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1.
Masahiro Toba Yoshio Ishida Kazuki Fukuchi Teruo Noguchi Akira Itoh Hiroshi Nonogi Makoto Takamiya 《European journal of nuclear medicine and molecular imaging》2000,27(5):517-523
Serial improvement in myocardial perfusion images from the acute or subacute to the chronic stage of acute myocardial infarction
(AMI) has been attributed to improved coronary microcirculation or cell function after acute ischaemia and reperfusion. However,
conventionally used non-gated imaging cannot eliminate the effect of improved regional contraction. We studied the possibility
that such scintigraphic improvement reflects the functional recovery by using ECG-gated myocardial perfusion imaging with
technetium-99m sestamibi. Nineteen AMI patients who received acute reperfusion therapy underwent ECG-gated myocardial single-photon
emission tomography (SPET) in the subacute and chronic stages. Serial changes in regional image count distributions were analysed
on the non-gated, end-diastolic (ED) and end-systolic (ES) images by using segmental mean percent peak activity (MPA) and
ΔMPA (MPA in chronic stage – MPA in subacute stage) on bull’s-eye polar maps. These changes were compared with those in regional
wall motion on biplane left ventriculography (LVG) from the acute (just after reperfusion) to the chronic stage. During the
follow-up, regional wall motion remained the same in 42 (group A) but improved in 17 (group B) of the 59 ischaemically compromised
segments. MPA showed no improvement in group A but significant improvement in group B on the non-gated and ES images (P<0.0001 and P<0.001, respectively). However, MPA on the ED images showed no improvement in either group. In the follow-up study of AMI,
the scintigraphic improvement documented on the non-gated myocardial images appears to be mainly related to the recovery of
wall thickening and not to a real improvement in myocardial perfusion. Therefore, ECG-gated myocardial imaging, which enables
simultaneous assessment of changes in perfusion and contraction, is preferable to conventional non-gated imaging for follow-up
of AMI.
Received 26 October 1999 and in revised form 20 January 2000 相似文献
2.
Hashimoto J Kubo A Iwasaki R Iwanaga S Mitamura H Ogawa S Kosuda S 《European journal of nuclear medicine》1999,26(12):1541-1546
This study was designed to apply ECG-gating to stress myocardial perfusion single-photon emission tomography (SPET) for the evaluation of myocardial stunning after exercise. Technetium-99m sestamibi was selected as the perfusion agent and a rest/exercise 1-day protocol was employed. Fourteen patients without coronary stenosis and 33 patients with coronary stenosis were enrolled in the study. We carried out three data acquisitions with ECG-gating: a 15-min data acquisition starting 30 min after the rest injection (AC1), a 5-min acquisition starting 5 min after the stress injection (AC2) and a 15-min acquisition starting 20 min after the stress injection (AC3). Calculation of left ventricular ejection fraction (LVEF) values was performed by means of automatic determination of the endocardial surface for all gating intervals in the cardiac cycle. Measured global EF values in 14 patients without coronary stenosis were 52.3% +/- 7.6% (AC1), 60.6% +/- 8.9% (AC2) and 55.6% +/- 5.6% (AC3), and those in 11 patients with severe ischaemia were 53.6% +/- 8.0% (AC1), 45.6% +/- 12.1% (AC2) and 49.7% +/- 10.7%. The magnitude of the depression of post-stress LVEF relative to the rest LVEF correlated with the severity of ischaemia (r = 0.594, P = 0.002), and segments manifesting post-stress functional depression were associated with ischaemic segments showing reversible perfusion defects. Stress myocardial perfusion SPET with ECG-gating is a feasible method for the evaluation of myocardial stunning as well as exercise-induced ischaemia. 相似文献
3.
Technetium-99m sestamibi brain single-photon emission tomography for detection of recurrent gliomas after radiation therapy 总被引:8,自引:3,他引:5
C. Soler P. Beauchesne K. Maatougui T. Schmitt F. G. Barral D. Michel F. Dubois J. Brunon 《European journal of nuclear medicine and molecular imaging》1998,25(12):1649-1657
Technetium-99m sestamibi (MIBI), an alternative radiopharmaceutical for myocardial perfusion imaging, has also been proposed
for use as an imaging agent for various tumours, including breast cancer, lung cancer, lymphomas, melanomas and brain tumours.
