脑SPECT显像在癫痫中的应用

目的：本文主要研究脑ＳＰＥＣＴ在癫痫应用中的作用和地位。材料和方法：对８１例癫痫患者进行了１０２次发作间期脑ＳＰＥＣＴ血流灌注显像，并与ＥＥＧ、脑ＣＴ、ＭＲＩ比较。结果：８１例ＳＰＥＣＴ检查中６６例显示异常，检出率８１．４％（６６／８１），ＥＥＧ、ＭＲＩ、ＣＴ阳性率分别为８２．９８％（３９／４７）、３８．２４％（１３／３４）、４５．９５％（１７／３７）。结论：ＳＰＥＣＴ显像在癫痫诊断和定位方面与ＥＥＧ、ＭＲＩ、ＣＴ相比具有优势，且有助于癫痫病灶局部血流变化与临床症状、疗效及其他影响因素之间关系的研究。     

儿童病毒性脑炎^99Tc^m—ECD SPECT脑血流显像的研究

目的 探讨＾９９Ｔｃ＾ｍ－双半胱乙酯（ＥＣＤ）ＳＰＥＣＴ脑血流显像在儿童病毒性脑炎中的显像特点和应用价值。方法 对２２例临床诊断为病毒性脑炎患儿进行＾９９Ｔｃ＾ｍ－ＥＣＤ ＳＰＥＣＴ脑血流显像，４例于治疗后１３～４０ｄ进行复查。结果 病毒性脑炎急性期２２例患儿中２１例脑ＳＰＥＣＴ显示异常。１７例为多发病灶，其中可有双侧对称性或不对称性改变；４例为单发病灶，病变处可表现出血流高灌注、低灌注或两者并存     

Video/EEG,SPECT和MRI对部分性癫痫定位诊断作用及临床意义探讨

目的：探讨录像脑电图检测（Ｖｉｄｅｏ／ＥＥＣ）,ＳＰＥＣＴ和ＭＲＩ３种方法对部分性癫痫的无创性定位和病因诊断的作用及临床意义。材料与方法：对５２例部分性癫痫患者分别进行Ｖｉｄｅｏ／ＥＥＧ,＾９９ｍＴｃ－ＨＭＰＡＯ－ＳＰＥＣＴ脑血流显像,＾１２３Ｉ－Ｉｏｍａｚｅｎｉｌ ＳＰＥＣＴ脑受体显像和全脑ＭＲＩ检查。根据Ｖｉｄｅｏ／ＥＥＧ记录的癫痫发作类型,ＳＰＥＣＴ显示的ｒＣＢＦ和ＢＺＤ的分布以及ＭＲＩ显示     

用三探头SPECT作快速复原的腺苷应激／静息_（99m）Tc－Tebor

０６５用三探头ＳＰＥＣＴ作快速复原的腺苷应激／静息￣（９９ｍ）Ｔｃ－Ｔｅｂｏｒｏｘｉｍｅ心肌灌注显像［英］／ＣｈｕａＴ…Ｊ　ＮｕｃｌＭｅｄ．－１９９３，３４（９）．－１４８５～１４９３．研究目的是测定三探头ＳＰＥＣＴ作快速复原的腺苷应激／静息９９ｍＴ...     

心肌SPECT灌注显像对慢性阻塞性肺疾病的诊断

心肌ＳＰＥＣＴ灌注显像对慢性阻塞性肺疾病的诊断刘保平，焦建国，孙秉奇，孟玉葆，常建东，张胜军应用ＳＰＥＣＴ心肌显像，通过观察右室心肌显像情况，结合计算右室心肌放射性计数／左室心肌放射性计数（ＲＣ／ＬＣ）比值，对３３例慢性阻塞性肺疾病（ＣＯＰＤ）患者进...     

