐injection the heart‐to‐blood, heart‐to‐lungs and heart‐to‐liver ratios are 3.18, 1.72 and 1.42, respectively. In respect of the relatively good rations after 5 min and the rapid clearance from non‐target, the complex ^99mTcN–MIBI may be suitable for instant myocardial imaging. In addition, the lyophilized kit enables the convenient preparation of this complex for clinical use. Based on these promising properties, ^99mTcN–MIBI should be a new potential myocardial perfusion‐imaging agent. Copyright © 2002 John Wiley & Sons, Ltd.     

11例早期肺癌^99Tc^m—MIBI肺显像诊断价值探讨

目的 探讨应用^99Tc^m-甲氧异丁基异腈(MIBI)肺显像诊断早期肺癌的价值。方法 收集经手术与病理证实的11例I期肺癌病例，进行^99Tc^m-MIBI肺显像并与X线片、CT检查准确率回顾对照分析。结果 11例患者平面显像有8例阳性考虑恶性，另3例平面显像阴性；其中阴性2例补充断层显像发现异常浓聚灶，考虑为恶性。核素显像符合率90．91％。CT扫描结果提示肺癌4例，肺结核2例，5例无法定性；CT定性诊断准确率44％。结论 应用^99Tc^m-MIBI肺显像是肺结节定性诊断有效而敏感的方法。     

分化型甲状腺癌68例手术治疗分析

目的探讨分化型甲状腺癌手术治疗的方式、效果。方法回顾性分析2005年5月～2010年12月本院收治的68例分化型甲状腺癌患者的临床资料。结果无手术死亡病例,术后出现喉返神经损伤4例。术后3-6个月恢复正常。双侧甲状腺全切术后出现低血钙3例,经补钙治疗后症状消失。术后随访1～8年,无死亡病例,再手术4例,颈淋巴结转移3例,骨转移1例。结论分化型甲状腺癌应根据病理类型、肿瘤大小、颈部淋巴结转移等选择合理手术方式,可获得良好效果。     

^99mTc—MIBI SPECT肺肿瘤显像及其临床初步应用

目的：探讨^99mTc-MIBI肺肿瘤显像的方法及对肺部结节的诊断价值。方法：对11例临床未明确诊断的肺结节患者行^99mTc-MIBISPECT肺肿瘤显像，并与病理等检查对照。结果：7例经手术病理证实的肺癌患者SPECT呈阳性显像而准确检出。4例肺良性结节患者有3例呈阴性显像而准确检出，另1例假阳性。结论：初步认为，^99mTc-MIBI SPECT肺肿瘤显像对肺结节的鉴别诊断有临床价值。     

Synthesis,separation and biodistribution of 99mTc‐CO‐MIBI complex

^99mTc‐CO‐MIBI was prepared by a two‐step procedure involving the convenient preparation of the [^99mTc(CO)₃(OH₂)₃]⁺ precursor and followed by the substitution of the water molecules by the MIBI (2‐methoxyisobutylisonitrile) ligands. In a second step, the reaction solution was adjusted to different pH values, and then the product, ^99mTc‐CO‐MIBI, was confirmed to be a mixture of two complexes: complex A and complex B, whose labeling yields could be over 90%. The ratio of complex B to the sum of A and B could increase gradually from 0 to 1 when pH was shifted from 3.0 to 9.0. These changes were monitored by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). The two complexes were stable within 8 h at room temperature in vitro. The partition coefficient of the two complexes indicated that there was distinct difference between them. Biodistribution in mice demonstrated that complex B showed better myocardial imaging properties than that of complex A. The heart/liver ratios of complex A, the mixture, and complex B were 1.57, 1.93, and 2.33, respectively, for 30 min post‐injection. The discovery of chemical and biological properties of ^99mTc‐CO‐MIBI would certainly promote the research on a new promising myocardial perfusion‐imaging agent. Copyright © 2004 John Wiley & Sons, Ltd.     

Effects of intra-arterial ketanserin in Raynaud's phenomenon assessed by 99MTc-pertechnetate scintigraphy

Summary The severity of the peripheral vasopastic condition in 10 patients with Raynaud's phenomenon was investigated using scintigraphy of both hands. ^99MTc-pertechnetate was used as a diffusable tracer and scintigrams were recorded with normal hand skin temperature and following immersion of the hands in ice-cold water.Cold provocation resulted in a marked reduction of the rate of blood inflow and tissue perfusion in affected hands.The selective peripheral S₂-antagonist ketanserin and placebo were administered intra-arterially according to a double-blind cross-over design. As compared to placebo, ketanserin significantly improved the rate of inflow following cold provocation, and it increased tissue perfusion in the hands of the patients to values normally observed in healthy individuals.The results support the use of ketanserin in the treatment of Raynaud's phenomenon.     

Metastatic thyroid carcinoma

Although metastases to the thyroid gland are common in autopsy studies, clinically significant metastases are rare. A 58-year-old Turkish patient, presenting with thyroid metastasis 2 years after undergoing left nephrectomy for renal cell carcinoma, is reported in this case report. Thyroid metastasis can be the initial presentation of renal cell carcinoma, or it may occur a long time after nephrectomy, which can lead to misdiagnosis of primary thyroid neoplasm. Radiographic features are not useful in making discrimination between the two, however a fine needle aspiration biopsy can be useful. The role of surgical therapy is controversial.     

Microbial and pyrogenic contamination of molybdenum 99/Technetium 99m radionuclide generators

Radionuclide generators employed for the production of short-lived radionuclides may be contaminated with microorganisms during use, although this may not result in significant microbial contamination of the eluate. The mechanism by which this reduction was achieved was examined, using technetium 99m generators deliberately contaminated with known numbers of Escherichia coli. Results indicated that a small proportion of the inoculum was eluted from loaded (‘active’) or unloaded columns suggesting that organisms were entrapped in the alumina bed. Cell death occurred and could be caused by significant exposure to radiation, and the toxicity of aluminium and molybdate ions. Loss of viability led to an increased release of pyrogenic material into the eluate.