药物成瘾的功能影像学研究进展

药物成瘾是世界上当前最严重的公共卫生问题之一，目前认为药物成瘾是一种慢性、复发性的脑部疾病。它具有两个重要特征：（1）不顾后果地强迫性觅药行为；（2）极高的复发率。对药物成瘾的确切机制，目前尚未完全阐明。近年来发展出的一些影像学技术包括单光子发射计算机断层显像（single photon emission computed tomography，SPECT），正电子发射断层扫描术（positron emission tomography，PET）和功能性磁共振成像（functional magnetic resonance imaging，fMRI），它们能够直观地反映脑的功能情况，为了解药物成瘾的机理提供了新的方法，本文就精神兴奋剂和阿片类药物成瘾的功能影像学研究作一简要的总结，重点在于药物成瘾过程中所涉及的神经环路和脑区，对于神经递质、受体等的变化不做主要描述。     

正电子发射计算机断层显像技术在药物成瘾机制研究中的应用进展

药物成瘾是当前世界上最严重的公共卫生问题之一,目前认为药物成瘾是一种慢性、复发性的脑部疾病.对药物成瘾的确切机制,目前尚未完全阐明.分子影像技术的发展和各种显像剂的合成为人们认识药物成瘾的神经药理学机制提供了很大帮助.本文综述了正电子发射计算机断层显像(PET)在药物成瘾机制研究中的应用,重点总结了使用PET活体成像技...     

电针对摇头丸滥用者~(99m)Tc-ECD脑灌注显像及脑功能活动的影响

目的·· :用单光子发射计算机断层扫描 (SPECT)脑灌注显像 ,观察电针 (EA)对摇头丸滥用者局部脑血流量(rCBF)及脑功能活动的影响。方法·· :17例摇头丸滥用者和20例健康志愿者 (对照组 )在电针治疗前后进行SPECT检查 ,用脑血流功能变化率 (BCFR % )数学模型进行定量分析 ,评价电针对上述观察指标的影响。结果·· :与对照组相比 ,17例摇头丸滥用者的大脑皮质额叶、颞叶、脑岛、基底节均存在局部脑血流量不同程度的降低,而脑岛、基底节区功能亢进的病理表现 ;电针治疗可显著增加或调整局部脑血流量 ,并改善大脑的功能活动 (P<0.01 ,P<0.001)。结论·· :摇头丸滥用可以导致大脑血液供应减少或病理性增加 ,进而引起中枢神经系统的功能异常 ;针刺治疗对此有显著改善作用 ,提示针刺可以作为一种简便、有效、无副作用的方法用于治疗摇头丸滥用所导致的脑部病理损害     

自发性脑出血后局部脑血流量动态变化及影响因素的相关研究

为研究自发性脑出血后局部脑血流（rCBF）动态变化规律及影响因素，应用单光子发射计算机断层扫描（SPECT）rCBF断层显像，依据ROI比值法分别测定66例脑出血患者急性期、亚急性期及慢性期的比值。结果：急性期rCBF显著减少，其程度与血肿量及出血部位有关，以后随时间推移rCBF逐步增加。影响脑出血后rCBF变化的因素主要是血肿量及出血部位。     

扩散加权磁共振成像和PET/CT在良、恶性淋巴结鉴别中的价值

目的探讨扩散加权磁共振成像(DWMRI)及正电子发射计算机断层扫描显像(PET)在良、恶性淋巴结鉴别中的价值。方法 18只健康新西兰白兔随机均分为两组,分别建立淋巴结炎模型和淋巴结转移模型。在常规图像基础上测量两组淋巴结的扩散系数(ADC)及标准摄取值(SUV)。结果恶性淋巴结的ADC值及相对表观扩散系数(rADC)明显大于良性淋巴结(P<0.05)。恶性淋巴结的早期标准摄取值(SUVearly)及延迟标准摄取值(SUVdelay)明显大于良性淋巴结(P<0.01)。结论 DWMRI能够有效的区分良、恶性淋巴结,与PET成像效果相似。其中rADC值诊断能力优于ADC值。     

PET、MRI和PET/MRI多模式分子显像在脑胶质瘤中的应用

神经影像学在颅内肿瘤尤其是脑胶质瘤的诊断、分级、疗效及预后评估等方面有重要的临床价值.不同模式的PET显像可用于评估肿瘤的位置、范围及其生物活性.MRI不仅可提供高对比度和分辨率的软组织信息,还可提供肿瘤功能代谢方面的一些信息.PET/MRI综合了二者的优势,实现了对大脑形态、功能、代谢和分子信息的同时评估.本文主要综述PET、MRI和PET/MRI在脑胶质瘤显像中的应用.     

