浅谈医学专业开设断层解剖学的必要性和紧迫性

断层解剖学是用断层方法研究正常人体形态结构及其相关功能的科学,随着超声成像(USG)、X一线计算机断层成像(CT)、磁共振成像(MRI)、正电子发射计算机断层显像(PET)和单光子发射计算机断层显像(SPECrr)等影像诊疗技术的发展与普及,断层解剖学已成为医学生了解新的影像诊断技术,掌握基本渎片技能所必须学习的一门继系统解削学和局部解剖学之后的人体解剖学课程为适应医学科学飞速发展的需要,必须不断完善教学内容,改进学生的知识结构。因而在形态学科中断层解剖学这一新型学科就显得尤为重要。     

核医学肿瘤乏氧显像的进展

乏氧是实体肿瘤普遍存在的现象,可降低放疗及化疗的治疗效果.一些有创的肿瘤乏氧的检测方法(如氧电极法)可以用于肿瘤乏氧的检测并预测疗效,但这些方法由于技术复杂、繁琐且重复性差而无法在临床常规使用[1].核医学乏氧显像利用可以选择性滞留在乏氧组织中的显像剂,进行单光子发射计算机断层显像(single photon emission computed tomography,SPECT)或正电子发射计算机断层显像(position emission tomography,PET),无创性地探测肿瘤乏氧组织,并进行定性和半定量分析,从而进行鉴别诊断、评价预后及指导治疗,已成为近几年生物医学肿瘤治疗领域研究的热点[2].     

垂体瘤SPECT显像的临床应用

单光子发射型计算机断层显像(SPECT)和正电子发射计算机断层扫描(PET)利用不同的药物对肿瘤内部的生化及代谢活动进行显像，常用于脑肿瘤的SPECT显像剂有铊^201(^201TLCL)、^99mTc-甲氧基异丁基异腈(^99mTc-MIBI)、^123I-α-甲基-L-酪氨酸(^123I—MT)、^131I-碘代脱氧尿嘧啶核苷(^131I—UdR)等，脑肿瘤摄取同位素的机制不是十分清楚，     

SPECT显像对癫痫诊断的意义

单光子发射计算机断层显像(SPECT)在临床的广泛应用,改善了癫痫诊断的效果。 SPECT 对癫痫的诊断,尤其是定位方面明显优于 CT 及脑电图(EEG)。现就本院收治的     

前列腺癌靶向放射性核素显像剂的研究进展

近年来,前列腺癌（prostate cancer,PCa）发病率逐渐上升,正电子发射断层显像（PET）、单光子发射计算机断层显像（SPECT）技术迅速普及,PCa诊断用放射性药物的研究与开发得到了飞速的发展。新型PCa诊断用放射性药物的开发以靶向标记前列腺特异性膜抗原（prostate-specific membrane antigens,PSMA）的药物为主要方向,包括特异性抗体和小分子量抑制剂等。同时也对前列腺癌相关的其他靶点进行了积极地探索,在临床实践中取得了不错的进展。本文就近年来针对前列腺癌特异性分子靶点放射性显像剂的研究进展做一评述。     

ECT在骨肿瘤、骨转移癌的诊断价值(附154例临床分析)

本文就154例恶性肿瘤病人应用发射计算机断层(ECT)全身骨显像进行分析.显像异常,结合病史,体征和实验室检查诊断为骨转移者106例,占68.8%;其中51例与 X 线检查对照,骨显像阳性而 X 线检查阴性的15例(29.4%)。本文对恶性肿瘤骨转移的发生率、显像特点及诊疗价值进行分析,认为 ECT 骨显像可比 X 线检查早发现骨转移病灶。     

电子发射计算机断层显像与CT技术诊断大血管炎二例

以发热起病并作为主要表现的系统性血管炎是不明原因发热患者的病因之一.通过2例不明原因发热患者的诊治经验,提示正电子发射计算机断层显像与CT技术（PET/CT）对于大血管炎的早期诊断具有重要意义.     

正电子发射计算机断层显像在脑转移瘤诊断中的应用

正电子发射计算机断层显像在脑转移瘤诊断中的应用赵军孙启银王明芳孙爱君李家敏王昌青隋邦森自ＤｉＣｈｉｒｏ［１］应用１８Ｆ－脱氧葡萄糖（ＦＤＧ）正电子发射计算机断层显像（ＰＥＴ）评价脑肿瘤以来，目前国外已将ＦＤＧＰＥＴ显像用于肺癌、乳腺癌、结直肠癌、黑色...     