~（99m）Tc－HMPAO SPECT在研究偏头痛中的临床应用

采用９９ｍＴｃ－ＨＭＰＡＯ　ＳＰＥＣＴ对４８例偏头痛患者做了脑灌注显像。结果显示，８５．４％患者局部脑血流灌注（ｒＣＢＦ）减低，有先兆偏头痛间歇期（ｎ＝５）ｒＣＢＦ均降低，无先兆偏头痛发作期９１．７％（ｎ＝１２）患者ｒＣＢＦ降低，而间歇期８３．９％（ｎ＝３１）患者ｒＣＢＦ降低，注射Ｓｕｍａｔｒｉｐｔａｎ治疗（ｎ＝４）后，头痛缓解后ｒＣＢＦ改善。因此，ＳＰＥＣＴ的脑灌注显像可用来评价临床偏头痛患者的脑血流状态，以及寻求针对性的治疗。     

~（99m）Tc－ECDSPECT脑血流灌注显像的临床应用

￣（９９ｍ）Ｔｃ－ＥＣＤＳＰＥＣＴ脑血流灌注显像的临床应用王信辉，侯治河，候庆田，王长生，陈勇，郝秋香，王雪清，李红对１２６例９９ｍＴｃ－ＥＣＤＳＰＥＣＴ脑血流灌注显像结果进行分析，探讨了正常人及各脑疾病的显像特征．资料与方法正常组７例．脑疾病组１１...     

癫痫发作期和发作间期~（99m）Tc－ECD脑断层显像

癫痫发作期和发作间期~（９９ｍ）Ｔｃ－ＥＣＤ脑断层显像［英］／ＧｒｕｎｗａｌｄＦ…∥ＪＮｕｃＩＭｅｄ．－１９９４，３５（１２）．－１８９６～１９０１方法：１６例患者行２３次脑ＳＰＥＣＴ（ＣＥＲＡＳＰＥＣＴ）显像研究，其中８次为发作期显像，１５次为发作?..     

肺癌的~（99m）Tc－DMSASPECT显像

肺癌的~（９９ｍ）Ｔｃ－ＤＭＳＡＳＰＥＣＴ显像［英］／ＨｉｒａｎｏＴ…ＪＮｕｃｌＭｅｄ．－１９９５，３６（２）．－２０２～２０７对３１例有肺部肿块的疑似肺癌病人静脉注射５５５ＭＢｑ￣９９ｍＴｃ－ＤＭＳＡ后３～４小时做５分钟平面显像和３２分钟３６０°Ｓ?..     

脑SPECT rCBF在同向性偏盲患者视觉功能研究中的价值

比较了８例同向性偏盲患者在定向动态彩色光刺激治疗前后９９ｍＴｃ－６－甲基丙二胺肟ＳＰＥＣＴ局部脑血流感兴趣区法测定结果，表明定向动态彩色光刺激治疗同向性偏盲有效（７／８）．其机制是通过多种视觉刺激信息激活枕叶区和中脑区的有关神经组织．同时显示脑ＳＰＥＣＴ显像技术在动态研究脑功能变化中有一定价值．     

~(99m)Tc-MIBI联合~(99m)Tc-HL91乏氧显像对60例原发性肺癌的诊断评价

目的探讨~(99m)Tc-甲氧基异丁基异腈(~(99m)Tc-MIBI)肺亲肿瘤显像联合~(99m)Tc-4,9-二氮- 3,3,10,10-四甲基十二烷-2,11-二酮肟(~(99m)Tc-HL91)乏氧显像对原发性肺癌的诊断效能。方法对60例拟诊断原发性肺癌患者,术前进行~(99m)Tc-MIBI及~(99m)Tc-HL91显像,以病理结果为金标准,分析~(99m)Tc-MIBI联合~(99m)Tc-HL91显像对原发性肺癌的诊断价值。结果病理结果证实原发性肺癌48例,良性病变12例。~(99m)Tc-MIBI、~(99m)Tc-HL91和~(99m)Tc-MIBI ~(99m)Tc-HL91显像对原发性肺癌诊断的灵敏度、特异度和准确率分别为89．6%(43/48)、77．1%(37/48)、95．8%(46/48),75．0%(9/12)、91．7%(11/12)、83．3%(10/12)和86．7%(52/60)、80．0%(48/60)、93．3%(56/60)。结论~(99m)Tc-MIBI肺亲肿瘤显像联合~(99m)Tc-HL91乏氧显像有助于提高对原发性肺癌的诊断效能。     

