~(99m)Tc-MAA肺灌注显像诊断小儿肾病综合征并发肺栓塞的临床价值

为观察小儿肾病综合征并发肺栓塞的临床特点 ,用99mTc -MAA肺灌注显像方法 ,检查 30例血D2 聚体阳性的肾病综合征患儿。结果检出肺栓塞患儿 14例 (占 4 6.7% ) ,肺栓塞节段分别为 1—7段。表明行肝素为主的抗凝治疗 2周后 ,绝大多数患儿痊愈好转。说明小儿肾小球疾病并发肺栓塞为临床常见 ,用99mTc -MAA肺灌注显像诊断肺栓塞方法可靠、灵敏 ,对判断治疗效果也有一定价值。     

99Tcm-MAA下肢深静脉显像在肺栓塞诊断中的应用

为了解肺栓塞（PE）患者下肢深静脉血栓（DVT）的情况,对71例PE患者行^99Tc^m-MAA下肢深静脉显像.结果表明,71例PE患者中有55例（77.5%）可检测到下肢DVT;在36例伴有下肢DVT症状的PE患者中,32例 （88.9%）可检测到DVT,而在35例无下肢DVT症状的PE患者中有23例（65.7%）可检测到DVT;无下肢症状患者DVT多位于远端静脉,有下肢症状患者DVT多累及到近端静脉.因此,^99Tc^m-MAA下肢深静脉显像对有下肢症状和无下肢症状的PE患者的DVT检出率均较高,应作为肺灌注显像前的常规检查手段.     

^99Tc^m—MIBI肿瘤阳性显像的临床应用

探讨了^99Tc^m-MIBI肿瘤阳性显像在多种恶性肿瘤临床诊断中的应用价值。静脉注射^99Tc^m-MIBI 15～30min后,用美国GE公司SPX-6型SPECT行病变局部平面和断层显像,计算肿瘤与本底比值（T/B）,当T/B≥1.5时判定显像结果为阳性;肝脏肿瘤诊断则比较胶体显像和阳性显像时肿瘤部位是否有填充,若有填充则为阳性。21例受检者中病理诊断为恶性肿瘤17例,良性肿瘤4例。17例恶性肿瘤^99Tc^m-MIBI阳性显像15例阳性,2例阴性;4例良性肿瘤患者显像结果均为阴性。本组病例^99Tc^m-MIBI阳性显像的敏感性为88%,特异性为100%,阳性预测值为100%,阴性预测值为66.7%,准确率为90%。结果表明^99Tc^m-MIBI阳性显像诊断和鉴别诊断良恶性肿瘤具有良好的临床应用前景。     

白塞氏病与慢性结节性红斑患者的99Tcm标记人免疫球蛋白显像

为探讨^99Tc^m标记人免疫球蛋白（HIgG）显像在白塞氏病早期诊断和疗效评估中的价值,对已确诊的5例慢性结节性红斑及6例伴有结节性红斑样损害的白塞氏病患者进行了^99Tc^m HIgG显像,并在治疗后进行重复显像。结果：5例慢性结节性红斑患者^99Tc^m HIgG显像：在皮下见异常放射性浓聚区。治疗后,原放射性分布增高区消失或淡化。6例白塞氏病患者^99Tc^m HIgG显像：在皮下及大血管周围见异常放射性浓聚区。其中2例患者,尚可见关节周围异常放射性分布增高区。治疗后显像：血管周围及关节部位的异常浓聚区基本消失。结论：^99Tc^m-HIgG显像是一种简便、安全、无创伤的检查方法,它有助于早期诊断白塞氏病,改善患者预后,及评估疗效,指导临床进一步的治疗。     

肺灌注显像与肺动脉造影诊断周围型肺栓塞的实验研究

摘要：采用家兔自体血凝块，在数字减影血管造影仪下建立急性周围型肺栓塞模型，栓塞前、后分别行肺灌注显像和数字减影肺动脉造影检查，以病理解剖发现栓子为诊断标准,比较二者诊断周围型肺栓塞的敏感性和特异性。结果显示，肺灌注显像诊断周围型肺栓塞的灵敏度为93.94%，特异度97.91%，阳性预测值为89.86%，阴性预测值为98.8%；数字减影肺动脉造影诊断周围型PE的灵敏度为90.91%，特异度95.52%，阳性预测值为80%，阴性预测值为98.16%，两种检查相比差异无显著性(P>0.05)。因此，肺灌注显像诊断急性周围型肺栓塞有较高的敏感性和特异性，与数字减影肺动脉造影有良好的诊断符合率，但由于肺灌注显像操作简便,安全、无创伤,可以作为筛选检查。     

