血清t-PSA、f-PSA检测联合99mTc-MDP全身骨显像诊断前列腺癌的临床价值

目的:比较血清前列腺特异抗原(t-PSA)、游离前列腺特异抗原(f-PSA)诊断前列腺癌(PCa)和全身骨显像对PCa骨转移的诊断效能,探讨PSA检测联合全身骨显像诊断PCa的临床价值.方法:回顾性分析33例PCa患者和14例前列腺增生(BPH)患者的血清t-PSA、f-PSA和全身骨显像结果,以病理诊断或临床随访为确诊标准,骨显像结果依照5分法评分(0分:骨显像正常;1分:骨良性病变可能性大;2分:不确定;3分:骨转移可能性大;4分:骨转移明确).比较t-PSA、f-PSA和全身骨显像的ROC曲线下面积和最佳域值点的诊断灵敏度和特异性.结果:t-PSA、f-PSA和全身骨显像的ROC曲线下面积分别为0.686、0.637和0.948,最佳域值点的诊断灵敏度和特异性分别为57.6%、78.6%;84.8%、42.9%,90.0%、82.6%.结论:血清PSA检测联合骨显像可有效地诊断PCa,排除高PSA水平良性病例,避免不必要的创伤检查.     

^99Tc^m-亚甲基二膦酸盐在肢体高压电损伤中的诊断价值

目的研究应用^99Tc^m-亚甲基二膦酸盐（MDP）评估高压电烧伤患者肢体受损稗度。方法选取46例肢体高压电烧伤患者,分别于术前进行^99Tc^m-MDP显影、多普勒检测、术中观察组织大体改变,出现血管栓塞或组织坏死者予以切除并进行组织病理学检查。结果轻度损伤肢体血池相及血流相均显示局部放射性浓聚,重度损伤肢体远端影像暗淡,近端影像明显增强,毁损性电击伤肢体血流灌注中断,各种组织均不显影,与未受损影像界限清晰,与彩色多普勒超声检测、临床表现和组织病理学检查相符。结论^99Tc^m-MDP三相动态显像可较直观地显示深度电烧伤后局部血供的改变及组织受损情况,它可以作为诊断电烧伤患者组织损伤程度的一种检测手段。     

风湿性骨关节炎患者99mTc-MDP骨显像的初步应用

为了解风湿性骨关节病的骨显像应用价值，我们对66例临床确诊的风湿性骨关节病患者行99m锝-亚甲基二膦酸（99mTechnetium methylenediphosphonate，99mTc—MDP）全身及局部骨显像以及感兴趣区（Regionofinterest，ROI）测定，并进行骨关节疼痛部位X线检查，测定血清类风湿因子（Rheumatoidfactor，RF）、血清C反应蛋白（C-reactiveprotein，CRP）及血沉（Erythrocyte sedimentationrate，ESR）。结果66例中骨关节显像阳性55例，阳性率为83．3％，明显高于X线（45．5％）、RF（51．5％）、CRP（63．6％）、ESR（69．7％）。病程〈1、1～、5～、〉10年患者‰Tc．MDP显像阳性率分别为75．O％、88．9％、92．3％、100．0％，X线阳性率分别为10．7％、33．3％、84．6％、100．0％（两者比较，病程5年以内P〈0．01，病程5年以上P〉0．05）。99mTc—MDP显像发现骨关节病灶177个，对称性病灶144个（81．4％）明显多于单发病灶（33个，18．6％），其影像改变常见于指问、掌指、腕和跖踝关节。我们可以看到99mTc-MDP显像能较早发现风湿性骨关节病的异常改变，对治疗有一定的指导意义。     

乳腺肿物的超声诊断价值

目的 回顾性分析经手术病理证实的69例乳腺肿物的声像图特征和彩色多普勒特点,以提高乳腺肿瘤超声定性诊断的符合率.方法 对乳腺肿物进行二维超声检查,了解其形态、边界、边缘、内部回声、有无后方衰减及侧方声影等,然后进行了彩色多普勒血流检查,观察肿物内部及周边血流情况,并分别与病理结果对照.结果 在乳腺肿物声像图诊断中,以肿物边界回声特征最为重要.及内部血流的多少是肿物良、恶性鉴别的关键.本组大多数恶性肿物形态不规则,边界不清,内部回声不均匀,肿物前侧缘有不规则强回声,同时彩色多普勒检出丰富血流信号.良性肿瘤多表现为边界光滑,侧缘回声减弱,彩色多普勒不能检出或检出少量星点状血流信号.结论 超声声像图及彩色多普勒特征,对乳腺肿瘤性质的判断有较大的临床应用价值.     