18F-FDG符合线路显像诊断骨转移瘤的价值及与99Tcm-MDP骨显像的比较

目的 评价^18F-脱氧葡萄糖(FDG)符合线路显像在骨转移瘤诊断中的价值，并与^99Tc^m-亚甲基二膦酸盐(MDP)骨显像进行比较。方法因怀疑恶性肿瘤或骨转移而行^18F-FDG符合线路显像者55例，41例于^18F-FDG检查前后4周内进行了^99Tc^m-MDP全身骨显像。其中30例骨转移瘤患者，15例无骨转移瘤，10例^18F-FDG显像示可疑肿瘤直接骨侵犯(单独进行分析)。结果 ^18F-FDG符合线路显像和骨显像对骨转移瘤的灵敏度、特异性、阳性预测值、阴性预测值、诊断准确性分别为100％，93％，97％，100％，98％和95％，50％，75％，86％，77％，前者特异性、阳性预测值、诊断准确性显著高于骨显像(P=0．024，0．035，0．007)；^18F-FDG显像发现30例骨转移瘤患者中的20例有骨外原发或转移肿瘤。10例^18F-FDG显像示可疑肿瘤直接骨侵犯患者中，4例被证实有骨受累，6例无骨受累，而骨显像对骨受累情况均作出了正确判断。结论 ^18F-FDG符合线路显像对骨转移瘤的诊断有较高的灵敏度和特异性，并能发现骨外原发或转移性肿瘤；^99Tc^m-MDP骨显像对骨转移瘤也有较高的灵敏度，但特异性较差。     

99Tcm-HL91显像、CT和血清肿瘤标志物测定联合应用诊断肺癌

目的探讨Tc^m-4，9-二氮．3，3，10，10-四甲基十二烷-2，11-二酮肟(HL91)显像、CT、血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片断(CYFRA21-1)、神经元特异性烯醇酶(NSE)]测定联合应用对肺癌的诊断价值。方法46例疑为肺癌患者在1周内进行^99Tc^m-HL91 SPECT显像、CT检查和血清肿瘤标志物测定。计算每种方法及三法联合应用诊断肺癌的灵敏度、特异性及准确性。结果最终经病理检查或细胞学诊断证实肺癌26例，经病理检查或治疗后影像学随访确诊肺部良性病变20例。^99Tc^m-HL91 SPECT显像、CT及血清肿瘤标志物测定诊断肺癌的灵敏度、特异性及准确性分别为77％、80％、78％，96％、60％、80％及50％、60％、54％。三法联合应用诊断肺癌的灵敏度、特异性及准确性分别为100％、90％、96％，其综合诊断效能明显优于其中任何一种检查方法。结论^99Tc^m-HL91显像、CT、血清肿瘤标志物测定联合应用在肺部肿瘤良恶性鉴别诊断中有较大价值。     

99Tcm-PPM及99Tcm-MIBI肺显像诊断原发性肺癌

目的 探讨99Tcm－培普利欧霉素（PPM）及99Tcm-甲氧基异丁基异腈（MIBI）肺显像诊断原发性肺癌的临床价值。方法 对28例临床诊断肺肿瘤患者进行99Tcm-PPM ey 99T0-MIBI肺肿瘤显像并进行比较。结果 肺癌与良性病变对99T -PPMey 99T-MIBI观的摄取差异有显著性（P＜0．01）,以肺癌晚期显像摄取比值（T／NT,X－S）作为判断良恶性阈值,99Tcm-PPM及99Tcm-MIBI对肺癌诊断的灵敏度,准确性分别为90％,89．3％,和80％,82．1％,两者结合显像阳性率为95％,病灶对放射性药物的摄取与肿瘤大小无明显相关（P＞0．05）,结论 99Tcm-PPM ey 99T-MIBI肺显像对肺癌的诊断,鉴别诊断有一定的临床价值。两者联合应用可提高肺癌的阳性检出率,单独使用99Tcm-PPM优于99Tcm-MIBI。     

Feasibility of dual-isotope coincidence/single-photon imaging of the myocardium.

