冷诱导心肌SPECT与UCG对诊断系统性硬皮病心肌损害的对比研究

目的：探讨SPECT心肌显像和超声心动图（UCG）冷诱导对诊断系统性硬皮病（SSC）心肌损害的临床价值。方法：应用99mTc－MIBI对23例SSC病人进行SPECT心肌显像冷诱导,并同期进行UCG冷诱导检测。结果：①14例病人（6O．9%）至少有一处心肌放射性分布异常,4例病人（17.4%）于UGG示局部室壁运动低下,P＜0．05.②SPECT阳性率在雷诺现象(RP)组和无RP组之间无显著性差异（0．5＞P＞0．25）。③SPECT异常组病人的左室射血分数、每搏输出量、心输出量在冷诱导即时较试验前显著降低（P＜0．05）,且与SPECT正常组比较也有显著性降低（P＜0．05）。结论：心肌SPECT冷试验可早期检出SSC病人的心肌损害,对这类病人的治疗效果和预后判断可以提供可靠的检测方法。     

平衡法核素心室造影对慢性阻塞性肺病右心室功能测定的临床研究

平衡法核素心室造影对慢性阻塞性肺病右心室功能测定的临床研究中山医科大学孙逸仙纪念医院核医学科（５１０１２０）梁九根肺心病右心室功能的研究正在重新引起人们的重视．平衡法核素心室造影简称“平衡法”是常用的研究和诊断方法。用于左心室功能测定．其准确性和重复...     

长期强的松治疗对绝经前SLE患者骨密度的影响

目的探讨长期强的松治疗对绝经前系统性红斑狼疮(SLE)患者骨密度的影响。方法142例SLE患者均为绝经前女性,年龄12~40岁(平均29·5岁)。正常对照78例女性,年龄15~39岁(平均28·9岁),排除影响骨代谢的各种急慢性疾病。应用HOLOGIC QDR4500双能量X线骨密度仪检测腰椎和股骨近端的骨密度值,测定血清雌二醇、雌三醇。结果①绝经前SLE患者骨量减少、骨质疏松发生率分别为42·96%、14·79%,均显著高于正常对照组(P值均<0·01);②骨质疏松和骨量减少患者服用强的松的时间、总剂量均显著高于骨量正常患者(P值均<0·01);③绝经前患者雌二醇与正常对照无显著差异,而雌三醇明显升高(P<0·01)。结论①长期服用强的松的绝经前SLE患者骨量减少和骨质疏松发生率均显著增高;②SLE患者骨量减少和骨质疏松的发生与使用强的松的时间和总剂量有关;③绝经前SLE患者雌三醇产生增多,可能对骨密度具有保护作用。     

25例肝癌术后患者18F-FDG SPECT/CT同机融合显像分析

目的:探讨^18F-FDG SPECT／CT同机融合显像在探测原发性肝癌术后疑复发中的价值。方法:对25例肝癌术后疑复发患者进行^18F-FDGSPECT／CT符合线路显像，经迭代法处理和重建，获得经衰减校正后的断层图像和融合图像，以目测双盲进行诊断分析，并与CT(MR)及手术病理检查、临床随访作出的最后诊断结果进行对比。结果:同机融合显像和CT(MR)对肝癌术后复发诊断的灵敏度、特异性及准确性分别为94．7％、100％、96％和78．9％、66．7％、76％。结论:FDG显像对肝癌术后复发及转移的定性诊断具有较高的灵敏度和准确性；SPECT／CT同机融合显像能准确定位复发病灶的解剖和功能信息。     

131I-MIBG全身显像发现功能性颈静脉球瘤1例

病例,男,36岁,因声嘶,多汗,血压升高3月入院,病史：3月前无诱因出现声嘶,伴多汗,头晕,头胀,心悸,情绪不稳,易冲动,食欲增加（夜间尤甚）,思考及精神紧张时出汗尤为增多.无明显咽痛及饮水呛咳,吞咽困难,胸闷.患者可感觉到右侧颈部血管搏动,放射至面前,测量血压升高,既往血压正常.     

