18F-FDG PET/CT监测肝癌治疗后复发转移的价值

目的 评价18F-脱氧葡萄糖(FDG)PET/CT显像在监测手术切除或肝动脉化疗栓塞(TACE)治疗原发性肝癌后复发残留或转移的价值.方法 24例原发性肝癌患者(肝部分切除术6例、肝移植术3例、TACE治疗15例)治疗后4周～2年行18F-FDG PET/CT检查,结果 经病理,DSA或随访证实.结果 24例患者中21例患者经活检、DSA或随访证实为复发或转移.1 9例可见18F-FDG放射性摄取增高灶,其中5例肝部分切除术后患者,2例复发,3例肝内转移;2例肝移植术后患者1例双侧肾上腺转移,1例肝转移、肺转移和骨转移;12例TACE治疗后患者肿瘤残留.2例TACE治疗后患者肿瘤内放射性分布与邻近非肿瘤的肝实质相近,未见异常增高灶,DSA证实肿瘤残留.3例未见异常放射性摄取增高灶,随访未见复发或转移.肝内转移灶的SUVma×3.4～12.5.18F-FDG PET/CT诊断肝癌治疗后复发转移的灵敏度为90.5%、特异性为100%、准确率为91.7%.结论 18F-FDG PET/CT显像可有效监测肝癌治疗后疗效,并指导进一步治疗.     

不同手术方案在严重肝外伤患者中的疗效和安全性研究

目的：探讨不同手术方案在严重肝外伤患者中的疗效和安全性。方法选取2005年1月至2013年12月严重肝外伤患者96例进行回顾性分析,其中以2005年1月至2007年12月的35例为A组,2008年1月至2010年12月的29例为B组,2011年1月至2013年12月的32例为C组。A组采用肝裂伤创面致密缝合手术治疗,B组采用损伤控制性手术治疗,C组采用选择性肝动脉结扎、肝裂伤面缝合加肝周填塞手术治疗,对不同手术方案在严重肝外伤患者中的疗效和安全性进行研究。结果 C组在手术时间、手术次数和住院时间上相对A、B组明显较少（P＜0．05）;术中出血量、术后3 d 腹腔引流量相对A、B组明显较少（P＜0．05）;C组治愈率相对A、B组明显较高（P＜0．05）,并发症发生率和病死率相对A、B组明显较低（P＜0．05）。三组肝功能表现均良好。结论采取选择性肝动脉结扎加肝周填塞的手术方案治疗严重肝外伤患者时最有效的、也是最安全的,不仅可以减少治疗手术术中、术后出血量,还可以缩短手术与住院的时间,最终提高了对患者的治愈率,避免了并发症的发生,节省了患者的花费,节省了医疗资源,该手术方案值得在临床进一步推广使用。     

18F-FDG PET/CT显像监测胃癌术后复发转移的价值

Objective PET with 18F-fluorodeoxyglucose (FDG) has been used to beth detect and stage a variety of malignancies. The aim of this retrospective study was to evaluate the clinical value of 18F-FDG PET/CT for recurrence and metastasis in gastric carcinoma patients after total gastrectomy. Methods A total of 45 gastric carcinoma patients who underwent total gastrectomy were included. PET/CT scans were obtained for restaging. The " gold standard" of 18F-FDG PET/CT diagnostic accuracy was based on either histopathology or clinical follow-up. By using the t-test from SPSS 11.5, the cut-off of maximum standard-ized uptake values (SUVmax) from 18F-FDG to differentiate benign from malignant lesion at stomach were determined and calculated. Results (1) Of the 45 patients, 22 were suspicion recurrent lesion at stomach. Of the 22 patients, 12 were confirmed to have recurrent lesions. The diagnostic accuracy were 100.0% (12/ 12) for sensitivity, 70.0% (7/10) for specificity, and 86.4% (19/22) for accuracy, respectively. A higher SUVmax in malignant than benign lesion was noted (6.27 ± 3.42 vs 3.92 ± 2.24), though not reached to the significance (t = 1. 862, P > 0.05). (2) For extra-gastric lesion detection, the sensitivity, specificity, and accuracy for region lymph nodes were 78.9% (15/19), 92.3% (24/26), and 86.7% (39/ 45), for peritoneal spreading were 6/9, 97.2% (35/36), 91. 1% (41/45), and for distant sites were 86.7%(13/15), 93.3% (28/30), 91.1% (41/45). (3) False positive were found in eight sites. All were either inflammatory or physiological uptake at intestine. False negative were found in nine sites. Either due to small in size (less than 1.0 cm in diameter), well differentiation of the tumor cell or with a nature of signet ring. Conclusion 18F-FDG PET/CT had a potential to detect local, regional, and distant metastasis in gastric cancer.     

