18F-FDG PET显像在鼻咽癌诊断治疗中的价值

目的:探讨18F-FDG PET显像在鼻咽癌诊断治疗中的价值.方法:35例鼻咽癌PET与同期CT、MRI、骨ECT诊断结果比较分析,全部经病理组织学证实.结果:35例鼻咽癌PET与临床和CT、MRI、骨ECT诊断相符31例(88.6%),诊断不符4例(11.4%),其中真阴性2例和假阴性2例,1例ECT疑为多处骨转移,PET未发现核素浓聚改变,随访排除了骨转移;1例MRI疑为复发,PET未发现核素浓聚改变,病理及随访排除了复发;1例CT诊断肝转移,1例MRI诊断桥脑转移,PET均未发现核素浓聚改变.PET检测出CT、MRI和ECT未发现的转移灶6例(17.1%).结论:18F-FDG PET对鼻咽癌定性诊断具有较高的准确性和特异性,在诊断淋巴结和远处转移方面优于CT和MRI;诊断肝、脑转移有假阴性表现,提示PET应结合CT、MRI进行综合分析,才能作出正确的诊断.     

18F-氟脱氧葡萄糖PET-CT诊断主动脉壁粥样硬化斑块的价值探讨

目的通过PET-CT明确18F-氟脱氧葡萄糖在主动脉壁粥样硬化斑块中摄取程度,探讨其临床价值。方法60例受检者,包括正常对照者6例,大动脉粥样硬化病例54例。测定主动脉壁粥样硬化部位标准化摄取值（SUV）和CT值,并依据CT值将54例主动脉壁局部18F-FDG高摄取的动脉粥样硬化病例分成3组,软斑块组CT值小于60HU,中等斑块组CT值介于60￣100HU之间,钙化斑块组CT值大于100HU。第4组为正常对照组。结果软斑块组42个测量部位的平均SUV为1.553±0.486;中等斑块组30个测量部位的平均SUV为1.393±0.296;钙化斑块组36个测量部位的平均SUV为1.354±0.189;正常对照组33个测量部位的平均SUV为1.102±0.141。多组之间比较差异具有统计学意义（F=678.909,P=0.000）;正常组与各斑块组比较差异具有统计学意义。结论18F-FDG在主动脉粥样硬化斑块中具有不同程度的摄取,其中软斑块对18F-FDG的摄取最高,提示18F-FDG PET-CT是诊断不稳定性主动脉粥样硬化斑块的有价值方法。     

18F-FDG PET-CT对裸鼠鼻咽癌移植瘤放疗疗效的早期评估及与Ki67表达的相关性研究

Objective To investigate the value of 18F-FDG PET-CT scans on early assessing the therapeutic effects on human nasopharyngeal carcinoma (NPC) xenograft in nude mice after radiotherapy,and preliminarily analyze the relation of 18F-FDG PET-CT scans and the positive expression rate of Ki67, and provide a basis for further clinical studies. Methods Fifteen xenograft nude mice of NPC were randomly divided into three groups (5 nude mice per group). Control group: all mice immediately executed after the 18F-FDG PET-CT scans and taken pathology; 6 Gy radiotherapy group: all mice took 18F-FDG PET-CT scans before and 1 d after receiving 6 Gy irradiation, and were killed immediately to take pathology; 12 Gy radiotherapy group: all mice received 12 Gy irradiation (6 Gy each time, totally 2 times). They took 18F-FDG PET-CT scans before radiotherapy, after receiving the first 6 Gy irradiation, 2 d and 6 d after receiving 12 Gy irradiation respectively ,and then were executed to take pathology after the last scan. The expression of Ki67 in xenografts of different groups was detected and the relation between their changes and T/NT were analyzed.Results ①For 12 Gy radiotherapy group, the average T/NT ratios of the NPC xenograft of pre-radiotherapy, after the first 6 Gy irradiation, 2 d and 6 d after 12 Gy radiotherapy were 2.17±0.31, 1.68±0.42, 1.41±0.40,and 0.70±0.12, respectively. The average T/NT ratios were not statistically difference before and after the first 6 Gy irradiation. The average T/NT ratio of 2 d after radiotherapy decreased significantly than pre-radiotherapy (t=2.80, P<0.05) and after the first 6 Gy irradiation (t=3.14, P<0.05); The average T/NT ratio of 6d after radiotherapy was decreased seriously than 2 d after radiotherapy(t=3.49, P<0.05, compared with preradiotherapy t=8.01, P<0.01). ② The positive expression rates of Ki67 of NPC xenograft markedly decreased after receiving irradiation. There were significant differences in the positive expressions of Ki67 between different group s(F=21.95, P<0.01).The positive expression of Ki67 in the 12 Gy radiotherapy group decreased significantly compared with the control group (t=7.145, P<0.01) and the 6 Gy radiotherapy group (t=2.384, P<0.05). The positive expression of Ki67 in the 6 Gy radiotherapy group was less than the control group, also have statistical significance(t=4.320, P<0.01).③There was no correlation between the T/NT ratio of NPC xenograft and the positive expression of Ki67. ④Positive correlation was found between the variance of T/NT ratio and the variance of the positive expression of Ki67 of NPC xenograft (r=0.532, P<0.05).Conclusions 18F-FDG PET-CT imaging has an important value on early assessing the therapeutic effects of NPC xenograft in nude mice after radiotherapy, and the 6th day after radiotherapy is an appropriate time point.18F-FDG PET-CT imaging can reflect the variance of the positive expression of Ki67 of NPC, and yet indirectly reflect the sensitivity of NPC to radiotheraphy.     

