四例原发性肾上腺淋巴瘤的影像表现

据尸检资料,约25%非霍奇金淋巴瘤(non-Hodgkin's lyrnphoma,NHL)可以出现肾上腺受累,为继发性肾上腺淋巴瘤[1];而原发性肾上腺淋巴瘤(primary adrenal lymphoma,PAL)却很少见,目前为止全世界共报道80余例[2] .     

四例原发性肾上腺淋巴瘤的影像表现

据尸检资料,约25%非霍奇金淋巴瘤(non-Hodgkin's lyrnphoma,NHL)可以出现肾上腺受累,为继发性肾上腺淋巴瘤[1];而原发性肾上腺淋巴瘤(primary adrenal lymphoma,PAL)却很少见,目前为止全世界共报道80余例[2] .     

11C-胆碱和18F-FDG PET反映兔VX2肺肿瘤增殖活性的对比研究

objective Tumor proliferative activity has been recognized as an indicator of malignant degree in lung cancer and related to prognosis.The purpose of this study was to evaluate the feasibility of assossing proliferative activity with 11C-choline and 18F-fluorodeoxyglucose(FDG)PET on a rabbit beating lung VX2 tumor model.Methoils About 0.5 ml of viable VX2 tumor cell suspension was slowly injected into the right lungs of 54 New Zealand white rabbits through a transthoracical needle insertion.11C-choline and18F-FDG PET scan were performed 10-11 d after tumor implantation.One ear vein was cannulated for administration of the tracem.11C-choline PET scan(with Discovery LS PET/CT scanner,GE)was performed 5 min after intravenously injection of 37 MBq11C-choline.Then 18.7 MBq18F-FDG was infused at 60 min after11C-choline administration and18F-FDG PET scan was performed at 60 min after18F-FDG administration.The maximal standardized uptake value of tumor was calculated.The animals were euthanized after examination.Histochemical stain with proliferating cell nuclear antigen(PCCNA)was performed and PCNA index was obtained to assess tumor prolireration.The difference of11C-choline and18F-FDG was analvzed using paired student t-test.The correlation of 11C-choline 18F-FDG and tumor cell density and PCNA index was analyzed using Pearson Iinear regression.Results Of the 54 rabbits.36 had a solitary pulmonary tumor.The rate of successful generation of a solitary VX2 tumor was 66.7%(36/54).Only 33 rabbits underwent both 11C-choline and 18F-FDG PET,and enrolled in this study.The mean cellular density was (547.36±64.78) cells/field and the mean PCNA index was(42.34±15.26)%.18F-FDG was hisher than 11C-choline(5.70±3.45 vs 4.02±3.07,t=-3.188,P=0.003).11C-choline significantly and positively correlated with PCNA index(r=0.786,P＜0.05).However,there was no significant correlation between 11C-choline and tumor cellular density(r=-0.176,P=0.327).18F-FDG significantly and positively correlated to PCNA index(r=0.531.P=0.001).There was no significant correlation between 18F-FDG and cellular density(r=-0.105.P=0.561).Conclusions In a rabbit bearing lung VX2 tumor model,11C-choline or 18F-FDG uptake correlates with PCNA index.Thus PET scan with these two tracers may reflect tumor proliferative activity.11C-choline PET may be more reliable to evaluate tumor proliferation than 18F-FDG PET.     