核素示踪乳腺癌前哨淋巴结活检的准确性与可行性

目的:探讨核素示踪乳腺癌前哨淋巴结(SLN)活检的准确性和可行性。方法:1999年4月-2001年10月期间,应用原发肿瘤周围皮下注射放射性核素示踪技术(99mTC-标记硫化锑胶体或99mTC-标记硫胶体),对79例早期乳腺癌患者进行前哨淋巴结活检(SLND),随后,行包括腋窝淋巴结清扫(ALND)在内的根治性手术。分析评估两种核素淋巴示踪和SLND的准确性及其影响因素。结果:75例行术前淋巴闪烁照相,淋巴结显像67例(89.33%,67/75);术中应用γ探测仪成功证实SLNs 68例,成功率为86.08%(68/79),SLN预测腋窝淋巴结状态的准确性为95.59%(65/68),假阴性率为3/36(8.33%);前28例患者有9例不能证实SLN,3例假阴性;而后51例只有2例不能证实SLN,没有假阴性。两者差异有显著性(P<0.05)。结论:本研究结果表明,99mTC-标记硫胶体作为示踪剂,手术当天(术前4-6小时)乳腺肿瘤上方皮下注药进行SLND,可以准确预测早期乳腺癌腋窝淋巴结状态。     

骨质疏松症筛选和治疗的成本-效果分析

骨质疏松症已成为我国严重的公共健康问题之一 .新的诊断和治疗方法可以减少骨质疏松性骨折发生率 ,但医疗费用也大幅增加 .因此有必要对现有各种骨质疏松症诊疗措施进行科学的成本 -效果分析 ,制定合理的防治策略 .本文综述了成本 -效果分析的主要内容及相关文献 ,并对其在中国应用的必要性进行了分析 .     

Contribution of lymphoscintigraphy by SPECT/CT to preoperative sentinel lymph node localization in oral squamous cell carcinoma

Objective:Sentinel lymph node biopsy(SLNB) is a minimally invasive method that helps to evaluate the status of the lymph node region of a primary tumor.A precise preoperative localization of the sentinel lymph node (SLN) may be helpful for surgical planning.Preoperative lymphoscintigraphy (LS) is important if the cancer is located in regions of anatomical complexity.But it fails to elucidate the specific lymphatic drainage and the anatomical relationship of SLNs.In the present study the benefit of LS by SPECT/CT to the preoperative localization of SLNs was evaluated.Methods:21 clinically nodes-negative patients with T1 or T2-staged oral squamous cell carcinoma were enrolled.LS were performed by submucosa injection of 37-74MB of 99mTc-DX at 4 to 6 points around the tumor followed by immediate dynamic,delay static imaging and skin marking of the SLN.Then the patients underwent SPECT/CT scintigraphy.Planar and fusion images were interpreted separately and compared.Intraoperative dye method was carried out.Results:In all patients,fusion images confirmed the localization obtained by planar images and skin marking.Moreover,in 9 of the 21 patients,the fusion images improved or corrected the preoperative localization of the SLNs in planar imaging:7 nodes that had been identified only on the fused images were located in basins other than or in addition to the basins identified on th planar images,and 1 node that was located closed to the injection sites was hidden by its scattered radiation signals in the planar images,and erroneous diagnosis occurred in 1 node resulted from the scattering.In addition,multiple draining basins were identified on the fusion images in 6 of the 21 patients,however,planar images only in 1 of the 21.Conclusion:Our results showed the additional value of SPECT/CT fusion imaging in revealing SLNs compared to planar imaging and sharpen the localization of the SLN that were of clinical relevance to SLNB in patients with oral squamous cell carcinoma.And by fusion images topographic landmarks could b     

心血池显像评价硝苯吡啶对COPD右心室功能的临床研究

近年来，国内外学者对血管扩张剂硝苯吡啶（Nifedipine，NIF）用于治疗COPD病人的缺氧性肺血管收缩研究较多，然结果不一[1.2]．NIF对COPD病人右心室功能的作用研究较少．本文对53例COPD病人和15例正常人进行了核素门控心血地显像，观察一次性舌下含服NIF对其右心室射血分数（RVEF）和舒缩协调性（RVSDP）的影响，并与血流动力学检查结果对比，探讨NIF对COPD病人右心室功能作用及其机制．材料与方法一、研究对象：肺气肿组20例，男16例，女4例，平均年龄％±11岁（32～77岁），胸片和体征符合阻塞性肺气肿；肺心病心功能代…