After routine radiation therapy, deteriorating clinical status or treatment failure may be due to either radiation-induced
changes or recurrent tumour. Computed tomography and magnetic resonance imaging offer imperfect discrimination of tumour viability
and radionecrosis. Against this background we undertook a retrospective study of 35 malignant glioma patients in whom clinical
deterioration had occurred, in order to clarify the value of 99mTc-MIBI SPET in identifying tumour recurrence. SPET was performed 15 min after intravenous injection of 1110 MBq 99mTc-MIBI. The images were obtained with a dual-headed gamma camera using a fan-beam collimator. Transverse, coronal and sagittal
views were reconstructed. Intense MIBI uptake was found in 31 patients. This uptake was correlated with tumour recurrence
as proved by histology and/or rapid, fatal evolution of these cases. The statistical analysis performed on this population
of patients with MIBI uptake revealed a group of patients with a long mean survival and a group with a short mean survival.
Two subgroups were found within each of these groups, according to the functional index ratio (tumour uptake/pituitary gland
uptake ratio). No MIBI uptake was found in four patients who are still alive and can be considered to be disease-free. In
those cases showing MIBI uptake, death occurred an average of 6.69 months following brain SPET. According to our results,
the specificity and sensitivity of 99mTc-MIBI brain SPET seem to be high. Moreover, this technique is more accurate than computed tomography or magnetic resonance
imaging for discriminating between tumour recurrence and radionecrosis.
Received 9 April and in revised form 9 July 1998 相似文献
4.
Alice Widding Birger Hesse Niels Gadsbøll 《European journal of nuclear medicine and molecular imaging》1997,24(1):42-45
The aim of this study was to compare technetium-99m labelled tetrofosmin and sestamibi myocardial perfusion single-photon emission tomography (SPET) with one common sestamibi reference file for bull's eye imaging, with quantitation of the extent and severity of perfusion defects. Twenty patients suspected or known to have coronary artery disease participated in the study. Patients first underwent routine sestamibi myocardial SPET over 2 days, receiving doses of 400–600 MBq at stress and 600–800 MBq at rest. Then within the same week a 1-day tetrofosmin myocardial SPET study was performed, with a dose of 300 MBq at stress, followed 2.5 h later by a dose of 750 MBq at rest. Bull's eye images were generated for visual evaluation. Black-out defects according to the Cequal software analysis were only recorded if they comprised more than 10 pixels in men and 20 in women. According to the Cequal program, extent score and severity scores were expressed as number of pixels and deviations below reference limits. Five patients had normal myocardial SPET imaging with both radiotracers, while 15 had reversible, irreversible or partially reversible defects. The concordance of the results was high. The only two significant differences were that one patient had a reversible defect which appeared to be located in different myocardial regions (LAD vs RCA), and another patient had a defect that was partially reversible with sestamibi but irreversible with tetrofosmin. The results showed very high correlation coefficients for the extent and severity scores (linear correlation coefficient values of 0.99 and 0.94, respectively). In conclusion, it appears that changing between sestamibi and tetrofosmin has little influence on the interpretation of bull's eye images from the data file of a common reference population using one of the tracers. 相似文献
5.
