GEMINI GXL16 PET-CT的验收与NEMA标准的应用

目的 依照美国国家电气制造协会(NEMA)最新版NEMA NU 2-2001标准,对飞利浦公司生产的GEMINI GXL16 PET-CT仪进行验收和性能评估.方法 使用NEMA NU 2-2001标准的测试模型和测试方法,对PET的空间分辨率、能量分辨率、散射分数、计数丢失、灵敏度、PET与CT图像的融合精度等参数进行测试.结果 空间分辨率[(半高宽)mm]轴向为6.06(0cm)和6.44(10 cm),横向为4.65(1cm)和5.98(10 cm);散射分数为34.27%;能量分辨率为18%;中心(0 cm)和偏离中心10cm处的灵敏度分别为8312和8472(计数·s-1·MBq);等效噪声计数率为53.29×103计数/s;清楚分辨直径为10 mm的最小热球;PET与CT图像融合无偏离(模型).结论 该PET-CT仪的PET部分被测试指标均达到出厂要求,通过验收.     

应用NEMA 2001标准测试Biograph 64/True V PET／CT性能

目的应用美国国家电器制造商协会（NEMA）2001标准对Biograph 64／True V（TV）PET／CT性能进行测试,以提供Biograph 64／TV测试数据并进行新老仪器测试结果对照。方法用NEMA 2001模型和测试方法测试Biograph 64／TV PET／CT空间分辨率、灵敏度、散射分数和计数丢失参数,测试中使用^18F。用空间分辨率模型测试空间分辨率。将放射性活度4．07 MBq的^18F注射到NEMA PET灵敏度模型,测试灵敏度,每300s采集1次数据。测散射分数和噪声等效计数：采用散射模型,且向模型内置入活度1．037MBq ^18F,采集35帧,每帧采集10min,间隔15min。使用体部模型图像评估图像质量,按照NEMA2001公式得到测试结果。结果离视野（FOV）中心1cm处径向和轴向空间分辨率分别为4．2和4．7min,10cm处分别为4．9和5．9mm。系统灵敏度为6．95×10^3计数·s^-1·MBq^-1。散射分数为32％,噪声等效计数率（NECR）为1．46×10^5计数／s和9．80×10^4计数／s。结论Biograph 64／TV PET／CT性能较好,空间分辨率小,灵敏度高,散射分数低,NECR较高。     

PET性能测量——2001版NEMA标准(续)

2001版"PET性能测量"的NEMA(美国电器制造商协会)标准是对1994年版本NEMA标准的修订,使之适合于各类PET(正电子发射体层显像)仪的质量保证和验收测量。内容主要包括以下几个部分:(1)定义、符号和参考出版物;(2)总论;(3)空间分辨率;(4)散射因子、计数丢失和随机符合测量;(5)灵敏度;(6)精确性:计数丢失和随机符合校正;(7)图像质量、衰减和散射校正精确性。     

PET性能测量——2001版NEMA标准

2001版"PET性能测量"的NEMA(美国电器制造商协会)标准是对1994年版本NEMA标准的修订,使之适合于各类PET(正电子发射体层显像)仪的质量保证和验收测量。内容主要包括以下几个部分:(1)定义、符号和参考出版物;(2)总论;(3)空间分辨率;(4)散射因子、计数丢失和随机符合测量;(5)灵敏度;(6)精确性:计数丢失和随机符合校正;(7)图像质量、衰减和散射校正精确性。     

PET性能测量——2001版NEMA标准

2001版“PET性能测量”的NEMA(美国电器制造商协会)标准是对1994年版本NEMA标准的修订，使之适合于各类PET(正电子发射体层显像)仪的质量保证和验收测量。内容主要包括以下几个部分：(1)定义、符号和参考出版物；(2)总论；(3)空间分辨率；(4)散射因子、计数丢失和随机符合测量；(5)灵敏度；(6)精确性：计数丢失和随机符合校正；(7)图像质量、衰减和散射校正精确性。     

ECAT HR+ PET仪性能初步测试

目的　鉴定PET仪的实际使用质量及维护其长期使用的稳定性 ,并为上海市核医学质控中心检测提供依据。方法　应用模型和放射源为 :NEMA标准圆柱模型、可灌注点源、可灌注线源、测试模型内的线源插件 ,测试用的放射源均为18F ,根据测试要求采用不同放射性的18F及68Ga的柱源。结果　测试前对PET仪进行完整的调试和校正 ,包括二维和三维的相对效率变异、能量阈值、支架以及活度仪的调试等。根据Siemens公司提供的测试程序 ,参照NEMA的测试标准 (1994年版 ) ,结果显示二维模式时横向分辨率 (FWHM)在中心点为 4.5 0mm ,距中心点 10cm处为 4.6 3mm ;轴向二维模式的FWHM为 4.0 5mm等。应用三维模式采集时 ,FWHM在中心点为 4.5 3mm ,距中心点 10cm处为4 76mm。二维模式散射分数为 15 .1% ,灵敏度为 6 .16 7 0 5MBq·mL-1·min-1。二维模式采集时体积偏差为 3.6 %。结论　SiemensECATHR 型PET仪的性能检测结果与出厂时的测试结果基本相符     

