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1.
目的探讨SPECT/CT图像融合在分化型甲状腺癌术后患者131I治疗后判断残余组织和转移灶的存在部位,并在确定治疗方案中的应用价值。方法对分化型甲状腺癌(DTC)术后患者30例(60例次)于131I治疗后5~7天行SPECT/CT全身和局部断层显像。131I治疗剂量为100~200mCi。结果DTC术后患者131I治疗行SPECT/CT融合图像显示:单纯残留甲状腺组织摄取131I37次,残余甲状腺和颈部淋巴结16次,纵膈和颈部淋巴结2次,双肺弥漫性及散在病灶1次,右锁骨上淋巴结1次,残余甲状腺和双肺转移2次,残余甲状腺组织和骨骼转移1次。结论SPECT/CT图像融合在131I治疗DTC后提高病灶的定位诊断、制定和调整治疗方案方面具有重要的应用价值。  相似文献   

2.
目的评价131ISPECT/CT融合图像对于分化型甲状腺癌(DTC)术后患者131I治疗后判断残留和转移病灶的存在和部位以及确定治疗计划的作用。方法DTC患者25例(50例次)于131I治疗后5~7天行131ISPECT/CT全身和局部断层显像。131I治疗剂量分别为100mCi、150mCi和200mCi。结果①治疗后131I融合图像显示:单纯残留甲状腺组织摄取131I13次(26%),残留甲状腺和颈部淋巴结6次(12%),双肺弥漫性及散在病灶4次(8%),咽喉部及残余甲状腺组织3次(6%),纵隔和颈部淋巴结1次(2%),双肺、颈部淋巴结和残余甲状腺组织13次(26%),咽喉部2次(4%),颈部淋巴结和双肺3次(6%),残余甲状腺和双肺3次(6%),残余甲状腺和骨摄取碘1次(2%),多发骨和颈部淋巴结1次(2%)。②本组DTC患者甲状腺球蛋白(Tg)>1000的12次(24%),Tg1000~50的11次(22%),Tg<50的20次(40%),7次(14%)无Tg资料。Tg值与131I摄取灶的数量和范围有关,但是部分患者131I摄取较多而Tg仅轻度增高或正常范围。③15例(60%)在治疗1~5次后不再行131I治疗,其中11例(11/15例)治疗后根据131I融合图像未再发现病灶并结合Tg正常而不再需要治疗,其余4例治疗后同机CT显示的双肺弥漫性或散在病灶不摄取131I。结论131I治疗后SPECT/CT融合显像有重要的临床意义,它可以明确诊断DTC的残留、转移和复发,同时为再次治疗提供依据。  相似文献   

3.
目的探讨甲状腺乳头状癌患者行甲状腺全切除术术后行I131核素及甲状腺激素治疗的疗效。方法对38例甲状腺乳头状癌患者行甲状腺全切除术,其中首次手术25例,第2次手术13例,并同时行改良颈部淋巴结清扫术5例。术后应用I131核素及甲状腺激素治疗,观察其疗效。结果 38例患者均手术顺利,无手术死亡病例,术后均未发生喉返神经、喉上神经及甲状旁腺损伤等严重并发症,术后均行I131核素治疗及服用甲状腺激素治疗。随访1~5年,均存活,无肿瘤复发及淋巴结转移和远处转移,无肝肾功能损害、骨髓抑制、白血病及肺组织纤维化等发生。结论对甲状腺乳头状癌患者行甲状腺全切除术,术后常规给予放射性核素治疗及甲状腺激素治疗是有效的综合治疗方案。  相似文献   

4.
患者女,48岁,因甲状腺肿块行双侧甲状腺根治术及双侧颈部淋巴结清扫术,术后病理为甲状腺乳头状癌及颈部淋巴结转移,胸部CT示双肺弥漫性小结节病灶。经131I100mCi清除术后剩余甲状腺组织,4个月后予131I200mCi治疗,扫描见颈、胸和腹部131I摄取阳性(图1),进一步排空肠道内容后再次显像,图像无明显变化。行同机图像融合见131I阳性显像部位在盆腔。腹部B超检查提示下腹部液性多囊性肿块,进而在超声引导下穿刺,病理示盆腔囊性肿块,源于卵巢可能,遂行卵巢肿块切除术,术中见右侧卵巢肿块大小约18cm×12cm×10cm,病理示卵巢黏液性囊腺瘤。再次131…  相似文献   