99Tc-亚甲基二膦酸盐治疗糖尿病并发骨质疏松症的临床研究

目的 观察^99Tc-亚甲基二膦酸盐（云克）治疗糖尿病并发骨质疏松症的疗效和安全性.方法 58例糖尿病并发骨质疏松症患者,选用云克治疗6个月.比较治疗前后患者疼痛、骨密度、血生化指标的变化,并观察不良反应.结果 经6个月治疗后,患者疼痛明显改善,腰椎、股骨颈和髋部骨密度增加,血清25-羟维生素D3[25-（OH） D3]水平升高,骨型碱性磷酸酶（BAP）水平下降,甲状旁腺素（PTH）变化不明显,副反应轻微且耐受性好.结论 云克治疗糖尿病并发骨质疏松症疗效显著、安全性好.     

^99mTcO4^—及^99mTc—MIBI对功能自主性甲状腺瘤显像的临床评价

目的：应用^99mTcO4^-及^99mTc-MIBI显像对功能自主性甲状腺瘤以外正常甲状腺组织影像进行临床评价。方法：对30例单发热结节病人同时分别应用^99mTc-O4^-及^99mTc-MIBI显像，并测定高灵敏度TSH、FT3、FT4；23例行手术切除与之比较。结果：^99mTc-MIBI被甲状腺组织摄取，不受血中甲状腺激素浓度的影响，在“热”结节存在时，正常甲状腺组织仍摄取^99mTc-MIBI。结节外正常组织显像25例，占83．3％，与应用^99mTc-O4^-甲状腺显像“热”结节屏蔽后正常甲状腺显像26全，占86．3％。相比P＞0．05，无明显差异，23例甲状腺“热”结节手术半年后行甲状腺显像，余留的甲状腺影象与治疗前显像相似。结论：以上两种方法能使功能受抑制的正常甲状腺组织显像，能帮且鉴别诊断甲状腺结节的功能自主性，具有简便、无过敏反应的优点。     

^99Tc^m-MIBI亲肿瘤显像对甲状腺癌的诊断价值

目的 探讨99Tcm-MIBI显像在甲状腺癌诊断中的价值.方法 对52例99TcmO4-甲状腺显像为"冷"结节的患者行99Tcm-MIBI显像.患者均行外科手术治疗,并作病理检查.计算其10 min和60 min患侧/健侧摄取放射性比值(T/N),分析假阳性和假阴性.结果 甲状腺癌组10 min和60 minT/N值分别为1.87±0.57和1.61±0.45,而甲状腺良性病变组分别为0.79±0.22和0.89±0.25,两组两时相T/N值比较均有显著性差异(P＜0.01).99Tcm-MIBI显像对甲状腺癌诊断的灵敏度、特异性和准确性分别为77.8%、82.4%和80.8%.结论 甲状腺"冷"结节行99Tcm-MIBI显像对于甲状腺癌的诊断具有较高的临床参考价值.     

99mTc-MDP骨显像诊断肾性骨病的临床意义

近20多年以来随血液净化技术的开展和进步,尿毒症患者的生命得以延长,可是肾性骨病的患者并没有减少,且由于内科透析因素的影响,铝中毒而导致的骨骼变化,透析膜生物相容性导致的骨、关节病变,慢性肾性骨病的病例反而有增加的趋势,它现已成为慢性肾衰和透析领域的主要问题之一。     

巴德枪改良穿刺法对乳腺肿物活检的临床应用研究

目的 探讨巴德枪改良穿刺法对乳腺肿物活检的临床应用价值。方法 选取山东省济南市市中区人民医院外科2013年12月~2015年12月100例乳腺肿物患者,使用巴德枪十字交叉穿刺法取得肿物标本并进行病理诊断,再与手术后常规病理诊断结果进行比较,讨论并分析其穿刺诊断价值。结果 99例穿刺成功,1例穿刺取得组织为脂肪组织穿刺失误,穿刺成功率达99.00%。巴德枪穿刺活检病理诊断与手术后常规病理诊断结果符合率达97.00%以上,假阴性率占5.50%,无假阳性。结论 巴德枪十字交叉穿刺法对乳腺肿物活检具有穿刺准确、诊断率高等优势。     

