新生儿肾积水的超声评价和随访

目的探讨新生儿肾积水的发病率及自然病程.方法应用超声方法对1154例生后 2～7 d 的新生儿进行双肾超声筛查,肾盂分离≥7 mm 作为入选标准,并分为4组Ⅰ组,只有肾盂扩张 7～11 mm;Ⅱ组,肾盂扩张延续到肾盏,11 mm＜肾盏分离前后径≤15 mm;Ⅲ组,肾盂和肾盏扩张,15 mm＜肾盂分离前后径≤21 mm;Ⅳ组,肾盂和肾盏扩张,肾盂分离前后径＞21 mm.定时超声随访.结果超声筛查中,29例32只肾盂前后径≥7 mm,占总例数的 2.52%,占总肾数的 1.39%.Ⅰ组肾积水2年内(22只肾)消退21例,2例明显减轻;Ⅱ组肾积水2年内消退1例,1例明显减轻;Ⅲ组肾积水1例(双肾积水)变化不大,另1例积水程度增加;Ⅳ组肾积水2例,积水程度加重.结论新生儿Ⅰ组及部分Ⅱ组肾积水呈相对良性的过程,大多数可以自然消退.Ⅲ组肾积水患儿有可能积水程度逐渐加重或变化不大,应注意随访.Ⅳ组肾积水患儿应及时手术.     

左室功能和结构改变与心脏起搏器起搏比例的关系

目的分析心脏起搏器植入后远期左室收缩功能和结构改变的特点及其与起搏比例的关系。方法共入选20例病人,其中植入VVI起搏器10例,DDD起搏器10例。采用双探头门控单电子发射计算机断层摄影系统测定病人植入起搏器3年~4年后自身心律状态时左室射血分数(LVEF)、左室舒张末容积(EDV)、左室收缩末容积(ESV)及每搏量(SV)。结果起搏器植入后远期EDV、ESV呈增高趋势,LVEF植入前为(61.5±14.2)%,植入后为(53.4±13.9)%呈降趋势,且植入后远期LVEF在≥50%与<50两亚组均呈下降趋势。结论起搏器植入后远期,可发生左室功能和结构重塑,表现为LVEF增高或降低和EDV增大或减小。EDV增大、LVEF降低与起搏心搏数呈正相关。     

99Tcm-二亚乙基三胺五乙酸与99Tcm-奥曲肽眼眶显像在甲状腺相关性眼病中的对比研究

Objective Through a comparative study of 99Tcm-diethylenetriaminepentaacetic acid (99Tcm-DTPA) and 99Tcm-octreotide (99Tcm-OCT) SPECT orbital scan, evaluated the clinic significance of two imaging of estimation activity in thyroid associated ophthalmopathy (TAO). Methods Aeording to the elinnic activity score (CAS), 26 TAO patients were divided into two groups: active group (CAS ≥3) and inactive group (CAS<3), 14 volunteers (control group) participates this study. Orbit scan were completed after intravenously injection with 99Tcm-DTPA 740 MBq and 99Tcm-OCT (every other day). Obtaining the uptake ratio (UR) of two kinds of orbit scans. The statistical analyses included Paired-samples t test analysis of variance and Spearman regression analysis. Results There is no statistically significance between the two methods in UR (t=0.075, P>0.05). There is a statistically significant correlation was found between CAS and the uptake ratios(99Tcm-DTPA: r=0.835, P<0.001; 99Tcm-OCT: r=0.912, P<0.001). Conclusions There is a good uniformity between 99Tcm-DTPA and 99Tcm-OCT orbital scan; 99Tcm-DTPA is a feasible and maybe a new promising estimation method of activity in the patients with TAO.     

131I治疗甲状腺疾病后对周围人群的辐射安全性评价

目前，^131I是治疗甲状腺疾病的主要放射性核素，但其可释放不同能级的γ射线，并透过人体作用于周围环境和人群。为了衡量服用^131I治疗的患者对周围人群（慰问及探视人员）可能产生的辐射危害，笔者应用单一公式法和实时测量累积法分别计算人群可能接受的当量剂量，结合国内外辐射安全标准进行评价。     

99Tcm-二亚乙基三胺五乙酸与99Tcm-奥曲肽眼眶显像在甲状腺相关性眼病中的对比研究

Objective Through a comparative study of 99Tcm-diethylenetriaminepentaacetic acid (99Tcm-DTPA) and 99Tcm-octreotide (99Tcm-OCT) SPECT orbital scan, evaluated the clinic significance of two imaging of estimation activity in thyroid associated ophthalmopathy (TAO). Methods Aeording to the elinnic activity score (CAS), 26 TAO patients were divided into two groups: active group (CAS ≥3) and inactive group (CAS<3), 14 volunteers (control group) participates this study. Orbit scan were completed after intravenously injection with 99Tcm-DTPA 740 MBq and 99Tcm-OCT (every other day). Obtaining the uptake ratio (UR) of two kinds of orbit scans. The statistical analyses included Paired-samples t test analysis of variance and Spearman regression analysis. Results There is no statistically significance between the two methods in UR (t=0.075, P>0.05). There is a statistically significant correlation was found between CAS and the uptake ratios(99Tcm-DTPA: r=0.835, P<0.001; 99Tcm-OCT: r=0.912, P<0.001). Conclusions There is a good uniformity between 99Tcm-DTPA and 99Tcm-OCT orbital scan; 99Tcm-DTPA is a feasible and maybe a new promising estimation method of activity in the patients with TAO.     