正电子发射断层显像在药物研究和开发中的应用

正电子发射断层显像（PET）是通过探测某些超短寿命放射性核素放射出的正电子与介质中的负电子发生碰撞（即“湮灭”）过程中,产生的一对方向相反、能量均为511KeV的光子的数量实现的一种定量、多维影像技术。它主要用于研究生物体（活体）的主要器官（或组织）在完成其生理功能过程中所伴随的生物化学反应。也可用于直接研究某些药物在生物活体内的生物学行为、疗效和毒性,因此,在药物研究开发中具有广泛的应用前景。本文简要综述了正电子发射断层显像技术的仪器和原理、正电子发射断层显像用放射性标记化合物、在药物研究和开发中的应用及其局限性。     

fMRI脑功能成像技术用于网络游戏成瘾诊断测评

目的运用蹦RI脑功能成像技术,总结网络游戏成瘾青少年的神经影像学改变,为其诊断和治疗提供客观依据。方法选择12名网络游戏成瘾青少年（IAD组）和12名正常青少年（对照组）参与本研究,两组被试者分别观看网络游戏相关图片和中性图片,同时采用fMRI技术扫描,获取被试者的大脑活动信号,使用SPM5软件分析处理。结果与观看中性图片时比较,IAD组观看游戏图片时双侧背外侧前额叶、扣带回前部、顶下小叶、颞下回、小脑、右侧岛叶及右侧角回激活增多。IAD组观看游戏图片时以下区域激活增多：双侧背外侧前额叶、双侧颞叶、小脑、右侧顶下小叶、右侧楔叶、左侧海马、海马旁回、左侧尾状核;对照组观看游戏图片时全脑未见激活增多。结论网络游戏成瘾的青少年脑功能成像影像改变与正常青少年存在差异,为网络成瘾的诊断测评标准提供了新的客观依据。     

单光子发射计算机断层技术脑静态显像的临床应用

目的对单光子发射计算机断层技术(SPECT)脑静态显像的临床应用价值进行分析。方法 23例脑恶性肿瘤患者,对其展开单光子发射计算机断层技术脑静态显像,并对影像资料展开回顾性分析。结果 23例患者中,有1例由于个人原因放弃治疗,因此被剔除。剩余的22例患者均完成相应的治疗,在接受放射治疗(放疗)前均经SPECT结合螺旋CT增强扫描进行检查,共计有34个病灶得到确诊,螺旋CT技术检测结果显示为阳性的病灶达到30个,阳性率为88%,SPECT阳性病灶33个,阳性率为97%。两种检查方法的诊断结果比较差异无统计学意义(P>0.05)。结论单光子发射计算机断层技术脑静态显像对脑肿瘤的诊断效果十分理想,临床价值较高,值得关注并推广。     

心肌磁共振显像与核素心肌灌注显像测定左心功能的对比研究

目的评价心肌磁共振显像(MRI)和门控核素心肌灌注显像(SPECT)检测急性心肌梗死(AMI)患者左心室功能的应用价值。方法AMI患者23例,分别于1周内行MRI和SPECT检查,测定左室舒张末期容积(EDV)、收缩末期容积(ESV)和射血分数(EF),将MRI检测结果作为标准,并与SPECT结果比较,行相关分析及一致性检验。结果MRI采用多层Simpson法,图像空间分辨率高,可以准确划分血池和心肌的界限。SPECT较MRI低估左室容积EDV(16±27)mL,ESV(8±21)mL,EF值两者大致相等。经相关分析,SPECT与MRI所测EDV、ESV、EF相关系数分别为0.79、0.84、0.84(P均<0.01)。经Bland-Altman一致性检验,SPECT与MRI所测左室容积及EF有等价性。结论MRI检测心功能准确、可靠。SPECT与MRI具有等价性。     