肺炎型细支气管肺泡癌CT和PET影像特征及其诊断价值

目的探讨肺炎型细支气管肺泡癌(PTBAC)多层螺旋CT(MSCT)和正电子发射体层成像(PET)影像学特征及其诊断价值。资料与方法回顾分析18例经病理证实的PTBAC的CT特点,其中9例行PET检查,对CT诊断正确率及其与PET结合后诊断正确率进行分析。结果18例肺实变密度均低于同层肌肉密度。支气管充气征或蜂房征9例,实变内血管造影征2例,混合阴影6例,边缘磨玻璃征1例。9例肺泡癌氟代脱氧葡萄糖(FDG)的摄取特点:单纯肺实变中斑片状高摄取3例,结节状高摄取4例,肺实变中有片状高摄取并纵隔淋巴结高浓聚1例,肺实变、肺部分结节及纵隔淋巴结均有高摄取1例。CT误诊2例,9例患者PET诊断中与CT相结合无一例误诊。结论PTBAC CT表现及对FDG的摄取特点多样,二者结合可以大大提高诊断率,减少误诊。     

^18F-FDG PET／CT在肝脏肿瘤介入治疗后的临床意义

目的：评价^18F-脱氧葡萄糖（FDG）PET／CT显像在肝动脉化疗栓塞（TACE）术后疗效的价值。方法：22例肝肿瘤患者（男19例,女3例,年龄31—65岁,平均52岁）TACE术后4周～1．5年行^18F-FDGPET／CT检查,22例均经病理或随访证实。结果：22例患者40个肝内病灶。①平扫CT：碘油全瘤均匀致密型沉积11个病灶,碘油不均匀型沉积29个病灶;②^18F-FDGP田显像：放射性分布缺损或稀疏8个病灶,放射性浓聚20个病灶,放射性分布与邻近正常肝实质相近12个病灶（2个病灶SUVratio〈0．6,10个病灶SUVratio〉0．6）;③^18F--FDGPET／CT显像：全瘤均匀致密碘油沉积并放射性分布缺损或稀疏8个病灶,全瘤均匀致密碘油沉积并瘤灶放射性分布与邻近肝实质相近3个病灶（2个病灶SU Vratio〈0．6,1个病灶SUVratio〉0．6）,碘油不均匀沉积并放射性浓聚20个病灶,碘油不均匀沉积并瘤灶放射性分布与邻近正常肝实质相近9个病灶,SUVratio〉0．6。放射性分布缺损或稀疏的8个病灶和SUVratio〈0．6的2个病灶,随访未见复发;其余30个病灶经随访证实复发或残留。^18F-FDGPET／CT显像发现全部肝外病灶。结论：^18F-FDGPET／CT显像可有效监测疗效,并指导进一步治疗。     

18F-FDG PET/CT显像监测胃癌术后复发转移的价值

Objective PET with 18F-fluorodeoxyglucose (FDG) has been used to beth detect and stage a variety of malignancies. The aim of this retrospective study was to evaluate the clinical value of 18F-FDG PET/CT for recurrence and metastasis in gastric carcinoma patients after total gastrectomy. Methods A total of 45 gastric carcinoma patients who underwent total gastrectomy were included. PET/CT scans were obtained for restaging. The " gold standard" of 18F-FDG PET/CT diagnostic accuracy was based on either histopathology or clinical follow-up. By using the t-test from SPSS 11.5, the cut-off of maximum standard-ized uptake values (SUVmax) from 18F-FDG to differentiate benign from malignant lesion at stomach were determined and calculated. Results (1) Of the 45 patients, 22 were suspicion recurrent lesion at stomach. Of the 22 patients, 12 were confirmed to have recurrent lesions. The diagnostic accuracy were 100.0% (12/ 12) for sensitivity, 70.0% (7/10) for specificity, and 86.4% (19/22) for accuracy, respectively. A higher SUVmax in malignant than benign lesion was noted (6.27 ± 3.42 vs 3.92 ± 2.24), though not reached to the significance (t = 1. 862, P > 0.05). (2) For extra-gastric lesion detection, the sensitivity, specificity, and accuracy for region lymph nodes were 78.9% (15/19), 92.3% (24/26), and 86.7% (39/ 45), for peritoneal spreading were 6/9, 97.2% (35/36), 91. 1% (41/45), and for distant sites were 86.7%(13/15), 93.3% (28/30), 91.1% (41/45). (3) False positive were found in eight sites. All were either inflammatory or physiological uptake at intestine. False negative were found in nine sites. Either due to small in size (less than 1.0 cm in diameter), well differentiation of the tumor cell or with a nature of signet ring. Conclusion 18F-FDG PET/CT had a potential to detect local, regional, and distant metastasis in gastric cancer.     