5.
目的分析大剂量^131I治疗分化型甲状腺癌肺内转移灶的影像学特征、临床疗效及其影响因素。方法应用大剂量^131I治疗分化型甲状腺癌患者156例,其中肺内出现转移灶12例(均已行甲状腺次全或全切除术及颈部淋巴结清扫)。^131I的单次使用剂量2.22~7.4GBq,总剂量7.4GBq~33.3GBq。随访持续时间至少一年。疗效判定:胸部X光及,或CT检查、^131I显像、血清甲状腺球蛋白和甲状腺球蛋白抗体水平测定,但主要为^131I显像。结果12例患者中11例在治疗后^131I显像发现肺内转移灶,其中9例在第1次治疗后显示肺内^131I摄取,2例在第2次治疗后显示肺内^131I摄取,另有1例患者治疗后肺内转移灶未显示有^131I摄取。11例显示肺内^131I摄取的患者中,6例X光胸片或CT检查未发现异常。所有患者大剂量^131I治疗后均有不同程度的好转,多次治疗后^131I显像示肺内^131I摄取逐渐降低,3例在治疗后最终显示正常。结论^131I是治疗分化型甲状腺癌肺内转移灶的有效方法,治疗后^131I显像是判断其疗效的可靠方法。  相似文献   

6.
目的 探讨甲状腺球蛋白(TG)、抗甲状腺球蛋白抗体(TGAb)联合颈部超声在诊断分化型甲状腺癌(DTC)治疗后复发或转移灶中的临床价值.方法 64例患者均为DTC术后131I清除残余甲状腺治疗后,行再次131I治疗前检测血清TGAb、TG水平,并行颈部超声检查,在131I治疗后1周行131I全身SPECT扫描(WBS).结果 对DTC复发或转移灶诊断的灵敏度、特异性和准确性:TG分别为76.9%、66.7%和75%;超声为79%、58%和75%;TG联合超声为96.8%、71.4%和92.1%.12例TG假阴性患者中,有10例患者TGAb≥,100 IU/ml,其TG诊断的灵敏度、特异性和准确性均明显降低.Logistic回归分析结果显示:TG阳性组患者WBS阳性风险是阴性组患者的8.591倍.超声阳性患者WBS阳性风险是阴性患者的6.953倍.结论 TG联合超声能显著提高对DTC治疗后复发或转移灶诊断的灵敏度、特异性和准确性;运用TG监测DTC治疗后复发或转移灶,应同时检测TGAb.  相似文献   

7.
患者男,63岁,1998年因甲状腺滤泡及乳头混合癌伴右颈部淋巴结转移接受手术治疗,2007年因左锁骨上及甲状软骨右侧肿物再次接受手术治疗.2008年1月和5月分别给予131I治疗,剂量5.55 GBq(150 mCi),其后患者偶感头痛.2008年12月头部平扫+增强MRI怀疑脑转移瘤,同时给予第3次131I治疗,剂量同前.7天后131 I全身显像及头部SPECT/CT显像(图1):左额叶见小灶状核素浓聚灶,密度基本同周围脑质密度,与MRI所示异常信号位置一致,诊断为甲状腺癌脑转移瘤.2009年5月给予第4次131I治疗,剂量同前.头部MRI示病变稍增大,最大径变化约0.3 mm;头部131I SPECT/CT显像发现左额叶病变仍摄取131I,但患者临床症状并未加重.2009年11月患者血清甲状腺球蛋白较前降低,CT示左额叶病变已呈高密度钙化,平均CT值为88.7 HU.  相似文献   