非侵入性心脏成像技术在冠状动脉疾病诊断中的应用进展

冠状动脉疾病(CAD)是全球发病率和死亡率最高的疾病。一直以来,侵入性冠状动脉造影是其诊断的金标准。但近年各种非侵入性心脏成像技术已被越来越多地应用于CAD的诊断,如负荷超声心动图、单光子发射计算机断层显像、正电子发射计算机断层显像、冠状动脉CT血管造影和心血管磁共振成像等。这些成像技术除了具备诊断价值外,还有助于指导疾病的治疗,且在敏感性和特异性不同。未来,应继续深入研究非侵入性心脏成像技术,以充分发挥其在判断患者预后及降低心血管疾病风险方面的作用。     

帕金森病患者脑多巴胺转运体SPECT功能显像研究进展

单光子发射计算机断层显像(single photon emission computed tomography,SPECT)利用特异放射性核素与人脑多巴胺神经元突触前膜脑多巴胺转运体(DAT)的高度亲和性,可进行帕金森病(PD)患者脑DAT显像,目前已广泛应用于PD患者的临床实践.大量研究表明,SPECT对于PD患者的早期诊断、鉴别诊断、病情监测、疗效评价及预后具有重要意义.本文对PD患者脑DAT SPECT显像的图像分析及临床应用研究进展作一综述.     

Single-photon emission computed tomography (SPECT). Applications and potential

Single-photon emission computed tomography has received increasing attention as radiopharmaceuticals that reflect perfusion, metabolism, and receptor and cellular function have become widely available. Perfusion single-photon emission computed tomography of the brain provides functional information useful for the diagnosis and management of stroke, dementia, and epilepsy. Single-photon emission computed tomography has been applied to myocardial, skeletal, hepatic, and tumor scintigraphy, resulting in increased diagnostic accuracy over planar imaging because background activity and overlapping tissues interfere far less with activity from the target structure when tomographic techniques are used. Single-photon emission computed tomography is substantially less expensive and far more accessible than positron emission tomography and will become an increasingly attractive alternative for transferring the positron emission tomography technology to routine clinical use. In addition, single-photon emission computed tomography has unique applications that are increasingly finding their way into the routine practice of clinical nuclear medicine.     

~(18)F-氟脱氧葡萄糖PET评价放化疗疗效的常见影响因素分析

~(18)F-氟脱氧葡萄糖正电子发射计算机体层扫描或者正电子发射计算机体层扫描/电子算机X线体层显像摄影术作为一种功能与代谢显像的集合体,能准确反应肿瘤治疗后的疗效,已广泛用于临床。但随着临床应用的深入,人们发现有不少影响结果分析的因素,尤其是肿瘤患者在经过放化疗后,由于存在炎性反应,显像时间的选择对结果的评价具有重要的影响。放化疗后早期准确区分治疗的疗效对于下一步的治疗决策和开展个体化治疗具有重要意义。现就这些因素加以综述,以提高临床在运用PET评价肿瘤放化疗疗效的准确性。     

Neuroprotective Effect of Shenfu Injection (参附注射液) Following Cardiac Arrest in Pig Correlates with Improved Mitochondrial Function and Cerebral Glucose Uptake

Objective：To test whether Shenfu Injection（参附注射液,SFI）might attenuate the impact of cerebral energy dysfunction after resuscitation in a pig model of cardiac arrest（CA）.Methods：Thirty-four Wuzhishan miniature inbred pigs were randomly divided into three groups：the SFI group（n=12）,the saline group（SA group,n=12）,and the sham-operated group（sham group,n=10）.Following successful return of spontaneous circulation（ROSC）from 8-min untreated ventricular fibrillation,animals received a continuous infusion of either SFI（0.2 mL/min）or saline for 6 h.Cerebral performance category score was evaluated at 24and 48 h after ROSC,followed by positron emission tomography and computed tomography scans of cerebral glucose uptake.Surviving pigs were euthanized 48 h after ROSC,and the brains were removed for detecting mitochondrial function.Results：Compared with the SA group,SFI treatment produced a better neurologic outcome48 h after ROSC（P〈0.05）.However,there was no significant difference of survival rate between the SA and SFI groups（83.3%vs.81.8%,P〉0.05）.After ROSC,the SA group showed a decrease in the maximum standardized uptake value of different regions in the brain tissue,where SFI treatment can ameliorate these decreases（P〈0.01or P〈0.05）.Improved mitochondrial respiratory properties and higher mitochondrial membrane potential were also found following SFI treatment compared with the SA group at 48 h after ROSC（P〈0.05 or P〈0.01）.Conclusion：SFI treatment after resuscitation has significant neuroprotective effects against disruption of cerebral energy metabolism from CA by improving glucose uptake and by normalizing mitochondrial function.     