右侧卧位显像对成年女性SPECT心肌灌注显像中左心室前壁衰减伪影的鉴别价值

目的 探讨采用右侧卧位并改变采集角度显像对成年女性SPECT MPI中左心室前壁衰减伪影的鉴别价值.方法 回顾性分析行99Tcm-MIBI MPI的成年女性49例[年龄(61.5±8.4)岁,属冠心病低发人群].运动负荷显像时患者左心室前壁均出现不同程度的稀疏或缺损,随机(抽签法)对患者先后行常规仰卧位和改变采集角度的右侧卧位静息显像.重建2种显像体位的心肌断层图像,利用靶心图获得左心室各壁段的放射性计数百分比.采用配对t检验比较2种显像体位间的放射性计数百分比差异.观察不同体位显像时左心室前壁放射性稀疏和填充的图像差异.结果 左心室前壁、下后壁、心尖部及侧壁的放射性计数百分比在右侧卧位显像时明显高于仰卧位显像,分别为(71.30±3.53)％和(66.50±3.85)％,(70.06±4.45)％和(65.44±4.16)％,(77.90±3.00)％和(75.81±4.08)％,(79.30±2.26)％和(72.60±3.87)％(t=6.731、5.286、3.555和10.885,均P＜0.01),间壁的放射性计数百分比明显低于仰卧位显像[(66.60±3.98)％和(70.06±4.51)％,t=-4.625,P＜0.01].左心室前壁中段和前壁心尖部放射性计数百分比在右侧卧位显像时明显高于仰卧位显像[中段:(76.40±3.80)％和(68.60±4.76)％,心尖部:(77.10±3.24)％和(69.00±3.54)％;t=9.916和8.870,均P＜0.01],前壁基底部放射性计数百分比在2种显像体位间的差异无统计学意义[(56.94±6.06)％和(58.50±4.98)％,t=-1.493,P＞0.05].目测49例受检者常规仰卧位显像时,左心室前壁均有不同程度的稀疏或缺损,其中出现前壁中段和前壁心尖部局限性稀疏缺损的受检者分别为46.9％ (23/49)和32.7％ (16/49);采用右侧卧位同时改变采集角度显像时,左心室前壁的稀疏缺损区均有不同程度的填充,其中出现明显填充和完全填充的受检者分别为24.5％(12/49)和65.3％ (32/49).结论 仰卧位显像时成年女性左心室前壁的衰减伪影主要表现为前壁中段或前壁心尖部?     

99mTc-PPM肺癌显像与肺癌DNA含量关系初探

目的 采用＾９９ｍＴｃ－培谱利欧霉素进行ＳＰＥＣＴ肺癌显像,分析＾９９ｍＴｃ－ＰＰＭ在体外显像诊断肺癌的价值及与肺癌ＤＮＡ含量的关系。方法 ２８例肺癌与１４例良性病变患者均进行ＳＰＥＣＴ早期及延迟平面及断层显像。结果 ＾９９ｍＴｃ－ＰＰＭ肺癌延迟摄取比值对肺癌的诊断灵敏度,特异性均为８５．７％,肺癌ＤＮＡ含量指数与延迟ＵＲ相关系数ｒ＝０．３６,异倍体细胞的发生率为８４．２％。     

ROC曲线评价18F-FDG PET/CT、99Tcm-MDP骨显像及二者联合对骨转移的检出效能

目的 采用ROC曲线比较18F-FDG PET/CT、99Tcm-MDP骨显像及二者联合对骨转移患者的检出效能.方法 296例恶性肿瘤患者在2个月内同时接受了18F-FDG PET/CT和99Tcm-MDP骨显像,对2种显像结果 按5分法(0分:骨转移阴性,1分:可能阴性,2分:不能确定,3分:可能阳性,4分:肯定阳性...     

