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?     

SPECT/CT 心肌灌注显像在原发性微血管性心绞痛患者中的临床价值?

目的：探讨SPECT/CT 心肌灌注显像在原发性微血管性心绞痛患者中的临床价值。方法回顾性分析36例原发性微血管性心绞痛患者(观察组)的SPECT/CT MPI结果,并将观察组患者的左心功能参数与42例正常对照组进行比较分析。结果(1)36例心肌缺血患者均为可逆性心肌缺血,共计70段,其中多壁段缺血的患者占83．3%(30/36)。(2)70个缺血壁段中,心尖部缺血占25．7%(18/70),前壁缺血占31．4%(22/70),下壁缺血占27．1%(19/70),侧壁缺血占12．9%(9/70),间壁缺血占2．9%(2/70)。缺血评分为1分、2分、3分者分别占85．7%(60/70)、11．4%(8/70)和2．9%(2/70)。(3)两组的左心功能参数：负荷LVEF、静息LVEF、负荷EDV、静息EDV、SSS和SDS之间均差异有统计学意义(均P<0．05)。结论原发性微血管性心绞痛患者SPECT/CT MPI特点是以多壁段受累为主的、可发生在任何壁段的可逆性心肌缺血,缺血程度较轻,且可能同时伴有左心功能的降低。     

精索扭转的诊断及治疗(附26例报告)

目的总结精索扭转的诊治经验。方法回顾性总结了1995年6月-2004年6月期间26例精索扭转患者的诊治资料,结合文献进行分析。结果本组26例患者经彩超检查（CDu）确诊为精索扭转23例,25例患者经手术证实为精索扭转。1例手法复位治愈,18例行坏死睾丸切除术。7例手术复位者随访0．5—3年,6例复位睾丸血流正常,1例睾丸萎缩。结论在诊断精索扭转中,CDU与核素显像相比,CDU具有准确率高,方便快捷。早期诊断、及时手术探查行扭转精索复位和睾丸固定是提高睾丸存活率的关键。     

CT及MRI检查对鼻咽癌颅底及颅内侵犯判断的比较

鼻咽癌是我国常见的恶性肿瘤之一，尤其在我国华南、西南各省高发。好发年龄为40岁～59岁，男女比例为2．5～4：1。鼻咽腔是被颅底、颈椎、软腭背侧、鼻腔后端围绕的一个深在腔隙。颅底中线及中线旁结构如蝶窦、海绵窦、斜坡、岩尖等刚好在鼻咽顶壁及顶侧壁上方，并有破裂孔、卵圆孔等天然孔道相通。因此，鼻咽癌伴颅底、颅内受侵多见，主要破坏颅底骨质、副鼻窦和颅内其他组织，是肿瘤T分期较晚表现。临床工作中，所见初次就诊鼻咽癌患者很多已出现颅底颅内受侵表现。因此，正确判断鼻咽癌有无颅底骨质破坏及颅内侵犯对临床诊疗极其重要。本文总结了我院2004年1月至2005年12月初诊鼻咽癌时于治疗前行鼻咽CT及鼻咽MRI检查的43例病例，予以分析比较CT及MRI检查对鼻咽癌颅底、颅内侵犯的判断。     

影响肺癌放射治疗预后的因素(附90例报告)

1964年4月至1981年12月本院经病理确诊行放射治疗的原发性肺癌90例;其中单纯放疗49例,术后放疗41例。治疗后的1、2、3、和5年生存率在单纯放疗组分别为32.7％、14.3％、6.1％和5.0％,而在术后放疗组各为53.6％、31.7％、21.9％和16.7％;术后放疗组明显优于单纯放疗组(P<0.05)。文章讨论了病期、放疗剂量、放疗对原发灶的控制率等对预后的影响,认为只要患者一般情况可以耐受手术,对于有淋巴转移的病例,术后补充放疗可比单纯放疗有较高的生存率。     

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...