^99Tc^m-MIBI阳性显像诊断甲状腺癌的临床价值

目的 以临床病理学为基础，分析评价^99Tc^m-MIBI阳性显像诊断甲状腺癌的临床价值。方法 对105例甲状腺癌患者行早期和延迟甲状腺阳性显像，并对其影像学特征进行分析比较。结果 105例甲状腺癌中，^99Tc^m-MIBI阳性显像乳头状癌阳性有43例（82．7％），假阴性有9例（17．3％），灵敏度为82．7％；滤泡状癌阳性有37例（86．1％），假阴性有6例（14．0％），灵敏度为86．1％；其它类型阳性有5例（50．0％），假阴性有5例（50．0％），灵敏度为50．0％。其中乳头状癌组和滤泡状癌组灵敏度无明显差异（P〉0．05），但二者均高，于其它类型组（P〈0．05）。结论 ^99Tc^m-MIBI阳性显像对甲状腺癌诊断具有重要的临床价值。     

乳腺显像装置的研制及108例乳腺亲肿瘤显像结果分析

目的 提高＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像的对乳腺癌的检出率。方法 采用我们设计的乳腺显像装置作＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像，采用特殊俯卧位检查。其中１０８例的结果与病理资料对照，结果 恶性病变组ＥＣＴ阳性４３／４７；阴性４／４７。良性病变组ＥＣＴ阴性５６／６１；阳性５／６１。＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像对乳腺恶性病变诊断的＾９９ｍＴｃ－ＭＩＢＩ乳腺亲肿瘤显像对乳腺恶性病变诊断     

Optical imaging of breast tumor through temporal log-slope difference mappings

A novel optical temporal log-slope difference mapping approach is proposed for cancerous breast tumor detection. In this method, target tissues are illuminated by near-infrared (700-1000 nm) ultrashort laser pulses from various surface source points, and backscattered time-resolved light signals are collected at the same surface points. By analyzing the log-slopes of decaying signals over all points on the source-detection grid, a log-slope distribution on the surface is obtained. After administration of absorption contrast agents, the presence of cancerous tumors increases the decaying steepness of the transient signals. The mapping of log-slope difference between native tissue and absorption-enhanced cancerous tissue indicates the location and projection of tumors on the detection surface. In this paper, we examine this method in the detection of breast tumors in two model tissue phantoms through computer simulation. The first model has a spherical tumor of 6mm in diameter embedded at the tissue center. The second model is a large tissue phantom embedded with a non-centered spherical tumor 8mm in diameter. Monte Carlo methods were employed to simulate the light transport and signal measurement. It is shown that the tumor in both the tissue models will be accurately projected on the detection surface by the proposed log-slope difference mapping method. The image processing is very fast and does not require any inverse optimization in image reconstruction.     

99mTc—HSA（FSA）药盒的制备研究

目的 研制一种快速、简便、可靠的~99nzTc标记的心血池显像剂.方法 用二氧硫脲(FSA)作人血清白蛋白(HSA)还原剂,用放射性直接标记方法制备~99nzTc标记一步法药盒,测定该药盒及其标记产物的~99nzTc-HSA的理化性质、还原蛋白巯基(-SH)数目及生物性能.结果 对还原后的HSA进行了~99nzTc的标记,放化纯度大于95%,标记后室温放置24小时,放化纯度仍大于95%,体外稳定性很好,小鼠体内分布血中浓度高且较稳定.结论 采用该方法制备的药盒明显提高了~99nzTc-HSA在小鼠体内血中浓度,与~99nzTc-二亚乙基三胺五乙酸一人血清白蛋白(~99nzTc-DTPA-HSA)小鼠体内分布数据二者无显著差异,宜于临床进一步研究.     