Primary pulmonary artery chondrosarcoma: the use of different imaging modalities

Fewer than 300 patients with primary pulmonary artery sarcoma have been reported since 1923,when it was first described by Mandelstamm.1 The diagnosis of pulmonary artery sarcoma is difficult,and misdiagnosis as chronic pulmonary embolism often occurs.Herein,we reported a case of primary pulmonary artery chondrosarcoma.So far as we know,this patient served as the first case ever reported to receive computed tomography pulmonary angiography （CTPA）,gadolinium enhanced magnetic resonance imaging （MRI）,and positron emission tomography/computed tomography （PET/CT） before surgery.By these means,the utility of different imaging modalities for pulmonary artery sarcoma was well demonstrated.Keywords：primary pulmonary artery chondrosarcoma; computed tomography pulmonary angiography;magnetic resonance imaging; positron emission tomography     

SPECT局部脑血流灌注断层显像在神经系统疾病中的应用

本文对６例正常人和８６例中枢神经系统疾病进行了脑ＳＰＥＣＴ血流灌注断层显像，并与脑ＣＴ检查进行了对比。采用半定量分析方法，对脑血管疾病进行了较准确的诊断，结果表明，对短暂性脑缺血发作、痴呆的诊断和鉴别诊断有重要意义。     

活体核素示踪神经受体研究进展

受体研究在脑功能研究中占据重要地位,其中核医学神经受体显像能对活体脑内受体的分布、密度以及生理病理条件下不同活动状态等进行可视化研究已成为当今热门的研究课题,其方法学上的应用与研究成果促进了脑科学的发展与进步.     

Usefulness of concomitant nitrate administration for the enhancement of viability detection with myocardial perfusion imaging

Myocardial viability assessment is crucial in the evaluation of patients who had prior myocardial infarction for revascularisation procedures. Conventional methods include nuclear myocardial perfusion imaging, dobutamine stress echocardiography and positron emission tomography. Utility of nitrate in assessment of viability was assessed. Twenty-five patients with prior myocardial infarction underwent 99mTc-sestamibi single photon emission computed tomography protocol of stress, rest and post 5 mg sublingual isorbide dinitrate. The mean age of the patients was 51.28 years. Eight (32%) had reduction in perfusion defect and increased tracer uptake following nitrate administration. It is concluded that addition of nitrate adds to utility of conventional perfusion imaging in the assessment of myocardial viability.     

轻度认知损害的神经影像学研究进展

轻度认知损害是新近提出的痴呆前临床综合征,临床上表现为记忆和其他认知域功能下降,在影像学方面表现类似阿尔茨海默病的大脑结构形态以及脑组织生化、代谢改变。近年来轻度认知损害的神经影像学研究众多,主要包括结构磁共振成像、功能磁共振、正电子发射断层显像、单光子发射计算机断层显像。     

系统评价PET在肺癌分型及诊断中的应用

1文献来源 Ung YC,Maziak DE,Vanderveen JA．et al．18Fluorodeoxyglucose positron emission tomography in the diagnosis and staging of lung cancer：A systematic review[J]．J Natl Cancer Inst,2007,99（23）：1753-1767．2证据水平1ao     

脑磁图、视频脑电图在癫术前评估中的应用

目的 探讨脑磁图(magnetoencephalography,MEG)、视频脑电图(video-electroencephalography,V-EEG)、单光子发射计算断层扫描(single photon emission computed tomography,SPECT)、正电子发射断层扫描(positron emission tomography,PET)技术术前定位癫(癎)致(癎)灶的准确性.方法 癫(癎)手术患者73例,术前均采用MEG、V-EEG行致(癎)灶定位,其中52例加行V-EEG+蝶骨电极记录,19例加行PET致(癎)灶定位,48例加行SPECT定位.结果 通过与术中皮层脑电图(ECoG)结果的比较,73例癫(癎)患者中术前MEG定位与术中ECoG致(癎)灶定位符合者66例,准确率90.41%;V-EEG定位与术中ECoG致(癎)灶定位符合者44例,准确率60.27%;52例癫(癎)行V-EEG+蝶骨电极描记,与术中ECoG致(癎)灶定位符合者34例,准确率为65.39%;19例行PET检查,与术中ECoG致(癎)灶定位符合者10例,准确率为52.63%;48例行SPECT检查,与术中ECoG致(癎)灶定位符合者23例,准确率为47.92%.MEG分别与V-EEG、V-EEG+蝶骨电极、PET、SPECT比较差异有统计学意义(P＜0.05).14例海马硬化所致颞叶癫(癎)患者,术前MEG定位与术中ECoG致(癎)灶定位符合者8例,准确率57.14%,V-EEG+蝶骨电极定位与术中ECoG致(癎)灶定位符合者12例,准确率85.71%,V-EEG+蝶骨电极与MEG比较差异有统计学意义(P＜0.05).结论 MEG可提高术前致(癎)灶定位的准确率;对于颞叶内侧深部癫(癎)而言,术前定位以V-EEG+蝶骨电极记录更准确.