Jens C. Stollfuss Felix Haas Ichiro Matsunari Jodi Neverve Stephan Nekolla Jan Schneider-Eicke Ullrich Schricke Sybille Ziegler Markus Schwaiger 《European journal of nuclear medicine and molecular imaging》1998,25(5):522-530
We investigated the use of visual and quantitative technetium 99m tetrofosmin ECG-gated single-photon emission tomography
(SPET) for the assessment of regional myocardial wall thickening (WT) and left ventricular (LV) ejection fraction (EF) in
comparison with gated magnetic resonance imaging (MRI) in patients with a low angiographic LVEF. Gated SPET using 99mTc-labelled flow tracers offers potential for simultaneous assessment of myocardial perfusion and LV function. Few data are
available on the use of visual and quantitative gated SPET in patients with low LVEF. In this study 21 patients with low angiographic
LVEF (mean 37%±5%) were studied. Resting gated 99mTc-tetrofosmin SPET and gated MRI were performed within 48 h. WT was assessed by visual interpretation (five point score)
and quantitative analysis based on count increase. There was good agreement for EF measurements by MRI and gated SPET (mean
EF: 33%±12% vs 35%±11%, r = 0.86, P<0.001). Areas under receiver operator characteristic curves (AUC) for differentiation between MRI WT score points ranged
from 0.60 to 0.66 for visual SPET WT analysis, from 0.59 to 0.71 for delta count increase values and from 0.46 to 0.60 for
% WT, indicating substantial overlap between WT categories. Absolute agreement for visual WT between MRI and gated SPET ranged
from 25% to 57% (kappa 0.03–0.25) depending on tracer uptake, and was limited in areas with moderate to severe perfusion defects
(kappa 0.03–0.13). It is concluded that gated SPET provided reliable estimates of regional WT and global function in patients
with low angiographic LVEF.
Received 15 October 1997 and in revised form 31 January 1998 相似文献
6.
Orazio Schillaci Bruno Laganà Roberta Danieli Raffaele Gentile Luigi Tubani Luigi Baratta Francesco Scopinaro 《European journal of nuclear medicine and molecular imaging》1999,26(7):713-717
In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death.
However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary
vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate
myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET).
Twenty-eight patients without overt cardiac involvement and risk factors were studied with 99mTc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent
defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which
normalized on dipyridamole images (”reverse redistribution pattern”). Coronary angiography was performed in eight patients
with positive 99mTc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that 99mTc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities
in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion,
rest/dipyridamole 99mTc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus,
and patients potentially at risk of later cardiac events.
Received 20 November 1998 and in revised form 19 February 1999 相似文献
7.
Eiji Tadamura Takashi Kudoh Makoto Motooka Masayuki Inubushi Tomohisa Okada Shigeto Kubo Naoya Hattori Tetsuya Matsuda Takaaki Koshiji Kazunobu Nishimura Masashi Komeda Junji Konishi 《European journal of nuclear medicine and molecular imaging》1999,26(7):705-712
In patients who had undergone cardiac surgery (coronary artery bypass graft) and whose hearts showed abnormal movement during
the cardiac cycle, we studied the accuracy of functional assessment using ECG-gated single-photon emission tomography (SPET)
and the automated software developed by Germano et al. by comparing the findings with magnetic resonance (MR) images acquired
three-dimensionally. Sixteen patients who had undergone cardiac surgery underwent 99mTc-sestamibi gated SPET (MIBI-g-SPET) and MRI on the same day. Left ventricular end-diastolic and end-systolic volumes (EDV,
ESV) and ejection fraction (LVEF) were measured using MIBI-g-SPET and the aforementioned algorithm. Regional wall thickening
was assessed using a four-point scale on MIBI-g-SPET and cine MRI. There was a good correlation between MIBI-g-SPET and MRI
in respect of EDV (r=0.89), ESV (r=0.93) and LVEF (r=0.89). A high degree of agreement was found between the wall thickening scores obtained by MIBI-g-SPET and MRI in total segments
(κ=0.62) and in septal segments (κ=0.67). It is concluded that ECG-gated perfusion SPET can provide regional and global functional
information, including absolute volumes, in patients following cardiac surgery.
Received 5 January and in revised form 18 March 1999 相似文献
8.