中西医结合治疗脑出血及血清微量元素相关性的临床观察

脑出血具有高死亡率、高致残率的特点 ,其颅内血肿及继发的脑水肿所形成的占位效应与预后密切相关。脑局部血流量下降、自由基、凝血酶等血肿溶出物参与了脑水肿的形成 ,体内 Zn、Fe等微量元素水平的下降在其中可能起了一定的作用。我们应用补气活血化瘀中药治疗脑出血已取得初步疗效 ,为进一步观察临床疗效与微量元素的关系 ,我们进行了下列研究。1　临床资料 :选择 1997年 7月～ 2 0 0 0年 12月住院的脑出血患者 6 0例 ,符合全国第 4届脑血管病学术会议制定的诊断标准并经颅脑 CT扫描证实为脑出血者 (年龄超过 75岁 ,合并心、肝、肾等严…     

辛伐他汀治疗心律失常临床疗效分析

目的观察辛伐他汀治疗心律失常的临床疗效及意义。方法将江门市人民医院2008年3月～2012年3月收治的60例心律失常患者随机分为观察组与对照组,各30例。对照组使用美托洛尔进行治疗,12.5～25.0mg/次,2次/d,观察组在此基础上使用辛伐他汀进行治疗,每晚口服20mg。两组患者连续治疗3个月为1个疗程,对比两组患者临床治疗效果。结果观察组患者治疗总有效率(23/30,76.67%)明显高于对照组患者(14/30,46.67%),室性、房性期前收缩次数(1507±1042,1124±428)明显少于对照组(2943±2147,1927±1046),差异有统计学意义(P<0.05);两组患者均未发现严重不良反应,且不良反应率差异无统计学意义(P>0.05)。结论辛伐他汀能够有效改善心律失常患者临床症状,比美托洛尔有更为理想的临床疗效。     

CYP2E1、GSTT1基因多态性与非霍奇金淋巴瘤易感性的关系

 目的探讨细胞色素P450酶2E1(CYP2E1)和谷胱甘肽硫转移酶(GSTT1)基因多态性与非霍奇金淋巴瘤（NHL）易感性的关系。方法分别采用聚合酶链反应-限制性片段长度多态性技术和聚合酶链反应技术对254例NHL患者和254例健康对照者CYP2E1和GSTT1基因多态性进行分析。结果NHL组和对照组CYP2E1基因多态性分布无明显差异(P>0.05);NHL组GSTT1基因缺失型频率明显高于对照组（48.0% vs 37.8%,P<0.05）。对NHL亚型分析显示,与GSTT1野生型者相比,携带GSTT1缺失型者发生弥漫大B细胞性淋巴瘤和滤泡性淋巴瘤风险分别为1.78倍（95%CI：1.12～2.82,P=0.02）和1.69倍（95%CI：1.03～2.77,P=0.04）。基因多态联合作用分析显示,CYP2E1野生型伴GSTT1缺失型者发生NHL的风险为1.83倍(95%CI：1.14～2.95,P=0.01)。结论GSTT1基因多态性可能是NHL的独立易感因素,GSTT1缺失型与CYP2E1野生型联合作用可进一步增加NHL的发病风险。     

肺癌性淋巴管炎的CT征象

目的 探讨肺癌性淋巴管炎的CT表现.方法 回顾性分析35例经病理证实的肺癌性淋巴管炎的CT及HRCT表现.结果 肺癌性淋巴管炎多见于右肺,35例均可见肺纹理增多增粗,为局限性非对称性分布,呈结节状或锯齿状改变;胸膜增厚26例,好发于叶间胸膜,病变程度轻,范围广;小叶间隔增厚25例;肺门和(或)纵隔淋巴结肿大25例;肺内小结节13例.结论 肺癌性淋巴管炎的CT表现具有较高的诊断价值,小叶间隔结节状增厚是PLC较为特征的CT表现.