^99mTc—HL9l肿瘤乏氧显像的动物实验

目的　用99mTc -HL91乏氧显像剂对肺腺癌小鼠模型进行体内分布和显像实验 ,以探索其对肿瘤显像的适用性 .方法　99mTc -HL91一步法标记 ,放化纯 >95 % .对 15只肺腺癌动物模型腹腔注射99mTc -HL9118 5MBq ,于 1～ 2 4小时处死取血液、肿瘤、脑、肺、心、肝、脾、肾、骨等标本称重 ,测定放射性计数 ,计算ID % /g及肿瘤组织与非肿瘤组织放射性比值 (T/NT) .同时在腹腔注射99mTc-HL91后于不同时间对模型进行静态显像 .结果　肿瘤组织对99mTc-HL91有较早较高的摄取和滞留 ,T/NT比值随时间延长而有增高趋势 .显像示肿瘤组织有较好的放射性浓聚 ,图像清晰 ,对比度良好 .结论　99mTc-HL91标记简单 ,标记率高 ,使用方便 ,在肿瘤组织中有较好的摄取与滞留 ,是一种良好的肿瘤乏氧显像剂 ,但需要进一步研究其机理和改进方法 ,提高T/NT比值 ,以开展临床试验     

Expression of Yes-associated protein (YAP) in breast phyllodes tumor

This study aimed to identify expression profiles of Yes-associated protein (YAP) and its phosphorylated form (pYAP) in phyllodes tumor (PT) of human breast and verify the clinical implications. We selected PTs from the pathologic archive and reviewed the histologic features (141 benign, 27 borderline, and 15 malignant). We made tissue microarray (TMA) block from the formalin-fixed paraffin-embedded (FFPE) tissue corresponding to the representative section. Using TMA block, we performed immunohistochemical staining of YAP and pYAP. In the stromal component, expressions of YAP and pYAP were increased in borderline/malignant PT with comparison of benign PT (P = 0.002, and P < 0.001, respectively). In the epithelial component, cytoplasmic expression of YAP was highest in borderline PT (P = 0.001). Stromal YAP expression (P < 0.001) and stromal pYAP expression (P = 0.042) were associated with shorter disease-free survival (DFS) and stromal pYAP expression (P = 0.001) was associated with shorter overall survival (OS) in univariate Cox analysis. In multivariate Cox analysis, stromal YAP expression was an independent prognostic factor associated with shorter DFS (Hazard ration: 3.206, 95% CI: 1.000-10.27, P = 0.050). In conclusion, expression level of YAP in stromal component was increased along with histologic grade of PT and YAP expression in PT was related to tumor progression and poor prognosis.     

~(99m)Tc-DTPA肾动态显像测定肾小球滤过率常见影响因素辨析

目的 探讨在~(99m)Tc-DTPA肾动态显像测定肾小球滤过率(GFR)过程中是否有影响GFR准确性的因素存在,以确保诊断的准确性.方法 对326例患者及1例健康志愿者应用~(99m)Tc-DTPA肾动态显像测定GFR.健康志愿者首次检查在饮水500 ml后5 min进行;第2次检查按常规在饮水500ml后30 min进行.结合肾功能曲线和GFR对检测结果进行分析.结果 注射放射性的有效剂量与实测剂量不符导致GFR误差共61例,发生率为18.7%(61/326).在该类患者中有88.5%(54/61)的病例是由于注射点有放射性药物外渗所致.有8.2%(5/61)的病例因袖口过紧导致放射性药物存留在袖口压迫点的远端并缓慢释放.有3.3%(2/61)病例在测量空针筒时没有采集注射器针帽内漏出的放射性,GFR减低.饮水后短时间内注射放射性药物,导致肾功能曲线峰值减低,排泄段抬高,GFR减低.65例糖尿病患者GFR异常增高,而肾功能曲线形态表现为正常.结论 GFR的影响因素较多.综合分析肾功能曲线与GFR值,对于发现误差,确保结果的准确性具有重要意义.再密切结合病史和肾脏影像,可以进一步确保诊断的准确性.     

^99mTc—NOEt心肌显像的最佳显像时间的研究

目的:研究~(99m)Tc-NOEt(NOEt:N—乙氧基—N—乙基氨荒酸钠)的最佳负荷显像时间及再分布显像时间,方法:32例CAD患者及8例正常对照者进行~(99m)Tc-NOEt动态心肌断层SPECT显像研究,分析心肌显像质量及心肌显像结果 结果:~(99m)Tc-NOEt心肌显像质量随时间的递增而明显改善,但再分布显像时间过长反而造成部分心肌显像质量下降;~(99m)Tc-NOEt再分布现象可能发生较早.结论:建议负荷心肌显像时间直在15分钟进行,再分布显像在2小时进行,最好不超过4小时.     