Marc J. Claeys Pierre P. Blockx Frank E. Rademakers Chris J. Vrints Jo P. Snoeck 《European journal of nuclear medicine and molecular imaging》1997,24(9):1121-1127
This study investigated the value of technetium-99m sestarnibi scintigraphy in identifying patients at risk for post-infarct ischaemia (=jeopardized myocardium), especially within the reperfused infarct region. In 51 patients with a recent (99mTc-sestamibi single-photon emission tomography (SPET) and dobutamine stress echocardiography (DSE) were performed and correlated with the presence of significant coronary artery stenosis [% diameter stenosis (DS) >50%] on quantitative coronary angiography. Regional perfusion activity was analysed semiquantitatively (score 0–4) on a 13-segment left ventricular model. DSE was used for the estimation of the infarct size (low-dose DSE) and for concomitant evaluation of ischaemia (high-dose DSE). A reversible perfusion defect within the infarct region was observed in 20 of the 37 patients with a significant infarct-related lesion (sensitivity of 54%) and only in one patient without a significant infarct-related lesion (specificity of 93%). Further analysis revealed that the scintigraphic assessment of jeopardized myocardium was fairly good in patients with a moderate (DS 51%–64%) infarct-related stenosis but was inadequate in patients with a severe (DS65%) infarct-related stenosis (sensitivity of 80% vs 36%,P<0.01), while the echocardiographic detection of ischaemia was not influenced by stenosis severity (sensitivity of 73% in both subgroups). This scintigraphic under-estimation of jeopardized myocardium was mainly related to a severely impaired myocardial perfusion under baseline conditions, as was evidenced by a significantly more severe rest perfusion score in the infarct region in patients with a severe stenosis as compared to those with a moderate stenosis (average score: 1.5±0.7 vs 2.1±0.6,P<0.01), while infarct size on echocardiography was similar for both subgroups. It may be concluded that early after an acute myocardial infarction, adenosine99mTc-sestamibi SPET may underestimate reperfused but still jeopardized myocardium, particularly in patients with a severe infarct-related stenosis. In these patients the evaluation of the ischaemic burden on rest-stress scintigraphy is hampered by the presence of a severely impaired myocardial perfusion in resting conditions. 相似文献
9.
Constantinos Anagnostopoulos Mark G. Gunning Dudley J. Pennell Robin Laney Haralambos Proukakis S. Richard Underwood 《European journal of nuclear medicine and molecular imaging》1996,23(8):909-916
We have validated ECG-gated emission tomography using technetium-99m methoxyisobutylisonitrile for the assessment of regional ventricular function by comparing it with cine magnetic resonance imaging (MRI). Gated tomography was performed at rest in 24 patients referred for myocardial perfusion imaging [17 males and seven females with a mean age of 58 years, nine of whom had had a previous myocardial infarction (MI)]. Scores were assigned to each of nine myocardial segments for wall motion and for thickening. Cine MRI was analysed in an identical fashion. Four out of 216 (2%) segments were uninterpretable by gated tomography because of inadequate tracer uptake. In eight patients without coronary artery disease (CAD), wall motion and thickening were normal by both methods. Gated tomography showed abnormal wall motion or thickening in all patients with previous MI and in five of seven patients with CAD but no prior MI. Association between wall motion and thickening was good (r
s=0.86). Overall, there was good agreement between gated tomography and MRI for both wall motion (178/212 segments, =0.66) and wall thickening (184/212 segments, =0.69). In segments with severely reduced perfusion, however, there was poorer agreement (=0.31). Interobserver and intraobserver agreement was high ( from 0.61 to 0.78). Thus, in patients investigated for CAD, there is good overall agreement between gated tomography and MRI but the agreement is lower in segments with severe perfusion defects. 相似文献
10.
H. Everaert C. Vanhove J. J. Hamill P. R. Franken 《European journal of nuclear medicine and molecular imaging》1997,25(1):3-7
Cardiofocal collimators (CFCs) are more sensitive than parallel-hole collimators (PHCs) of the same resolution because the
rays converge in the centre of the field of view. After reconstruction a useful field of view with a 10 cm radius in which
both sensitivity and resolution are homogeneous is obtained. In this article the feasibility and accuracy of gated single-photon
emission tomographic (gated SPET) myocardial perfusion imaging using a triple-head camera equipped with CFC, is evaluated.