99TCm-MDP、99TCm(V)-DMSA和99Tcm-Citrate显像对骨组织良恶性疾病鉴别诊断的对比研究

为评价^99Tc^m(V)-二巯基丁二酸钠(DMSA)显像和^99Tc^m-枸缘酸(Citrate)显像在骨转移癌和骨及骨关节炎症诊断中的意义，对骨转移癌患者和骨及骨关节炎症患者各18例分别进行^99Tc^m-亚甲基二膦酸(MDP)、^99Tc^m(V)-DMSA和^99Tc^m—Citrate全身显像，并比较了它们的显像结果。18例经病理学、CT或MRI证实有骨转移癌的患者，^99Tc^m-MDP显像共检出64个病灶，^99Tc^m(V)-DMSA显像显示在与^99Tc^m-MDP显像相同部位同检出49个病灶，而^99Tc^m—Citrate显像仅检出1个病灶。18例经细菌学、cT或MRI证实的骨及骨关节炎症患者，^99Tc^m—MDP显像共检出22个病灶，^99Tc^m(V)-DMSA显像显示在与^99Tc^m-MDP显像相同部位同检出l7个病灶，^99Tc^m-Citrate显像检出l6个病灶。本组病例^99Tc^m(V)-DMSA显像诊断骨转移癌的灵敏度为76．56％，特异性为22．73％；^99Tc^m-Citrate显像诊断骨转移癌的灵敏度仅为1．56％，特异性为27．27％,^99Tc^m(V)-DMSA显像诊断骨及骨关节炎症的灵敏度为77．27％，特异性为23．44％；^99Tc^m-Citrate显像诊断骨及骨关节炎症的灵敏度为72．73％，特异性为98．44％。以上结果表明，^99Tc^m（V）-DMSA显像在诊断骨转移癌和骨组织炎症时应该慎重，因为它不能区分骨组织的良恶性病变性质，其对骨组织的良恶性病变性质的鉴别诊断应排除外骨组织炎症、骨折等骨组织良性病变的干扰。而^99Tc^m—Citrate显像对于骨及骨关节炎症诊断特异性比^99Tc^m-MDP骨显像和^99Tc^m（V）-DMSA骨显像都高。     

荷人肺腺癌裸鼠的^99Tc^m-CD44-McAb放射免疫显像

采用^99Tc^m直接标记法标记抗CD44的单克隆抗体，并对标记抗体的特性进行鉴定；利用^99Tc^m-CD44-McAb对荷人肺腺癌裸鼠进行放射免疫显像及体内分布研究。结果显示，^99Tc^m-CD44-McAb的标记率为92．3％±4．1％，比活度为2．9±0．5TBq／g，放化纯度为96．2％±3．1％。放射免疫显像结果显示，肿瘤组织对^99Tc^m～CD44-McAb有较高的摄取，通过感兴趣区（Regional Interest，ROD技术测得肿瘤部位与对侧相应部位的放射性摄取比（T／NT）为2．29±0．56，明显高于对照组（P〈0．05）。标记抗体的小鼠体内分布结果与显像结果基本一致。以上研究结果说明，^99Tc^m-CD44-McAb用于荷人肺腺癌裸鼠的放射免疫显像能得到较理想的T／NT，CD44是肺腺癌放射免疫显像研究值得推荐的目标抗原之一。     

小细胞肺癌单克隆抗体2F7 F(ab′)2片段的99Tcm标记试剂盒的制备

采用2-亚氨噻酚盐酸盐修饰2F7F(ab′)2,通过葡庚糖酸转换,将^99Tc^m标记在小细胞肺癌单克隆抗体2F7F(ab′)2上,并测定抗体的修饰率、标记率、胶体含量、免疫活性、稳定性及安全性,探讨一种高效便捷的^99Tc^m-2F7F(ab′)2放免显像药盒的研制方法。结果显示：已修饰2F7F(ab′)2的修饰效率(巯基／分子)为6.3,^99Tc^m的标记率为93,5％,^99Tc^m胶体含量为2．5％,修饰抗体有良好的稳定性和免疫活性;进行无菌、无热原、急慢性毒性实验,结果表明各项指标符合中国药典规定,所以建立的高效、便捷的单抗片断放免显像方法可以适应药盒化发展方向,该修饰、标记技术将对单抗2F7F(ab′)2的放免显像的应用起到良好的作用。     

