^99mTc-MIBI心肌三维立体显像在心肌梗塞诊断中的应用

对５例正常人，１８例心肌梗塞患者分别进行了ＳＰＥＣＴ心肌断层显像和三维立体显像。结果显示：三维立体显像和对正常人提供近似实际解剖标本的图像；在心肌梗塞显示病灶直观、形象。对心肌表层的梗塞病变，在解剖定位、病变范围及程度估价方面明显优于断层显像；诊断深部病变时应与断层显像结合。     

18F-FDG PET/CT显像在恶性胸膜间皮瘤诊断中的价值

Objective Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the diagno-sis and to staging of MPM and to determine if the mean standardized uptake value (SUVmax) of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 pa-tients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pa-thology were proven by histopathology and clinical follow-up. 18F-FDG PET/CT imaging was performed 1 h af-ter injection of 7.4 MBq/kg 18F-FDG. Patients with MPM confirmed by histopatholagy were divided into two groups: with and without metastasis. PET/CT findings were analyzed to determine if SUVmax of primary tumor correlates with staging and prognosis. Receiver operating characteristic (ROC) curve of SUVmax of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmax between MPM and benign pleural were statistical significant (5.78±1.81 vs 2.72± 2.51, t = 2. 8, P < 0.05). The diagnostic sensitivity, specificity and accuracy of 18F-FDG PET/CT imaging for MPM were 100% (12/12) , 4/5 and 94% (16/17). All 7 cases of bone and lymph node metastases were detected by 18F-FDG PET/CT imaging. Area under the curve (AUC) was 0.80. Conclusions 18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmax in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.     

18F-FDG PET/CT显像在恶性胸膜间皮瘤诊断中的价值

Objective Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the diagno-sis and to staging of MPM and to determine if the mean standardized uptake value (SUVmax) of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 pa-tients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pa-thology were proven by histopathology and clinical follow-up. 18F-FDG PET/CT imaging was performed 1 h af-ter injection of 7.4 MBq/kg 18F-FDG. Patients with MPM confirmed by histopatholagy were divided into two groups: with and without metastasis. PET/CT findings were analyzed to determine if SUVmax of primary tumor correlates with staging and prognosis. Receiver operating characteristic (ROC) curve of SUVmax of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmax between MPM and benign pleural were statistical significant (5.78±1.81 vs 2.72± 2.51, t = 2. 8, P < 0.05). The diagnostic sensitivity, specificity and accuracy of 18F-FDG PET/CT imaging for MPM were 100% (12/12) , 4/5 and 94% (16/17). All 7 cases of bone and lymph node metastases were detected by 18F-FDG PET/CT imaging. Area under the curve (AUC) was 0.80. Conclusions 18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmax in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.     

X线和PET/CT在早期食管癌诊断中的应用

目的:探讨早期食管癌的细微X线征像。方法:回顾性分析16例经手术病理证实的早期食管癌X线表现和其中6例PET/CT征像。结果:16例患者中食管鳞状上皮重度不典型增生1例,鳞癌14例,原位癌1例。食管钡餐造影表现有:①结节样充盈缺损;②扁平样充盈缺损;③粟粒样充盈缺损;④粘膜线增粗。PET/CT检查显示6例患者病灶均显示FDG代谢增高。结论:早期食管癌的钡餐造影检查表现多样,PET/CT对病灶的检出敏感性高,多种检查方法相结合可以提高诊断准确性,同时更准确的进行术前评估。     

^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。     

PET／CT在胸段食管癌诊断与淋巴分期中的应用价值

目的：探讨^18F-脱氧葡萄糖（FDG）正电子发射型计算机断层（PET／CT）在胸段食管癌诊断与淋巴分期中的应用价值。方法：回顾性分析了经PET／CT显像的34例患者资料。患者在显像后2-3周内行手术治疗,手术时对颈、胸、上腹部三野淋巴结清扫,所有淋巴结送病理学检查。病理学证实34例患者均为鳞状细胞癌。胸上段食管癌4例,中段食管癌16例,下段食管癌14例。结果：34例患者食管肿瘤长度为1-8．3cm（4．5±1．6cm）。PET／CT均显示FIX;代谢增高,SUV最高值范围4．3-23．2（10．84±5．32）,平均SUV值3。16．7（8．92±4．09）。作为对照,分析36例PET／CT健康查体人员,发现有2例食管平滑肌瘤显示假阳性。PET／CT诊断食管癌的准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为：97．1％、100％、94．4％、94．4％和100％。34例患者中有20例发生不同程度的淋巴结转移,PET／CT显示转移淋巴结高FDG代谢,SUV最高值为2．7-13．9（7．28±2．75）,SUV平均值为2．3-10．7（5．63±2．49）;其中有6例患者转移到腹腔内,6例腹腔淋巴结转移患者中有5例为下段食管癌,1例为中段食管癌。4例转移至颈部淋巴结,为中上段食管癌转移。手术清除淋巴结163枚,其中病理示转移淋巴结52枚,PET／CT显像结果与病理结果比较,有7枚小淋巴结未能显示,排除了3枚直径大于1cm的可疑转移淋巴结,有13个良性淋巴结显示假阳性,对淋巴结诊断的准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为：87．7％、86．2％、88．2％、77．6％和85．2％。结论：PET／CT对食管癌原发灶的诊断有很高的价值,对淋巴结分期有较高的灵敏度与特异性。     

血清IgE RIA在过敏患者术前使用苯海拉明抗过敏反应中的意义

已经征实,免疫过敏(依赖IgE)机制可以使肥大细胞和嗜碱性粒细胞释放组胺。一些物理刺激也能诱发组胺产生。为防止有明显过敏史患者在术中出现过敏反应,我们对80例有明显过敏史患者进行观察,其中42例术前服用苯海拉明,38例未服用该药。同时,我们对患者进行IgE浓度检测,并与26例健康人比较,结果报告如下。 对象和方法 一、对象:80例(男45例,女35例),有过敏史患者均来自本院手术室。年龄11～63岁。42冽术前服用苯海拉明40mg,38例未服用该药。正常对照组来自健康查体人员,均无过敏史。晨起8小时采空腹静脉血,离心取血清,存于20℃冰中一次性测量。     

SLE患者血清SF,尿Alb RIA的临床意义

木文对44例全身性红斑狼疮(简称SLE)患者的血清铁蛋白(SF)、尿白蛋白(Alb)进行了测定,观察其活动期与非活动期,治疗前及治疗后的变化,并与106例正常人进行对照。 材料和方法 一、临床资料:44例SLE患者均来自皮肤科和内一科门诊,符合美同风湿病学会1982年修订的分类标准。皆为女性,年龄14～52岁,平均29岁。病期3个月～25年,平均病期3年,其中临床活动期35例,控制及稳定期9例。正常对照组106例,皆为女性,年龄18～46岁,平均32岁,选自本院体格合格的健康人。