Twenty patients with a history of myocardial infarction were studied. SPET myocardial perfusion images, gated in eight time
bins, were acquired in a random sequence with a PHC and a CFC for each patient. Imaging was started 60 min after the injection
of 925 MBq of technetium-99m tetrofosmin at rest. Ninety-six projections over 360° were acquired, with 32 stops of 40 s for
the PHC and 20 s for the CFC in order to obtain similar count densities. The extent (EXT) and severity (SEV) of perfusion
defects were quantified on polar maps using the non-gated data. Left ventricular volumes [end-diastolic volume (EDV), end-systolic
volume (ESV)] and ejection fraction (LVEF) were calculated from gated data using the Cedars-Sinai program. In 17 of 20 patients
the complete left ventricle was positioned within the useful field of view of the CFC. The results in respect of perfusion,
volumes and ejection fraction were almost identical to those obtained with the PHC. The mean difference±SD between the CFC
and the PHC was −2.30±7.16 (% of LV area) for EXT, −0.48±2.90 for SEV (arbitrary units), −1,50±5.25 (ml) for EDV and 0.53±4.10
(%) for LVEF. The largest differences in EXT and LV volumes were observed in patients in whom a part of the LV was not positioned
within the useful field of view. We conclude that, for the majority of patients, identical information with regard to both
perfusion and function can be derived from gated SPET myocardial perfusion studies obtained with PHCs or with CFCs. Because
of the greater sensitivity, however, a much shorter acquisition time is required with CFCs.
Received 7 May and in revised form 31 August 1997 相似文献
11.
Hendrik Everaert Christian Vanhove Philippe R. Franken 《European journal of nuclear medicine and molecular imaging》1999,26(10):1298-1303
Electrocardiography gated single-photon emission tomography (gated SPET) allows the assessment of regional perfusion and
function simultaneously and in full spatial congruency. In this study changes in global and regional left ventricular function
in response to dobutamine infusion were assessed in ten healthy volunteers using sequential gated SPET myocardial perfusion
acquisitions. Four consecutive gated SPET images were recorded 60 min after injection of 925 MBq technetium-99m tetrofosmin
on a three-head camera equipped with focussing collimators. Two acquisitions were made at rest (baseline 1 and 2), and the
third and fourth acquisitions were started 5 min after the beginning of the infusion of 5 and 10 μg kg–1 min–1 dobutamine, respectively. Systolic wall thickening (WT) was quantified using a method based on circumferential profile analysis.
Left ventricular ejection fraction (LVEF) and volumes were calculated automatically using the Cedars-Sinai program. Nine of
the ten subjects presented a definite increase in WT during dobutamine infusion. WT increased on average from 46%±14% at baseline
to 71%±23% (range: 37%–106%; P<0.05) during 5 μg kg–1 min–1 dobutamine infusion and to 85%±25% (range: 62%–123%; P<0.05 with respect to WT at 5 μg kg–1 min–1) during 10 μg kg–1 min–1 dobutamine infusion. Apical segments showed the largest WT at baseline. The average WT response to dobutamine was similar
for all parts of the myocardium. It is concluded that changes in WT induced by infusion of low-dose dobutamine can be assessed
by sequential gated SPET myocardial perfusion studies. The ”stress gated SPET” protocol proposed in this study might be helpful
to distinguish viable from scar tissue in patients with coronary artery disease, by demonstrating a preserved inotropic response
in hypoperfused myocardium.
Received 6 March and in revised form 6 May 1999 相似文献
12.
Pierre Weinmann Jean-Marc Foult Dominique Le Guludec Feyzi Tamgac David Rechtman Alain Neuman Nadine Caillat-Vigneron Jean-Luc Moretti 《European journal of nuclear medicine and molecular imaging》1994,21(3):212-215
Two hundred and thirty-one patients underwent dual-isotope myocardial imaging (rest thallium-201 followed by stress technetium-99m sestamibi). The feasibility of the procedure was excellent: camera scheduling flexibility was improved and the duration of the procedure was less than that of a classical stress-redistribution procedure. Interpretation of defects due to image attenuation was facilitated by the different attenuation properties of 201Tl and 99mTc-sestamibi in 11 of 19 patients. 210Tl cross-over on 99mTc was found to be 15% ± 3% with doses of 201Tl and 99mTc-sestamibi of 3 and 10 mCi, respectively, and 7% ± 2% with doses of 3 and 20 mCi. This protocol should preferentially be reserved for patients with a history of myocardial infarction and/or a basal left ventricular dysfunction, in whom assessment of myocardial viability is of major interest. Extensive clinical validation of the dual-isotope procedure is required and optimal acquisition and reconstruction parameters should be established. 相似文献
13.