正电子断层显像与新药研究

正电子发射断层 (ｐｏｓｉｔｒｏｎｅｍｉｓｓｉｏｎｔｏｍｏｇｒａｐｈｙ ,ＰＥＴ)显像技术是目前唯一用解剖形态方式进行功能、代谢和受体显像的技术 ,具有很高的灵敏度和特异性 ,可从体外无损伤、定量和动态地从分子水平观察到药物或代谢物在人体内的生理、生化变化[1] ,已成为诊断肿瘤、冠心病和脑部疾病等 3大威胁人类身体健康的最优手段[2 ] 。药物通过改变体内异常生化变化达到治疗目的。ＰＥＴ可评价在治疗疾病不同阶段的药物作用。ＰＥＴ不仅可用于临床前药物研究 ,而且可直接用于临床药物研究。1　基本原理ＰＥＴ显像基本原理 :利…     

The utility of radiolabeled PSMA ligands for tumor imaging

Prostate-specific membrane antigen (PSMA) is a glycosylated type-II transmembrane protein expressed in prostatic tissue and significantly overexpressed in several prostate cancer cells. Despite its name, PSMA has also been reported to be overexpressed in endothelial cells of benign and malignant non-prostate disease. So its clinical use was extended to detection, staging, and therapy of various tumor types. Recently small molecules targeting PSMA have been developed as imaging probes for diagnosis of several malignancies. Preliminary studies are emerging improved diagnostic sensitivity and specificity of PSMA imaging, leading to a change in patient management. In this review, we evaluated the first preclinical and clinical studies on PSMA ligands resulting future perspectives radiolabeled PSMA in staging and molecular characterization, based on histopathologic examinations of PSMA expression.     

开发评审新药的药物动力学进展

综述了有关新药开发的审评中临床药理学的新进展，包括：１．创新药：阶段性流水作业法，新药开发各阶段的药物动力学研究，药物流行病学研究，毒物动力学；２．仿制药：实验设计与受试人数，药物动力学参数，统计分析，指导原则的国际协调。     

Imaging of 186Re-liposome therapy in ovarian cancer xenograft model of peritoneal carcinomatosis

This study determined the biodistribution of rhenium-186 (¹⁸⁶Re) encapsulated in biotin-liposomes containing patent blue dye, injected intraperitoneally (IP) with avidin in an OVCAR-3 ovarian cancer xenograft model and evaluated tumor response of this therapy with fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) microPET imaging. Treated rats (n = 8) received an IP injection of ¹⁸⁶Re-blue-biotin-liposomes (1000 MBq/kg) 30 min before an IP injection of avidin (5 mg), whereas control rats (n = 4) received a sham IP injection of saline. Scintigraphic images showed that ¹⁸⁶Re-blue-biotin liposomes/avidin were retained in the peritoneal cavity with 18% of the original activity remaining after 5 days. From 1 to 4 weeks post-treatment, peritoneal ¹⁸F-FDG standard uptake values decreased 30% in treatment group, yet increased 44% in control group. Total number of cells in ascites was significantly higher in control versus treatment group. Omental fat in control rats had numerous tumor cells compared with treated rats. Results show the potential for ¹⁸⁶Re-blue-biotin-liposome/avidin system in treating advanced ovarian cancer involving peritoneal carcinomatosis.     

Guidance on current good radiopharmacy practice for the small‐scale preparation of radiopharmaceuticals using automated modules: a European perspective

This document is meant to complement Part B of the EANM ‘Guidelines on current good radiopharmacy practice (cGRPP) in the preparation of radiopharmaceuticals’ issued by the Radiopharmacy Committee of the European Association of Nuclear Medicine, covering small‐scale in‐house preparation of radiopharmaceuticals with automated modules. The aim is to provide more detailed and practice‐oriented guidance to those who are involved in the small‐scale preparation of radiopharmaceuticals, which are not intended for commercial purposes or distribution.     