PET/CT在肿瘤放疗和疗效评估的应用进展

随着放射肿瘤学的不断发展,放射治疗在肿瘤治疗中的地位愈显重要。X线、CT、MRI、B超等传统形态学检查往往不能可靠地用来进行肿瘤分期和肿瘤疗效的评价。PET/CT将PET功能代谢信息与CT解剖结构信息结合在一起,更准确地显示肿瘤与周围正常组织的关系,在肿瘤放疗前分期、放射敏感性及预后判断、放疗计划的优化及放疗后疗效评估等方面具有重要的临床价值。     

18F-FDG符合显像在肺部肿瘤诊断中的临床应用

目的探讨18F-脱氧葡萄糖(FDG)符合显像在肺部肿瘤诊断中的临床应用价值.方法回顾性分析98例临床怀疑肺部肿瘤患者术前18F-FDG符合显像结果,观察各种病变摄取18F-FDG的情况及特征.结果98例被怀疑肺部肿瘤的病例中确诊为肺癌60例,其18F-FDG符合显像结果全部为阳性;肺部良性肿瘤9例,8例为阳性;确诊为肺结核20例,11例显像阳性;炎症9例,4例显像阳性.结论18F-FDG符合显像诊断肺部肿瘤具有很高的敏感性和准确性.对肺癌的分期亦具有重要的价值,但须结合临床对显像的特征进行分析,以提高对肺癌诊断的特异性.     

PET／CT显像的图像融合精度测试研究

目的:通过模拟和临床实际应用状态,测试3D全身显像方式PET/CT显像图像融合精度.方法:用测试模型及其配套的22Na固体点源,模拟人体宽度和厚度,采集点源PET/CT图像数据;然后将相同的点源置于检查床两测的床垫下,在检查床无负重和负重85 kg时,分别采集PET/CT图像数据.重建图像后,在PET/CT融合图像的三个断层面分别寻找CT和PET点源图像的中心,测量二者中心偏差的mm数,即PET/CT图像融合精度.结果:PET和CT两种模态融合图像肉眼可见较明显的错位.模型点源PET/CT融合图像最大偏差为(4.25±0.26)mm、检查床无负重时为(3.96±0.26)mm,检查床负重85 kg时为(5.36±0.26)mm.结论:本研究方法可以比较精确地测量PET/CT图像融合精度,并有效地指导PET/CT仪器的验收和故障检测等.     

99mTc-HL91肺显像在肺部恶性肿瘤诊断中的价值

目的　评估 99mTc -HL91肺显像对肺部恶性肿瘤的诊断价值。方法　 17例肺良性病变及 90例肺部恶性肿瘤 (81例原发性肺癌 ,9例肺部转移性瘤 )患者在给药 99mTc -HL91(92 5MBq)后 180min完成前位和后位静态显像。计算病灶和对侧正常肺组织摄取 99mTc -HL91的放射性计数比值 (T/NT)。结果　 99mTc -HL91在肺良性病变的T/NT值为 1.15± 0 .2 5 ;肺恶性病组T/NT为 1.4 5± 0 .2 2 (与良性组比较P <0 .0 0 1,t=4 .998) ,其中鳞癌 1.4 7± 0 .2 7(与良性组比较P <0 .0 0 1,t =4 .137) ,腺癌为 1.4 0± 0 .2 5 (与良性组比较P <0 .0 1,t=3.2 74 ) ,转移性病变为 1.4 6± 0 .2 2 (与良性组比较P <0 .0 1,t =3.12 8)。目测法分析 99mTc -HL91肺显像诊断肺恶性病变的灵敏度为 93.3% (84 / 90 ) ,特异性为 6 4 .7% (11/ 17) ,准确性为 88.8% ;炎性假瘤是最主要的假阳性病变。结论　 99mTc -HL91对诊断及鉴别诊断肺良恶性病变具有明确的价值。