8.
目的探讨儿童及青少年分化型甲状腺癌131I治疗的疗效。方法本研究中共37例患者,男17例,女20例,年龄5~19岁,平均15.6岁。所有患者均已行甲状腺全切或近全切及颈部淋巴结清扫术,经术后病理学诊断确诊为甲状腺乳头状癌及其亚型,均符合131I治疗适应证。在术后或停服左旋甲状腺素片3~4周后行131I内照射靶向治疗,两次131I治疗间隔3~6个月。患者定期复查血清甲状腺素(FT3与FT4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白(Tg)、血常规及肝肾功能等实验室检查,以及超声、CT及MRI等相关影像学检查。结果 131I治疗后随访1~35个月(中位时间21.3个月),无瘤生存1例,病情明显缓解24例,病情稳定12例,未出现复发及新的转移灶。结论儿童及青少年分化型甲状腺癌易转移及复发,年龄≤15岁、原发灶的外侵、累及双侧腺叶和远处转移是影响分化型甲状腺癌患者预后的重要因素,此类患者术后应行131I治疗,可明显改善患者的预后,提高其生存质量。  相似文献   

9.
弥漫性甲状腺癌的超声及病理特点分析   总被引:1,自引:1,他引:0  
目的:探讨弥漫性甲状腺癌的超声及临床病理特点及诊断以提高对本病的认识.方法:收集经手术病理证实的8例弥漫性甲状腺癌患者的临床病理特点及超声图像资料.结果:(1)8例中7例表现为甲状腺回声普遍增高、增粗、不均,微小钙化散在分布,腺体内未见明确局灶性病变,未见正常的甲状腺组织回声,1例仅单侧及峡部为上述改变.(2)彩色多普勒超声检查,所有病例均表现为甲状腺血流信号增多.(3)8例中7例伴有双侧颈部淋巴结转移,转移的淋巴结内部见微小钙化灶,1例伴液化回声.(4)8例患者中7例(包括1例肝脏及肺脏转移)行双侧甲状腺全切及双侧颈部淋巴结清扫术,1例行双侧全切单侧颈部淋巴结清扫术,术后均行131I治疗及内分泌抑制疗法.结论:弥漫性甲状腺癌的超声表现具有特征性,超声对弥漫性甲状腺癌的诊断具有重要价值.弥漫性甲状腺癌应尽早手术,术后辅以放射治疗及内分泌抑制疗法,以延长患者生存期.  相似文献   

10.
利用放射性~(131)I治疗甲亢在国内已有30多年的历史,由于此方法特异性强、安全、可靠、简便、经济,目前仍是治疗甲亢的重要方法之一。我国从50年代末期开始应用于临床,许多医院在这方面积累了丰富的经验。1984年在全国核素治疗质量控制会上又制定了一系列规程,使此方法更规范化,因而大大地提高了疗效。一、~(131)I治疗甲亢的原理甲状腺具有高度浓聚碘的能力,甲亢时甲状腺组织浓聚碘的能力更强,放射性~(131)I具有一般碘的化学性质,因而口服~(131)I后,~(131)I能迅速而选择性地被甲状腺组织摄取,使部分甲状腺组织受到β射线的集中照射而遭到破坏,从而减少甲状腺激素的合成而达到  相似文献   