~(99)Tc~m-MAA下肢深静脉显像在肺栓塞诊断中的应用

为了解肺栓塞(PE)患者下肢深静脉血栓(DVT)的情况,对71例PE患者行99Tcm-MAA下肢深静脉显像。结果表明,71例PE患者中有55例(77.5%)可检测到下肢DVT;在36例伴有下肢DVT症状的PE患者中,32例(88.9%)可检测到DVT,而在35例无下肢DVT症状的PE患者中有23例(65.7%)可检测到DVT;无下肢症状患者DVT多位于远端静脉,有下肢症状患者DVT多累及到近端静脉。因此,99Tcm-MAA下肢深静脉显像对有下肢症状和无下肢症状的PE患者的DVT检出率均较高,应作为肺灌注显像前的常规检查手段。     

静息门控心肌显像室壁增厚率判断心肌梗死存活心肌的价值

探讨99mTc-甲氧基异丁基异腈(MIBI)门控心肌灌注显像所获得的室壁增厚信息在判断冠心病心肌梗死患者中存活心肌的价值.26例确诊的冠心病心肌梗死的男性患者,均在2周内完成12导联心电图(EKG)、99mTc-MIBI静息门控心肌灌注显像、18F-脱氧葡萄糖(FDG)心肌代谢显像,所有病人均接受冠状动脉造影(CAG).在双核素心肌显像结果提示为缺血存活心肌的心肌节段中,MIBI分布缺损但室壁增厚(WT)正常的心肌节段占双核素显像结果提示为缺血存活心肌节段的68.2%;在双核素心肌显像结果提示为梗死心肌的心肌节段中,MIBI分布缺损且WT异常的心肌节段占双核素显像结果提示为梗死心肌节段的96.8%.静息门控心肌灌注显像所获得的血流灌注和室壁增厚信息与99mTc-MIBI/18F-FDG双核素心肌显像结果具有较高的符合率,故在单纯的心肌血流灌注图像的基础上,结合室壁增厚信息与传统的心肌灌注显像相比有助于检出更多的存活心肌.     

肺灌注与通气显像对慢阻肺诊断的临床价值

慢性阻塞性肺部疾病５１例，应用＾９９ｍ－ＭＡＡ行肺灌注及＾９９ｍＴｃ－ＤＴＰＡ气溶胶行肺通气显像，两者有很好的匹配，其阳性率达９６．０％，明显高于ＺＸ线胸片检查，并优于肺功能定位检查，说明此法对ＣＯＰＤ的病情估计和疗效评价提供一定依据。     

Proportion of viable myocardium is more reliable than semi-quantitative score in predicting functional recovery： a pilot study of PET myocardial viability imaging

PET myocardial viability imaging is the"gold standard"for the non-invasive assessment of myocardial viability.The research aims to find out the best methods of imaging interpretation in predicting the postoperative functional recovery.Twenty-one CAD patients with multi-vessel involvement Were recruited.All pailents underwent gated myocardial perfusion imaging(G-MPI) and FDG PET myocardial imaging within 2 weeks before coronary artery bypass grafting.The postoperative G-MPI was performed in all patients 3 months after the surgery.Out of the total 420 segments,164 segments of ischemic myocardium were detected by preoperative G-MPI.Among them,93ischemic segments were identified as non-viable(difference score≥0)and the rest 71 segments Were identified as viable(difference score＜0).The proportion of viable segments(the ratio of viabl esegments versus iscbemic segments)and summed difference score of metabolism to perfusion were calculated.The patients were further divided into 2 groups according to the proportion of viable myocardium:group Ⅰ(the proportion≥50%,12 cases)and group Ⅱ(the proportion＜50%,9 cases)while another division was made according to SDS:group A(SDSE≥0),group B(-5≤SDS＜0)and group C(SDS＜-5).The diagnostic accuracy of proportion of viable segments and SDS in predicting the post-revascularization improvement in the left ventricular ejection fraction by at least 5 or more ejection fraction units was 88.89%(8/9)and 55.56%(5/9)respectively.It is concluded that both approaches allow accurate evaluation of myocardial viability.Furthermore,the proportion of viable myocardium is more reliable in predicting the postoperative functional recovery.     