PET性能测量——2001版NEMA标准（续）

2001版“PET性能测量”的NEMA(美同电器制造商协会)标准是对1994年版本NEMA标准的修订。使之适合于各类PFT(正电子发射体层显像)仪的质量保证和验收测量。内容主要包括以下几个部分：(1)定义、符号和参考出版物；(2)总论；(3)空间分辨率；(4)散射因子、计数丢失和随机符合测量；(5)灵敏度；(6)精确性：计数丢失和随机符合校正；(7)图像质量、衰减和散射校正精确性。     

Discovery LS PET/CT的验收及性能评估

目的　全面评估DiscoveryLSPET CT的性能指标。方法　PET CT验收包括CT性能测试、PET性能测试及图像融合精度测试。CT性能测试采用陕西省疾病控制中心“CT验收标准” ,模型为美国体模实验室生产的CT专用模型。PET性能测试采用美国全国电子工厂协会 (NEMA)标准 ,模型为NEMAPET标准模型 (1994年版 )。结果　CT定位光及床精度偏差为 0 ,CT值 0 7,噪声 3 5 8,空间分辨13lp cm ,对比分辨 3mm。PET横向空间分辨半高宽 (FWHM)为 4 33mm ,灵敏度 0 15 7·s- 1 ·Bq- 1 ·ml- 1(二维 ) ,散射分数 11 16 % (二维 ) ,散射分数校正精度 1 37% ,均匀性 7 4 4 %。Jaszczak模型可分辨7 9mm圆柱及 9 5mm圆球 ,均匀性良好。结论　该PET CT的性能指标达到出厂要求 ,个别指标误差 <10 % ,通过验收。     

eZ-SCOPE AN手持式半导体γ相机性能评估

目的检测eZSCOPEAN手持式半导体(碲化镉)γ相机的性能指标及观察小鼠骨显像效果。方法使用半导体γ相机和泛源模型、圆形样本盒、毛细玻璃管等质控模型,根据NEMA(NationalElectricalManufacturersAssociation)标准进行了固有能量分辨率、固有计数率特性、泛野系统均匀性、系统平面灵敏度及系统空间分辨率测试,并进行了小鼠骨显像实验。结果固有能量分辨率FWHM为507%,20%丢失计数率和最大计数率均未出现,积分均匀性为384%,低能高分辨准直器的系统灵敏度(计数·min-1·MBq-1)0mm为20988,30mm为19535,低能高灵敏准直器的系统灵敏度(计数·min-1·MBq-1)0mm为61090,30mm为52876,系统空间分辨率0mmFWHM=22mm,30mmFWHM=57mm。小鼠骨显像实验示半导体γ相机可在较短时间内获得较为满意的小脏器影像。结论该仪器具有高灵敏度和高分辨率,能满足临床对小脏器和小动物单光子显像的要求。该仪器具有质量轻、便携、显像速度快等特点。对半导体探头计数率特性测定的方法需进一步研究。     

18F-FLT与18F-FDG PET/CT对非小细胞肺癌淋巴结分期的比较

目的 比较3′-脱氧-3′-18F-FLT与18F-FDG PET/CT对NSCLC淋巴结分期的诊断价值,探讨肿瘤FLT和FDG摄取与细胞周期蛋白Cyclin D1表达的相关性.方法 选择手术治疗的NSCLC患者31例,男22例,女9例,年龄38～84岁.术前2周内行18F-FLT和18F-FDG PET/CT检查,术后行病理和转移淋巴结的免疫组织化学Cyclin D1检测.以病理诊断为“金标准”,评价18F-FLT和18F-FDG PET/CT显像对NSCLC的诊断价值.应用SPSS 12.0软件,计数资料行,检验,组间SUV.差异行方差分析,SUV.与Cyclin D1的表达行直线相关分析.结果 FLT和FDG PET/CT对NSCLC原发灶诊断的灵敏度分别为74.2％(23/31)和93.5％ (29/31),二者差异有统计学意义(x2=4.29,P =0.038).FLT PET/CT对NSCLC区域淋巴结诊断的灵敏度、特异性、准确性和阳性预测值分别为65％(39/60)、98％ (291/296)、93％(330/356)和85％(39/46),FDG PET/CT则分别为85％(51/60)、84％(249/296)、84％(300/356)和52％(51/98),二者差异有统计学意义(x2值分别为6.40、32.89、12.40、14.32和2.98,P均＜0.05).对于N分期,FLT PET/CT能使77.4％(24/31)的NSCLC患者分期正确,6.5％(2/31)的患者分期过高(假阳性),16.1％(5/31)的患者分期过低(假阴性);而FDG PET/CT相应数据则分别为77.4％(24/31)、16.1％(5/31)和6.5％(2/31).原发灶18F-FLT SUVmax与肿瘤组织Cyclin D1表达呈正相关(r=0.644,P＜0.01),FDG SUVmax则无相关性(r=0.293,P＞0.05).临床分期越晚,FLT SUVmax越高(F=12.2,P＜0.05),但FDG SUVmax则无此趋势(F=3.1,P＞0.05);二者在不同病理类型、分化程度之间差异无统计学意义(F=1.1、0.6、0.8和1.1,P均＞0.05).结论 与FDG PET/CT相比,FLT PET/CT对NSCLC淋巴结分期过低的患者多,而分期过高的患者少;对区域淋巴结诊断灵敏度降低,但有更高的特异性、准确性和阳性预测值.肿瘤FLT摄取与细胞周期蛋白Cyclin D1的表达有相关性.     

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.     

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).     

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.     

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.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.