Evaluation of global and regional left ventricular function using technetium-99m sestamibi ECG-gated single-photon emission tomography 总被引:3,自引:2,他引:1
Kuang-Tao A. Yang Hon-Der Chen 《European journal of nuclear medicine and molecular imaging》1998,25(5):515-521
We evaluated a method for the assessment of left ventricular (LV) function with technetium-99m sestamibi ECG-gated single-photon
emission tomography (GSPET). GSPET was performed at rest in 21 patients. Images were reconstructed to obtain end-diastolic
(ED) and end-systolic (ES) images. Endocardial and epicardial edges of the left ventricle for the ED and ES images were defined
using the gradient images and the algorithm developed. LV wall thickness was measured for the mid-ventricular slices of ED
and ES images at 10° intervals. The systolic thickening (ST) and the LV ejection fraction [LVEF(GSPECT)] could be determined.
These values were compared with the LV ejection fraction (LVEF) estimated using the gated blood pool method. There was a linear
correlation between LVEF and ST (r=0.79), and LVEF and LVEF(GSPET) (r=0.87). Histograms of LV thicknesses were generated. Agreement for evaluation of regional wall motion between the method using
histograms of LV thicknesses and the gated blood pool study was 92.8% (kappa=0.75). It is concluded that with an appropriate
method for LV edge detection, GSPET with 99mTc-labelled perfusion agents is of use for simultaneous evaluation of myocardial perfusion and assessment of LV function.
Received 1 December 1997 and in revised form 26 January 1998 相似文献
14.
Asit K. Paul Shinji Hasegawa Jun Yoshioka Eiichiro Tsujimura Hitoshi Yamaguchi Naoki Tokita Atsushi Maruyama Mu Xiuli Tsunehiko Nishimura 《European journal of nuclear medicine and molecular imaging》1999,26(4):410-415
To elucidate the after-effect of exercise on left ventricular (LV) function, end-diastolic volume (EDV), end-systolic volume
(ESV) and ejection fraction (LVEF) were evaluated at 1 h after exercise and at rest by technetium-99m tetrofosmin gated myocardial
single-photon emission tomography (SPET) using an automated program in 53 subjects. The subjects were grouped as follows:
normal scan (n = 16), ischaemia (n = 19) and infarction (n = 18), based on the interpretation of perfusion images. Postexercise LVEF did not differ from resting LVEF in the groups
with normal scan and infarction. In patients with ischaemia, postexercise EDV (90±17 ml, mean ±SD) and ESV (44±15 ml) were
significantly higher than EDV (84±15 ml, P = 0.001) and ESV (36±14 ml, P<0.0005) at rest. LVEF was significantly depressed 1 h after exercise (53%±9% vs 58%±9%, P<0.0001). In ischaemic patients with depressed postexercise LVEF, LVEF difference between rest and postexercise showed a significant
correlation with the sum of defect scores, which were reversible from exercise to rest perfusion images (r = 0.92, P<0.0001). These results indicate that exercise-induced LV dysfunction (myocardial stunning) continues for at least 1 h in
ischaemic patients and that the extent of LVEF depression is determined by the severity of ischaemia.
Received 1 October and in revised form 29 December 1998 相似文献
15.