11.
BACKGROUND: Analgesics are commonly used to provide pain relief after surgery. These drugs produce some extended depression of immunity. A prospective randomized controlled trial was designed to observe expressions of T-lymphocyte subsets (CD3(+), CD3(+)CD4(+) and CD3(+)CD8(+)), natural-killer cells (CD3(-)CD16(+)CD56(+)), and activated T-lymphocytes (CD3(+)CD25(+)) of patients undergoing gastric cancer surgeries and receiving patient-controlled intravenous analgesia (PCIA). METHODS: Forty-five patients undergoing elective gastric cancer surgeries under general anesthesia were randomly allocated into 3 groups. Group I received PCIA using morphine after surgery, group II using tramadol, and group III using tramadol with lornoxicam. The analgesic efficacy was evaluated by visual analog scale (VAS) and Bruggrmann comfort scale (BCS). Expressions of CD3(+), CD3(+)CD4(+), CD3(+)CD8(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) were measured as percentages of total lymphocytes by flow cytometer at 5 time points. RESULTS: There was no significant difference in analgesic efficacy and the baselines of CD3(+), CD3(+)CD4(+), CD3(+)CD8(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) in all groups. Compared with the baseline, CD3(+)CD8(+) had no changes in all groups at any time point. Ninety minutes after incision, CD3(+), CD3(+)CD4(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) were lower in all groups (P<0.05). 24 h after surgery, CD3(+), CD3(+)CD4(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) were lower in group I and group II (P<0.05); meanwhile CD3(+), CD3(+)CD4(+), and CD3(+)CD25(+) returned to the baseline but CD3(-)CD16(+)CD56(+) was still low (P<0.05) in group III. 48 h after surgery, CD3(+), CD3(+)CD4(+), CD3(-)CD16(+)CD56(+), and CD3(+)CD25(+) returned to the baseline in group II and group III, but not in group I (P<0.05). 72 h after surgery, CD3(+), CD3(+)CD4(+), CD3(+)CD4(+)/CD3(+)CD8(+) returned to the baseline, but CD3(+)CD25(+) and CD3(-)CD16(+)CD56(+) were still low in group I (P<0.05). CONCLUSION: PCIA using lornoxicam with tramadol has the same good analgesic efficacy and less immunity depression than PCIA using morphine or tramadol.  相似文献   

12.
To control drugs in vivo, new approaches are needed. Considerable progress has been made towards the applications of fluorine (19F) in pharmacotherapy in this regard. To date, many authors have showed that by using 19F labelled drugs and non-invasive magnetic resonance imaging (MRI) techniques together, drug biodistribution can be tracked. This review presents methods for 19F incorporation into pharmaceuticals by forming C–F bonds and drug fluorine oil-water emulsions. Inadequate drug delivery is a major cause of drug resistance, which can be improved using approaches discussed herein aided by 19F MRI.  相似文献   

13.
PURPOSE: The aim of the study is to retrospectively investigate the usefulness of (11)C-acetate (ACE)-positron emission tomography (PET) for evaluation of brain glioma, in comparison with (11)C-methionine (MET) and 2-deoxy-2-(18)F-fluoro-D: -glucose (FDG). PROCEDURES: Fifteen patients with brain glioma referred to initial diagnosis were examined with ACE, MET, and FDG-PET. Five patients had low-grade gliomas (grade II), three had anaplastic astrocytomas (grade III), and seven had glioblastomas (grade IV). PET results were evaluated by visual and semiquantitative analysis. For semiquantitative analysis, the standardized uptake value (SUV) and tumor to contralateral normal gray matter (T/N) ratio were calculated. The sensitivity for detection of high-grade gliomas was calculated using visual analysis. RESULTS: Sensitivities of ACE, MET, and FDG were 90%, 100%, and 40%, respectively. ACE and MET T/N ratios were significantly higher than that of FDG. ACE and FDG SUV in high-grade gliomas were significantly higher than that in low-grade gliomas. No significant differences were observed using MET. CONCLUSIONS: ACE PET is a potentially useful radiotracer for detecting brain gliomas and differentiating high-grade gliomas.  相似文献   

14.
Myocardial perfusion and fatty acid uptake at rest were assessed by SPECT with 201Tl (Tl) and 123I-BMIPP (BMIPP) in 50 consecutive patients with coronary heart disease. Discrepant regional myocardial uptake was observed in 19 patients and classified into the following two groups: mismatch (MM; Tl uptake > BMIPP uptake, n = 14, mean age, 66 years) and paradoxical mismatch (PM; Tl uptake < BMIPP uptake, n = 5, mean age, 68 years). In the MM group, 77% was single- or zero-vessel disease and the artery-perfused region in the mismatched area was almost always ischemia related. Sixty percent of the regions observed with the PM were related to the inferior wall. In the PM group, 80% of cases were associated with multivessel stenoses and 60% of cases was suffered from ischemic attack within a week before scintigraphy. In conclusion, mismatch was related to abnormal fatty acid uptake caused by coronary heart disease. Although the paradoxical mismatch might mainly be related to diaphragmatic attenuation of Tl scans and augmented artifacts of BMIPP scans in the inferior wall, we should not overlook severe coronary heart disease in patients with paradoxical mismatched phenomenon.  相似文献   