18F-NaF PET/CT对初始肺癌患者骨转移诊断的价值

目的:通过与常规99mTc-MDP骨显像(bone seintigraphy,BS)比较,研究18F标记氟化钠PET/CT(18F-NaFPET/CT)时初始肺癌患者骨转移诊断的价值.方法:34例初始诊断的肺癌患者在1周内完成BS和18F-NaF PET/CT检查,分别在患者水平和病变水平对BS和18F-NaF PET/CT的诊断结果按照五点等级评分,进行受试者特征曲线(ROC)分析,ROC曲线下面积反映诊断系统的准确性.骨转移的评价方法包括MRI(34例)、18F-FDG PET/CT(4例)、组织学活检(2例)和临床随访(6例).结果:按患者水平分析,34例患者中的11例(32.3%)发生骨转移.18F-NaFPET/CT诊断真阳性11例(100%),2例不确定诊断,无假阳性和假阴性.BS诊断真阳性6例(55.0%),5例患技者不确定诊断,假阴性3例,假阳性2例.按病变水平分析时,117个病变获得最终诊断,其中转移病变47个,良性病变70个.18F-NaF PET/CT诊断真阳性病变47个,2个病变不能确定(良性).BS诊断真阳性病变24个(51%),真阴性病变48个,不确定诊断9个,假阳性4个,假阴性2个,其余病变被BS忽略.按患者水平和病变水平分析时18F-NaF PET/CT的ROC分析曲线下的面积分别为0.978(BS为0.781,P<0.05)和0.986(BS为0.725,P<0.05).根据18F-NaF PET/CT的结果4例患者(11.7%)治疗方案发生改变.结论:18F-NaFPET/CT是初始肺癌患者骨转移诊断的有效手段,其诊断准确性优于BS.与BS比较18F-NaFPET/CT检查结果对患者的治疗计划产生显著影响.     

18F-FDG PET脑显像SPM分析法在颞叶内侧癫痫术前定位中的价值

目的探讨18F-FDG PET脑显像像素统计参数图（SPM）法在颞叶内侧癫痫术前定位中的价值。方法对17例颞叶内侧癫痫患者行脑18F—FDG PET检查,对其所有PET图像进行感兴趣区（ROI）法及SPM分析法比较。SPM分析法所用健康对照组选自同期于本中心健康查体者20例。结果ROI法对癫痫灶准确定侧率为70．6％,准确定位率为29．4％;SPM法分别为70．6％、47．1％。二者准确定位率比较,P〈0．05。SPM法发现双侧颞叶代谢异常9例（52．9％）,伴额、顶叶皮层代谢异常者12例（70．6％）。结论18F-FDG PET脑显像SPM法是一种简便、客观、有效的颞叶癫痫灶定位方法,且有助于发现脑代谢异常。     

高泌乳素血症中巨泌乳素检测的研究进展

目前公认凝胶过滤色谱法是检测巨泌乳素的金标准，但因检测技术较复杂且费用昂贵，不适合临床筛查，故多种检测方法备受重视，现就多种巨泌乳素检测方法及临床意义研究进展作一综述。     

FDG-PET在分化型甲状腺癌诊断中的应用

^18F-氟脱氧葡萄糖(FDG)-正电子发射型计算机断层(FDG-PET)在分化型甲状腺癌的诊断中有一定的临床价值。研究显示它不仅可用于甲状腺癌原发灶的诊断，而且在肿瘤分期、术后再分期、治疗效果评价和疾病预后评价方面可能具有更大的价值。葡萄糖转运蛋白、己糖激酶活性是影响病灶对FDG摄取的正相关因素，而葡萄糖-6-磷酸酶活性则与药物摄取呈负相关关系。此外，肿瘤灶内炎症细胞的浸润、肿瘤细胞缺血、损伤，以及血清促甲状腺素水平都可能影响病灶对FDG的摄取。     

呼吸运动对PET/CT显像诊断右上腹病灶的影响

目的探讨呼吸运动对PET／CT全身显像诊断右肺底、肝顶病灶的影响。方法回顾分析100例胸部病变患者的^18F-脱氧葡萄糖（FDG）PET／CT显像结果，观察PET、CT及两者融合图像。患者在检查时平静呼吸。观察呼吸运动伪影在不同断面的特点，对右上腹可能出现定位误差的病灶加做常规屏气CT扫描。结果①6例患者因合并胸腔、腹腔积液而未列入统计，其余38．3％（36／94例）的患者PET／CT图像有明显的呼吸运动伪影，矢状面是观察呼吸运动伪影的最佳断面：②呼吸运动致肝顶在矢状面表现为“波浪状”，横断面表现为肝脏边缘模糊，冠状面表现为突入肺底的软组织密度影。③5例患者存在右肺底、肝顶病灶，其定位可能因呼吸运动造成误差。结论呼吸运动伪影是PET／CT显像中常见的现象，对右上腹病灶定位有疑问者应加做常规屏气CT扫描。     

SPM与ROI法用于AD患者18F-FDG PET脑显像

本研究旨在探讨ROI法与统计参数图(SPM)法在阿尔茨海默病(AD)18F-FDG PET脑显像诊断中的价值.