SPECT、MRI和PSA对复杂部分性发作癫癎病灶定位诊断的相关比较

对33例复杂部分发作癫痫患者进行单光子计算机断层摄影(SPECT)、磁共振(MRI)和脑电频谱分析(PSA)检查。其中有30例在发作间期进行SPECT检查,均显示颞叶局灶性脑血流减低,14例定位在左侧,10例在右侧,6例为双侧病灶。MRI结果显示26例存在颞叶异常改变(16例在左侧,7例在右侧,3例为双侧病灶)。PSA发现30例有明确的病灶(11例在左侧,16例在右侧,3例为双侧)。SPECT和PSA结果完全或部分一致的占73.4％,MRI和SPECT完全或部分一致的占76.9％,MRI和PSA完全或部分一致的占55.1％,34.6％的病人3种检查定位完全一致。     

Serotonin transporter occupancy by the SSRI citalopram predicts default-mode network connectivity

The default mode network (DMN) is an important connectivity hub, and alterations may play a role in the pathophysiology of several neuropsychiatric disorders. Despite the growing body of research on DMN (dys)function, the underlying neurochemical substrate remains to be elucidated. The serotonergic neurotransmitter system has been suggested to play a substantial role in modulating the DMN. Therefore, we investigated the association between serotonin transporter (SERT) occupancy by the selective serotonin reuptake inhibitor citalopram and DMN functional connectivity. Forty-five healthy female volunteers (mean age?=?21.6y) participated in a double-dose study. The subjects were randomized to pre-treatment with placebo, a low (4?mg; ‘low group’) or clinically standard (16?mg; ‘high group’) oral citalopram dose (corresponding to 0%, ～40% and ～80% SERT occupancy, respectively). They underwent [¹²³I]FP-CIT single-photon emission computed tomography (SPECT) imaging to assess SERT occupancy. In addition, resting-state functional magnetic resonance imaging was used to measure DMN connectivity. With non-parametric permutation testing we assessed the association between SERT occupancy and DMN connectivity. We found that SERT occupancy by citalopram was negatively associated with DMN connectivity with a number of cortical regions, including the anterior cingulate cortex (ACC), paracingulate gyrus, postcentral gyrus, superior parietal gyrus and temporal pole. These findings provide further neurochemical evidence that the serotonin system dose-dependently modulates DMN function.     

The role of in vivo molecular imaging with PET and SPECT in the elucidation of psychiatric drug action and new drug development

This paper reviews the contribution of human PET and SPECT neuroreceptor occupancy studies to the understanding of drug action in psychiatric illness, and how they can aid the development of new drugs. All effective antipsychotics show significant D₂ receptor occupancy. However, at least for atypical antipsychotics, there is no clear relationship between occupancy and clinical response. The mechanisms underlying antipsychotic efficacy, and the minimal effective D₂ occupancy, remain to be elucidated, particularly for drugs with modest or transient occupancy. The low liability of some atypical antipsychotics for extrapyramidal side effects does not appear to be explained by their 5-HT_2A antagonism, and the muscarinic receptor occupancy of some drugs may be partly explanatory. Previous reports of apparent ‘limbic selectivity’ of atypical antipsychotics may be in error, and may be due to technical differences in radiotracers. For SSRIs, high occupancies at the serotonin transporter (SERT) are achieved at therapeutic doses, although the minimum SERT occupancy required for therapeutic response remains undefined. Previous attempts to augment the antidepressant effect of SSRIs by pindolol have generally used daily doses which result in inadequate 5-HT_1A receptor occupancy. For benzodiazepines, clinical doses would appear to leave a wide margin of unoccupied receptors. For methylphenidate and cocaine, typical doses occupy more than 50% of dopamine transporters, and their profiles are extremely similar. In therapeutic drug development, these techniques may be used to assess receptor occupancy profiles, likely drug dosages and dosing intervals which cannot be reliably assessed in humans by other methods.     

发射计算机断层脑血流显像在儿童癫癎诊断的应用

对127例癫痫儿童于癫痫发作间歇期进行单光子发射计算机断层(SPECT)脑血流显像,并与脑电图(EEG)、脑CT和MRI检查进行比较。结果表明,SPECT脑血流显像阳性率高达82.7％,EEG、脑CT和MRI的阳性率分别为50.4％,18.4％和32.1％。EEG出现异常时,SPECT脑血流显像常亦有异常,二者定位结果的一致及相对一致率为78.1％(25/32)。脑CT出现局灶性异常时,SPECT脑血流显像亦会有相应部位的异常。说明SPECT脑血流显像在癫痫灶的检出和定位诊断上有一定价值。