Quantitative simultaneous In-111/Tc-99m planar imaging in a long-bone infection phantom

In-111-white-blood-cell and Tc-99m-sulfur-colloid dual-radionuclide imaging are frequently utilized in the evaluation of patients with suspected osteomyelitis. We have developed a quantitative planar imaging method in which Tc-99m and In-111 scans are acquired simultaneously in accurate spatial registration. Long, thin tubes containing only In-111 or Tc-99m were first imaged in a list mode within a water bath inclined with respect to the water surface; from these, 12 energy spectra corresponding to different Tc/In ratios were synthesized. Triple-energy-window (TEW) parameters for scatter and radionuclide crosstalk correction, including scatter windows and weights, were optimized using 100 noise realizations of each of the spectra (1200 total). A long-bone phantom containing a simulated infection site was then imaged in water with five In/Tc ratios; 100 noise realizations of two conjugate-view images were generated from each acquisition (500 total). Two regions of interest (ROIs) were defined, and the ratio of In/Tc count ratios in these two ROIs was evaluated with and without the TEW scatter correction and geometric mean attenuation compensation. The average bias improved from 17.2% to 5.3%, with comparable precision. TEW corrections with non-optimized but practical energy windows also improved the bias to 6.4%. Compared with subjective visual assessment, quantitation of In-111/Tc-99m ratios may improve diagnostic accuracy and could eventually permit grading of osteomyelitis.     

99Tcm—MIBI亲肿瘤显像在乳腺癌诊断中的应用价值

目的 评价99Tcm锝-甲氧基异丁基异腈（99Tcm-MIBI）乳腺显像对乳腺癌诊断的价值。方法 对57例乳腺肿块患者经病变乳腺对侧肿静脉注射99Tcm-MIBI740～1110MBq后15min即行早期乳腺显像，分别采集正前位、左、右侧位像，采集计数1000k，1．5h后按上述条件作延迟显像。结果 57例乳腺肿块患者，99Tcm-MIBI核素显像阳性39例，阴性18例；41例乳腺癌患者99Tcm-MIBI核素显像阳性37例、阴性4例；16例良性病变中99Tcm MIBI核素显像阴性14例、阳性2例；99Tcm-MIBI核素显像诊断乳腺癌的灵敏度为90．2％，特异性87．5％。准确性为89．5％，阳性预测值94．9％．阴性预测值77．8％。结论 99Tcm-MIBI显像对乳腺肿块的患者能提供非常有价值的临床信息，对乳腺癌的诊断厦良、恶性病变的鉴别有较高的敏感性和准确性。     

Molecular imaging for assessment of mesenchymal stem cells mediated breast cancer therapy

The tumor tropism of mesenchymal stem cells (MSCs) makes them an excellent delivery vehicle used in anticancer therapy. However, the exact mechanisms of MSCs involved in tumor microenvironment are still not well defined. Molecular imaging technologies with the versatility in monitoring the therapeutic effects, as well as basic molecular and cellular processes in real time, offer tangible options to better guide MSCs mediated cancer therapy. In this study, an in situ breast cancer model was developed with MDA-MB-231 cells carrying a reporter system encoding a double fusion (DF) reporter gene consisting of firefly luciferase (Fluc) and enhanced green fluorescent protein (eGFP). In mice breast cancer model, we injected human umbilical cord-derived MSCs (hUC-MSCs) armed with a triple fusion (TF) gene containing the herpes simplex virus truncated thymidine kinase (HSV-ttk), renilla luciferase (Rluc) and red fluorescent protein (RFP) into tumor on day 13, 18, 23 after MDA-MB-231 cells injection. Bioluminescence imaging of Fluc and Rluc provided the real time monitor of tumor cells and hUC-MSCs simultaneously. We found that tumors were significantly inhibited by hUC-MSCs administration, and this effect was enhanced by ganciclovir (GCV) application. To further demonstrate the effect of hUC-MSCs on tumor cells in vivo, we employed the near infrared (NIR) imaging and the results showed that hUC-MSCs could inhibit tumor angiogenesis and increased apoptosis to a certain degree. In conclusion, hUC-MSCs can inhibit breast cancer progression by inducing tumor cell death and suppressing angiogenesis. Moreover, molecular imaging is an invaluable tool in tracking cell delivery and tumor response to hUC-MSCs therapies as well as cellular and molecular processes in tumor.