15.
BackgroundNegative regulatory T cells (Tregs) not only deplete effector T cells but also inhibit the clearance of HIV during infection, which may allow Tregs to be used as informative diagnostic markers. To facilitate both diagnosis and treatment, a thorough understanding of these regulators by characterizing them on temporal and spatial scales is strongly required.MethodsHundred HIV‐infected/AIDS patients, including 87 males, with an average age of 35.8 years, as well as 20 healthy controls, were enrolled. Flow cytometry was used to analyze CD3+T cells, CD4+T cells, and CD8+T cells to evaluate the immune status of the participants. Then, a group of representative negative regulatory T cells, including CD4+PD‐1+T cells, CD4+PD‐1highT cells, CD8+PD‐1+T cells, and CD4+CD25high Tregs was also analyzed to explore their effects on disease progression and intercorrelation.ResultsThe percentages of CD4+PD‐1+T cells and CD4+CD25highTregs increased in patients with the same ultrahigh significance. Temporally, the patients with both intermediate‐stage and late‐stage disease had higher percentages of CD4+PD‐1+T cells; however, the percentage of CD4+CD25highTregs only increased in the patients with late‐stage disease. In addition, CD4+PD‐1+T cells but not CD4+CD25highTregs were negatively correlated with the absolute CD4+T cell count. Spatially, no correlations between CD4+PD‐1+T cells and CD4+CD25highTregs were observed, which suggests these Tregs function differently during immunosuppression.ConclusionsThis study characterized negative regulatory T cells in HIV‐infected/AIDS patients at both temporal and spatial scales and found that CD4+CD25+Tregs and CD4+PD‐1+T cells could be used as potential diagnostic markers for identifying different disease stages and monitoring disease progression.  相似文献   

16.
Thapsigargin has been shown the elevate intracellular Na(+) concentration in human lymphocytes, but mechanisms underlying thapsigargin-induced Na(+) entry are little understood. In the present study we investigated thapsigargin-induced changes in cytosolic free Na(+) and Ca(2+) concentration in human lymphocytes after inhibition of the Na(+)/Ca(2+) exchange with two structurally unrelated compounds, dimethylthiourea ad bepridil. The intracellular Na(+) increase induced by 5 microM thapsigargin was significantly enhanced in the presence of 5 mM dimethylthiourea or 40 microM bepridil. In contrast, both compounds significantly decreased the thapsigargin-induced intracellular Ca(2+) elevation. No effect of dimethylthiourea or bepridil on thapsigargin-induced Ca(2+) influx was observed in the absence of extracellular Na(+). These observations are consistent with the hypothesis that thapsigargin stimulates Na(+)/Ca(2+ )exchange in human lymphocytes. However, Na(+)/Ca(2+) exchange does not mediate Na(+) influx in human lymphocytes.  相似文献   

17.
Antibodies of high avidity (maximum Km 1.3 × 1010 L/M) were produced in rabbits against bradykinin coupled to ovalbumin with toluene-2,4-diisocyanate. Tyrosin8 bradykinin was labelled to a specific activity of 530–700 Ci/mmol with 125I by means of lactoperoxidase. Sensitivity of the radioimmunoassay was 0.01 μg/1 blood. Specificity studies demonstrated the essential role of the C-terminal arginine of bradykinin for binding to antibody. Mean recovery of [3 PHJbradykinin internal standard after the preparation of 86 blood samples was 39.0%. The major loss occurred during ethanol precipitation. In venous blood collected at random conditions from 32 normal subjects the bradykinin concentration ranged 0.04–0.46 μg/1 and showed no sex difference.  相似文献   