Hybrid PET scanners offer the possibility of obtaining myocardial viability information from coincidence imaging of the positron emitter (18)F-FDG and perfusion measurements from a single-photon tracer-potentially simultaneously. This new approach is less costly and more readily available than dedicated PET and offers potential for improved FDG resolution and sensitivity compared with SPECT with 511-keV collimators. Simultaneous imaging of the coincidence and single-photon events offers the further advantages of automatic image registration and reduced imaging time. However, the feasibility of simultaneous coincidence/single-photon imaging or even immediately sequential imaging is unknown. In this study, the potential of using standard low-energy high-resolution (LEHR) collimators with hybrid PET to obtain coincidence and SPECT data was assessed. METHODS: Phantom and human studies were performed to investigate the effect of LEHR collimators on FDG coincidence imaging with a hybrid PET system, the effect of the presence of (99m)Tc during FDG coincidence imaging with LEHR collimators, and the effect of the presence of FDG during (99m)Tc SPECT imaging. RESULTS: FDG images were somewhat degraded (a measure of myocardial nonuniformity increased 10%) with LEHR collimators. With 148 MBq (4 mCi) (99m)Tc present during FDG imaging of a phantom, image quality was maintained and the number of detected coincidences changed by <5%. With (99m)Tc/(18)F whole-body ratios of 7:1, crosstalk from (18)F photons accounted for the majority of counts in the (99m)Tc SPECT images and resulted in severe artifacts. The artifacts were decreased with a simple crosstalk correction scheme but remained problematic. CONCLUSION: (99m)Tc/(18)F ratios of at least 9:1 and state-of-the-art reconstruction and crosstalk correction are likely to be required to perform immediately sequential coincidence/single-photon imaging of the myocardium with clinically useful results. Additional challenges remain before simultaneous imaging of coincidence events and single photons can be realized in practice.     

99Tcm-DMSA肾显像诊断肾盂肾炎和 肾脏瘢痕的动物模型实验研究

目的　制作猪肾盂肾炎和肾脏瘢痕动物模型 ,评价99Tcm 二巯基丁二酸 (DMSA)肾脏平面显像和SPECT断层显像诊断肾盂肾炎和肾脏瘢痕的灵敏度和特异性 ,并探讨SPECT的诊断价值。方法　中国实验动物小型猪 13只 ,先制成膀胱输尿管返流动物模型 ,然后引入大肠埃稀杆菌导致上尿路感染 ,感染前后用ADACVertex型双探头SPECT仪 ,配低能高分辨率准直器进行肾脏前后位平面和断层显像 ,将显像结果同组织病理学检查进行对比研究。结果　平面显像诊断肾盂肾炎和肾脏瘢痕的灵敏度为 71 2 % ,特异性为 10 0 % ,准确性为 87 5 % ;平面加断层显像诊断肾盂肾炎和肾脏瘢痕的灵敏度为 78 3% ,特异性为 10 0 % ,准确性为 90 5 %。以病理检查为标准 ,平面显像和平面加断层显像对病灶的检出率差异无显著性。结论　99Tcm DMSA肾脏显像是诊断肾盂肾炎和肾脏瘢痕的灵敏可靠方法。平面加断层显像可能有助于提高检测的灵敏度 ,并对病变范围作更准确的估价     

核医学显像在急诊医学中的应用

目的:探讨核素显像在急诊显像中的应用价值。方法:105例急诊核素显像分为4组,A组78例行急诊心肌显像;B组5例行急诊脑显像;C组15例行急诊胃肠道出血显像;D组7例行急诊大血管显像。结果:78例急诊心肌显像中,阳性74例;阴性4例;5例急诊脑显像全部阳性;15例胃肠道出血显像中6例阳性,9例阴性;7例大血管显像全部阳性。结论:核素显像在急诊医学中能发挥重要作用。     