The role of 131Ⅰ in the apoptosis of thyrocytes of patient with Graves' disease

The changes of Fas.FasL and Bcl-2 expression in thyrocytes of patients with Graves'disease were investigated before and 2 weeks after 131Ⅰ administration. The results showed that 131Ⅰ couhl induce thyrocytes to express the apoptotic protein Fas, FasL and the anti-apoptotic protein Bet-2 in patients with Graves'disease. A statistically significant correlation was found between the dose of 131Ⅰ and the expression levels of Fas and FasL but not Bet-2 ,suggesting that early onset of hypothyroid after 131Ⅰ administration may be due to the increased expression of Fas and FasL in thyrocytes.     

^18F-FDG PET/CT不同重建算法对肺结节SUV的影响

目的 比较18 F-脱氧葡萄糖(FDG) PET/CT的4种重建算法对肺结节标准摄取值(SUV)的影响.方法 回顾性收集2018年2月至2019年7月在山西医科大学第一医院行^18F-FDGPET/CT检查的46例实性肺结节患者[男27例,女19例,中位年龄66(44~82)岁]的PET/CT图像,采用有序子集最大期望值迭代法(OSEM)、OSEM+飞行时间(TOF)、OSEM+TOF+点扩散函数(PSF)及正则化算法(BSREM)进行图像重建(方法依次以G1~G4表示),通过视觉和半定量方法分析肺结节及背景参数.根据肺窗所测结节直径,分为小结节(直径≤10 mm)和大结节(10 mm<直径≤30 mm).行Kruskal-Wallis秩和检验及Bonferroni法分析不同算法间SUV的差异,行Spearman相关分析探讨SUV变化率(%△SUV)与结节直径的相关性,行受试者工作特征(ROC)曲线分析探讨SUV对肺结节良恶性的诊断效能.结果 共114个结节,大结节55个,小结节59个.在视觉分析中,G4较G1 ~ G3的小结节视觉检出率分别提高了55.93%(33/59)、44.07% (26/59)和20.34% (12/59).在114个肺结节中,最大SUV(SUVmax)、平均SUV(SUVmean)在不同算法间比较差异有统计学意义(中位SUVmax:2.65~5.29,中位SUVmean:2.05~ 2.99;H值:20.628和17.749,均P<0.001),G4对G1的SUVmax(中位数分别为5.29和2.65)和SUVmean(中位数分别为2.99和2.05)有明显提升(均P<0.001).%△SUVmax(中位数:4.45%~52.96%)、%△SUVmean(中位数:1.69% ~47.56%)与结节直径呈负相关[9.75(6.20,16.58) mm;rs值:-0.371^-0.354、-0.371 ^-0.320,均P<0.001].在59个小结节中,G4对G1的SUVmax(中位数分别为4.05和2.14)有明显提升(H=18.327,P<0.001),G4对G1和G3的SUVmean(中位数分别为2.31、1.26和1.53)有提升作用(H=16.808,均P<0.05).在55个大结节中,SUV在不同算法间的差异无统计学意义(H值:0.812~7.290,均P>0.05).G1~G4的SUVmax诊断良恶性的最佳截断值分别为4.335、5.185、5.410、5.745,曲线下面积(AUC)分别为0.747、0.699、0.756和0.778,四者的SUVmean及SUVpeak最佳截断值对应的AUC也显示出类似趋势.结论 在4种重建算法中,BSREM可明显提高图像质量和直径10 mm以下肺结节的SUVmax及SUVmean,其SUV良恶性诊断阈值应适当上调.     

99Tcm-二亚乙基三胺五乙酸与99Tcm-奥曲肽眼眶显像在甲状腺相关性眼病中的对比研究

Objective Through a comparative study of 99Tcm-diethylenetriaminepentaacetic acid (99Tcm-DTPA) and 99Tcm-octreotide (99Tcm-OCT) SPECT orbital scan, evaluated the clinic significance of two imaging of estimation activity in thyroid associated ophthalmopathy (TAO). Methods Aeording to the elinnic activity score (CAS), 26 TAO patients were divided into two groups: active group (CAS ≥3) and inactive group (CAS<3), 14 volunteers (control group) participates this study. Orbit scan were completed after intravenously injection with 99Tcm-DTPA 740 MBq and 99Tcm-OCT (every other day). Obtaining the uptake ratio (UR) of two kinds of orbit scans. The statistical analyses included Paired-samples t test analysis of variance and Spearman regression analysis. Results There is no statistically significance between the two methods in UR (t=0.075, P>0.05). There is a statistically significant correlation was found between CAS and the uptake ratios(99Tcm-DTPA: r=0.835, P<0.001; 99Tcm-OCT: r=0.912, P<0.001). Conclusions There is a good uniformity between 99Tcm-DTPA and 99Tcm-OCT orbital scan; 99Tcm-DTPA is a feasible and maybe a new promising estimation method of activity in the patients with TAO.     

关于~（201）Tl心肌显像反相再分布的重新认识

近年来，有许多关于反相再分布的报道，对其发生机制有许多不同的假设，但均无可靠的证据来证实，其临床意义及病理生理意义尚不十分清楚。比较一致的观点是，急性心肌梗塞患者出现反相再分布的频率较高，可能是梗塞区心肌尚存活的标志。