18.
To gain insights into the mechanisms by which soluble heat shock protein (hsp) fusions can elicit CD8(+) cytotoxic T lymphocytes (CTLs) against the fusion partner, mycobacterial (Mycobacterium tuberculosis) hsp70 was dissected to ascertain whether a particular hsp domain is necessary, and knockout mice were used to determine whether the fusion protein's immunogenicity is dependent on CD4(+) T lymphocytes. We found that the ability to elicit CD8(+) CTLs depends on a discrete 200-amino acid protein domain, indicating that the fusion protein's immunogenicity for CD8(+) T cells does not require coupled chaperone function or peptide binding. Further, we found that ovalbumin (OVA).hsp70 fusion protein elicited anti-OVA CD8(+) CTLs about equally well in CD4 knockout and wild-type C57BL/6 mice, and also when the hsp70 was of murine (self) origin. The ability of hsp70 fusion proteins to elicit CD4-independent CTL responses suggests that hsp70 fusion proteins may be useful for immunological prophylaxis and therapy against disease in CD4(+) T cell-deficient individuals.  相似文献   

19.
CD137 (4-1BB) is a TNFR superfamily member that mediates the costimulatory signal resulting in T cells and NK cells proliferation and cytokines production, but the effects of CD137 signaling on CD3+CD56+ cell subpopulation have not been well-documented. The aim of this study was to investigate the effects of CD137 signaling on regulation of CD3+CD56+ cell function. Anti-CD137 mAb or mouse IgG1 isotype control was added to CIK cell culture to determine the effects of proliferation and anti-tumor effects on CD3+CD56+ cells. We observed that anti-CD137 mAb could dramatically promote proliferation of CIK cells. And CD137–CIK cells and CD3+CD56+ cell subpopulation within them possessed higher ability to kill tumor cell line A549. The SCID mice engrafted with A549 cells and treated with CD137–CIK cells have prolonged survival. Further studies revealed that the percentages of CD3+CD56+ cells were elevated significantly in CD137–CIK cells. The expression of NKG2D was up-regulated on CD3+CD56+ cells from CD137–CIK cells. The expression of IFN-γ, IL-2 and TNF-α increased significantly whereas the production of TGF-β1, IL-4 and IL-10 decreased in CD3+CD56+ cells from CD137–CIK cells. In addition, anti-CD137 mAb can elevate the capacity of CD3+CD56+ cells to induce CD4+ Th1 responses. We further showed that the anti-CD137 mAb also had the same effects on CD3+CD56+ cells expanded from the PBMCs of patients with NSCLC. We concluded that CD137 signaling could enhance the abilities of CIK cells to kill tumor cells in vitro and in vivo via increasing the proportion of CD3+CD56+ cells and their cytotoxicity. Furthermore, CD137 signaling can elevate the capacity of CD3+CD56+ cells to induce CD4+ Th1 responses which may enhance their anti-tumor activity indirectly. Taken together, our studies could be considered as valuable in CIK cells-based cancer immunotherapy.  相似文献   

20.
Purpose  The suitability of [18F]FDG, [18F]FLT, [18F]FET, and [18F]FCH as non-invasive positron emission tomography (PET) biomarkers for monitoring response to chemotherapy was analyzed in various experimental tumor models. Procedures  Tracer uptake into three syngeneic rodent tumor models and ten human xenograft models was evaluated using semiquantitative analysis of small-animal PET data. Murine RIF-1 fibrosarcomas and [18F]FLT were selected to monitor the effects of the novel cytotoxic patupilone. Results  Except [18F]FCH, all tracers provided good tumor visualization. Highest [18F]FDG uptake was identified in syngeneic tumors. Xenograft models, however, showed low [18F]FDG SUVs and were better visualized by [18F]FLT. Monitoring the effects of patupilone on [18F]FLT uptake in RIF-1 tumors revealed a significant decrease of tracer uptake after 24 h, which strongly negatively correlated with apoptosis. Conclusion  [18F]FLT PET of experimental tumors is a viable complement to [18F]FDG for preclinical drug development. [18F]FLT may be an excellent biomarker for patupilone-induced apoptosis. T. Ebenhan and M. Honer contributed equally to this work. An erratum to this article can be found at  相似文献   

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