Evaluation of dysthymic disorder with technetium-99 m hexamethylpropylene amine oxime brain single-photon emission tomography 总被引:2,自引:0,他引:2
Ali Sarikaya Engin Karaşin Tevfik Fikret Çermik Ercan Abay Şakir Berkarda 《European journal of nuclear medicine and molecular imaging》1999,26(3):260-264
Dysthymic disorder is a chronic disorder characterised by the presence of a depressed mood and is classified as a distinct
category in DSM-IV, separately from major depression. Although brain imaging studies have been performed in major depressive
disease, there have to date been no reports of such studies in dysthymic disorder. In this study 36 patients with dysthymic
disorder were compared with 16 normal subjects using technetium-99m hexamethylpropylene amine oxime brain single-photon emission
tomography. A relative blood flow ratio was calculated for each region of interest using the average tissue activity in the
region divided by activity in the cerebellum. There were significant differences in the bilateral inferior frontal, bilateral
parietal, right superior frontal and left posterior temporal regions in the patients with dysthymic disorder compared with
the healthy controls. These findings support the hypothesis that the biological bases for dysthymic disorder and major depression
are similar. Recognition of these regional abnormalities may have clinical utility in both the diagnosis and the treatment
of dysthymic disorder. Further studies are needed to confirm our results and to assess the influence of treatment in patients
with dysthymic disorder.
Received 14 August and in revised form 24 October 1998 相似文献
16.
Technetium-99m methoxyisobutylisonitrile single-photon emission tomography in hepatocellular carcinoma 总被引:2,自引:0,他引:2
Fukushima Kazuhito Kono Michio Ishii Kazunari Sakai Eiro Hirota Shozo Yuri Hidehisa 《European journal of nuclear medicine and molecular imaging》1997,24(11):1426-1428
Nine lesions in eight patients with hepatocellular carcinoma (HCC) were studied using single-photon emission tomography (SPET)
and technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) to evaluate the pattern of uptake of 99mTc-MIBI in the lesions and the relation between the uptake pattern and the histopathology of HCC. All the lesions were diagnosed
as HCC by percutaneous needle biopsy. Four of the nine lesions showed positive uptake of 99mTc-MIBI, while the other five showed negative uptake. All of the lesions which showed positive uptake were of the compact
type. Of the five lesions that showed negative uptake, four were of the trabecular type while one was of the compact type.
These results suggest that the patterns of 99mTc-MIBI accumulation in HCC are divided into positive and negative types and that these uptake patterns are associated with
the tissue structure of HCC.
Received 10 August and in revised form 15 August 1997 相似文献
17.
Ching-yee Oliver Wong Gary E. Meyerrose Samuel Sostre 《European journal of nuclear medicine and molecular imaging》1994,21(5):445-448
Cerebral atrophy often coexists with other brain disorders and by itself may alter the pattern of cerebral perfusion. If unrecognized, it may confound diagnoses based on brain single-photon emission tomography (SPET). In this retrospective study, we describe and evaluate criteria for the diagnosis of cerebral atrophy on technetium-99m hexamethylpropylene amine oxime brain SPET studies. The SPET scans of 11 patients with cerebral atrophy and ten controls were evaluated for the presence of a prominent interhemispheric fissure, presence of prominent cerebral sulci, separation of thalamic nuclei, and pronounced separation of caudate nuclei. The SPET studies were interpreted by two independent observers blind to the findings of magnetic resonance imaging, which provided the final diagnosis of cerebral atrophy. The combination of the four scintigraphic signs was accurate in the diagnosis of cerebral atrophy in 95% of the cases and had a sensitivity of 91% and a specificity of 100%.
Correspondence to: S. Sostre 相似文献
18.
Gianmauro Sacchetti Eugenio Inglese Angelo S Bongo Franco Aina Marco Brambilla Alberto Baroli Carmelo Cernigliaro Pierfranco Dellavesa Edgardo Pittaluga Marco Rudoni 《European journal of nuclear medicine and molecular imaging》1997,24(10):1230-1236
The aim of this study was to determine the diagnostic accuracy of technetium-99m tetrofosmin myocardial imaging for the localization
of coronary artery stenoses of different degrees of severity. Stress-rest single-photon emission tomography (SPET) was performed
on separate days in 80 patients (64 males, 16 females; mean age 61 years; 43 patients with previous myocardial infarction;
18 patients with pharmacological stress), within 6 months of coronary angiography. Scintigraphic images were blindly and independently
evaluated by three observers. Coronary stenosis was defined as a >50% narrowing in luminal diameter; severe stenosis was defined
as a proximal stenosis of >75% or a peripheral stenosis of >90%. Coronary angiography revealed normal coronary arteries or
insignificant coronary stenosis in 13 patients and significant coronary stenoses in 67 patients. The sensitivity and specificity
of 99mTc-tetrofosmin SPET in respect of severely stenosed vessels were, respectively, 80% and 65% for the left anterior descending
artery (LAD), 100% and 46% for the right coronary artery (RCA) and 58 and 78% for the left circumflex artery (LCx) territories.