不同能量放射性核素在PET/CT及SPECT采集中的相互影响

目的 利用模型探讨99TcmO4-与18F-氟脱氧葡萄糖(FDG)在图像采集中的相互影响,讨论同一患者是否可以同日分别采用PET/CT及SPECT两种仪器行高低两种能量放射性核素显像.材料与方法 利用统一规格、相同容积( 500ml)的5个塑料瓶(编号A、B、C、D、E),其内均注入500ml蒸馏水制作成模型.A瓶注入0.5mCi 18F-FDG行PET/CT显像;B瓶注入1mCi99TcmO4-行SPECT显像;C瓶内同时注入混合好的0.5mCi18F-FDG和1mCi99TcmO4-;D瓶内先注入1mCi99TcmO4-后再注入0.5mCi18F-FDG;E瓶先注入0.5mCi18F-FDG后再注入1mCi99TcmO4-.然后对C、D、E瓶分别行PET/CT显像和SPECT显像,并判断图像效果.结果 A瓶PET/CT显像和B瓶SPECT显像图像效果为1级;C、D瓶SPECT及PET/CT显像图像均为2级;E瓶SPECT显像图像为3级,PET/CT显像图像为1级.结论 同时加入18F-FDG和99TcmO4-对PET/CT和SPECT图像质量均有影响.先加入18F-FDG后加入99TcmO4-对PET/CT图像质量影响小,但SPECT图像不能分辨.先加入99TcmO4-后加入18F-FDG对PET/CT和SPECT图像质量均有影响.     

Nuclear medicine imaging of lung cancer

Although nuclear medicine imaging is still widely under-appreciated and underused by the medical and radiologic communities, FDG PET imaging and Tc 99m depreotide SPECT imaging are safe, cost-effective methods with advantages over CT and other imaging methods in the diagnosis and management of patients suspected or known to have lung cancer. Physicians involved in the care of these patients should familiarize themselves with both of these relatively new nuclear medicine imaging procedures. Both F-18 FDG PET imaging and Tc 99m depreotide SPECT imaging have a high degree of sensitivity, specificity, overall accuracy, and both PPV and NPV in the management of patients with a solitary pulmonary nodule. Nuclear imaging with either of these agents provides a noninvasive, cost-effective method to select patients for aggressive intervention without contributing to increased morbidity. There has not been a direct comparison of these two techniques in terms of their relative role and cost-effectiveness in the management of patients with a solitary pulmonary nodule. Both methods have incremental value over CT imaging in selecting patients with solitary pulmonary nodules either for invasive biopsy or for thoracotomy. To date, only FDG PET has been proved to have additional application in: 1. Improving the staging of patients by identifying or excluding mediastinal disease. Some authors are reluctant at the present time to deny patients an opportunity for curative resection based on the finding of foci of increased metabolism in the mediastinum (characterized by increased FDG activity) because there are occasional false-positive studies. They propose, however, that a negative study justifies a surgical approach (and an opportunity for cure) regardless of the findings on CT. 2. Evaluation of therapy and early detection of recurrence by using FDG PET imaging as a monitoring procedure. Tc 99m depreotide may have a role also in these other clinical indications for imaging in patients with lung carcinoma. It is too soon, however, to know if Tc 99m depreotide SPECT imaging, properly performed, can mimic the success of FDG PET in the detection or exclusion of mediastinal metastases, evaluating the response to therapy, and the early detection of recurrent disease during post-therapeutic monitoring.     

The role of Tc-99m sestamibi imaging in predicting clinical response to chemotherapy in lung cancer

Multidrug resistance (MDR) is a major problem in lung cancer. Tc-99m methoxyisobutyl isonitrile (MIBI) has been demonstrated to be a non-invasive marker to diagnose MDRI related P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP) expression in various solid tumors. The aim of this study was to evaluate the relationship between the degree of Tc-99m MIBI uptake and its retention on delayed images and the response to chemotherapy in lung cancer. Twenty-three patients (1 woman and 22 men, age range 40-67 years) with lung cancer (9 small cell and 14 non-small cell) were examined with Tc-99m MIBI imaging before chemotherapy. After i.v. administration of 740 MBq Tc-99m MIBI, planar and SPECT imaging at 30 minutes and 2 hours was performed. Tumor to normal lung uptake ratio (T/N) and percent retention were measured. Response to chemotherapy was evaluated according to follow-up CT and grouped as complete responders (CR), partial responders (PR) and non-responders (NR). Clinical follow-up and CT evaluation revealed that 12 patients had partial remission, 4 patients had complete remission and 7 patients had no-remission after chemotherapy. Statistically, there was no significant correlation between early (30 min), delayed (2 hr) T/N ratios and percent retention of Tc-99m MIBI with chemotherapeutic response of the lung cancer among the three groups (p > 0.05). Results of the current study imply that Tc-99m MIBI uptake and the retention index may not correlate with chemotherapy response in lung cancer, so that the accuracy of this method needs to be verified in a larger series with additional investigation at the molecular level.