Determination of the degree of pulmonary artery hypertension by plasma atrial nateiuretic peptide levels and pulmonary perfusion imaging

1 INTRODUCTIONSelecting non-invasive methods for judging the level of pulmonary artery pressure(PAP) in time and accurately is a popular subject of present research. It has importantclinical significance in the early diagnosis and therapy of lUng or heart diseases duringslight increase of PAH. Using different stages of rabbit PAH models, we examined thepulmonary perfusion imaging and plasma arterial nateiuretic peptide (ANP) levels, controlled with cardiac catheterization to Observe …     

系统性硬皮病心肌损害在冷诱导心肌断层显像和超声心动图的表现

应用＾９９ｍＴｃ－ＭＩＢＩ对２３例系统性硬皮病（ＳＳＣ）病人进行了心肌断层显像冷诱导试验,并同期应用于维超声心动图检测左心室功能和室壁运动。结果表明,１４例病人（６０．９％）有心肌放射性分布异常,其中３例可逆性缺陷６个节段,５例固定性缺损９个节段,６例两种缺损共存１４个节段;心脂显像异常率在雷诺现象（ＲＰ）组和无ＲＰ组之间显著性差异（０．５〉Ｐ〉０．２５）;心肌显像异常组病人的左室射血分数、每搏输     

Parathyroid and bone imaging in primary hyperparathyroidism

Skeletal derangements occur quite often in patient with primary hyperparathyroidism (PHPT). We investigated parathyroid and bone imagings in 59 cases of pathologically proven PHPT. Forty-nine cases were pathologically proven parathyroid adenomas; 8 presented hyperplasia and the other 2 were adenocarcinomas. Parathyroid imaging (early phase imaging, EPI) was conducted at 30 min alter injecting 740-925MBq ^99mTc-MIB1 and 2-3h later (delayed phase imaging, DPI) separately. The following thyroid imagings were performed at the same posture 10 min after intravenous injection of 74～111MBq ^99mTcO4^-. The ^99mTc^- M1B1 subtraction imaging data were obtained by subtracting thyroid imaging from that of DP1. Among 49 cases of proven hyperparathyroid adenoma 45 yielded positive imagings. Eight cases with hyperplasia gave negative results. The results were positive in 2 cases of parathyroid adenocarcinoma. Results of ^99mTc-MDP/bone imaging: 35 cases of hyperparathyroid adenocarcinoma (disease duration 1-6 months) showed normal bone images, while 14 cases showed superscan images, course being 4～12 months. Bone imaging for 2 cases of adenocarcinoma showed multiple, radioactive aggregated loci (brown tumor imaging); course lasting 10～24 months. The results of bone imaging in 8 cases of hyperplasia/hyperparathyroidism were normal. It was concluded that diagnostic accuracy for parathyroid was 79.6% and for parathyroid adenoma was 91.8%, and the technique has no diagnostic value for hyperplasia. The ^99mTc-MDP / bone imaging results for PHPT can be classified into three categories, i.e. normal, superscan and brown tumor. The imaging results correlated well with the different categories and degrees of bone damage, the duration of clinical course and the pathological types. Therefore, it‘s important to use bone imaging data in association with therapy to reflect the stage and progress of PHPT.     

A comparative study of primary coronary stenting and intravenous thrombolysis for acute myocardial infarction using ^99mTc-MIBI SPECT imaging

1 INTRODUCTIONRe-perfusion therapy is one of the important progresses of acute myocardial infarction (AMI) therapy. It is established that early intravenous thrombolysis is effective and convenient for patency-related artery (IRA)[']. But obvious limitation existsfor thrombolysis application such as low IRA patency rate, recuxrent ischeAnc events,high re-infarction rate, hemorrhage complication and so many contraindications. Recentyearst primary coronary steming has been developed as …     

肺动脉高压病人肺灌注显像的初步研究

肺灌注显像是了解肺血管病变的一种无创性方法,它可以直接显示肺动脉血流灌注的情况,尤其对肺动脉血栓栓塞性病变的诊断,如结合~(133)Xe通气检查,有其独特的价值。