Considering all the significantly stenosed vessels, a significant decrease in sensitivity was observed for LAD territories
(to 59%, P=0.05), and a nonsignificant decrease for RCA (88%) and LCx (47%) territories while specificity values remained essentially
unchanged. No significant changes in sensitivity or specificity were observed when regions with previous myocardial infarction
were excluded. In conclusion, the sensitivity of 99mTc-tetrofosmin SPET for the localization of individual stenosed vessels is only moderate when all significant stenoses are
considered, but the ability of this technique to predict the location of severe coronary artery stenoses seems satisfactory,
with the exception of the low specificity in respect of RCA territories.
Received 26 April and in revised form 7 June 1997 相似文献
19.
N. P. Rowell M. A. Flower B. Cronin V. R. McCready 《European journal of nuclear medicine and molecular imaging》1993,20(7):591-599
A single-photon emission tomography (SPET) technique for the absolute measurement of tumour perfusion is described. Phantom studies have shown that source-background ratios are dependent upon source size and radial position within the phantom. A means of correcting source-background count ratios for these variables has been developed and used to correct tumour-lung ratios obtained in 28 patients with bronchial carcinomas who underwent technetium-99m hexamethyl-propylene amine oxime (99mTc-HMPAO) SPET. On SPET images, the normal lung appears as a relatively homogeneous background. The relationship between 99mTc background concentration (kBq/ml) and counts/pixel was determined from phantom studies and the tumour 99mTc concentration from the background 99mTc concentration and corrected tumour-lung ratio. The total activity of the lipophilic 99mTc-HMPAO species injected was measured. The activity reaching the systemic circulation (A
sys) was obtained by subtracting the activity trapped in the pulmonary circulation (obtained from background 99mTc concentration and lung volume). Tumour blood flow may then be calculated from fraction of A
sys contained in the tumour provided cardiac output and extraction fraction are known. Blood flow through the central region of tumours ranged from zero to 59.0 (mean 14.1) ml min–1 100 g–1 and through the whole tumour from 0.6 to 68.0 (mean 20.6) ml min–1 100 g–1. 相似文献
20.
Ahmet Tutus Mustafa Kibar Seher Sofuoglu Mustafa Basturk Ali S. Gönül 《European journal of nuclear medicine and molecular imaging》1998,25(6):601-606
We have not encountered any brain single-photon emission tomography (SPET) study performed in adolescent depressed patients
in the literature. Therefore, we used technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) brain SPET in adolescent patients with major depressive disorder (MDD) to examine the possible changes in cerebral
perfusion and the possible association between perfusion indices and clinical variables. Fourteen adolescent out-patients
(nine females, five males; mean±SD age: 13.11±1.43 years; range: 11–15 years) fulfilling the DSM-IV criteria for MDD and 11
age-matched healthy control subjects (six females, five males; mean±SD age: 13.80±1.60 years; range: 12–15 years) were included
in the study. 99Tc-HMPAO brain SPET was performed twice in the patient group and once in the control group. The first SPET investigation was
performed under non-medicated conditions and the second was performed after depressive symptoms had subsided. A relative perfusion
index (PI) was calculated as the ratio of regional cortical activity to the whole brain activity. We found significant differences
between the PI values of the untreated depressed patients and those of the controls, indicating relatively reduced perfusion
in the left anterofrontal and left temporal cortical areas. No significant differences in regional PI values were found between
the remitted depressed patients and the controls. Our study suggests that adolescent patients with MDD may have regional cerebral
blood flow deficits in frontal regions and a greater anterofrontal right-left perfusion asymmetry compared with normal subjects.
The fact that these abnormalities in perfusion indices have a trend toward normal values with symptomatic improvement suggests
that they may be state-dependent markers for adolescent MDD.
Received 11 January and in revised form 11 February 1998 相似文献