2011 Vol. 35, No. 5
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2011, 35(5): 257-261.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.001
[PDF 455KB]
Abstract:
Cardiac neural plays a crucial role in cardiac function.Cardiac diseases usually cause damage to cardiac autonomic function.123I-metaiodobenzyl-guanidine imaging is an ideal evaluation method of cardiac autonomic function.It evaluates the damage to the sympathetic nerve of various cardiac patients, guides pharmacologic therapy, and determines the necessity of mechanical devices and cardiac transplant. The radiotracer imaging allows visualization and quantitative measurements of the cardiac lesion.
Cardiac neural plays a crucial role in cardiac function.Cardiac diseases usually cause damage to cardiac autonomic function.123I-metaiodobenzyl-guanidine imaging is an ideal evaluation method of cardiac autonomic function.It evaluates the damage to the sympathetic nerve of various cardiac patients, guides pharmacologic therapy, and determines the necessity of mechanical devices and cardiac transplant. The radiotracer imaging allows visualization and quantitative measurements of the cardiac lesion.
2011, 35(5): 261-264.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.002
Abstract:
Multimodality imaging, specifically PET-CT, brought a new perspective into the fields of clinical imaging.Clinical cases have shown that PET-CT has great value in clinical diagnosis and experimental reaserch.But PET-CT still bears some limitations.A major drawback is that CT provides only limited soft tissue contrast and exposes the patient to a significant radiation dose.MRI overcome these limitations, it has excellent soft tissue contrast, high temporal and spatial resolution and no radiation damage.Additionally, since MRI provides also functional information, PET-MRI will show a new direction of multimodality imaging in the future.
Multimodality imaging, specifically PET-CT, brought a new perspective into the fields of clinical imaging.Clinical cases have shown that PET-CT has great value in clinical diagnosis and experimental reaserch.But PET-CT still bears some limitations.A major drawback is that CT provides only limited soft tissue contrast and exposes the patient to a significant radiation dose.MRI overcome these limitations, it has excellent soft tissue contrast, high temporal and spatial resolution and no radiation damage.Additionally, since MRI provides also functional information, PET-MRI will show a new direction of multimodality imaging in the future.
2011, 35(5): 264-268.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.003
Abstract:
The imaging diagnostic techniques include X-ray plain film, ultrasound, CT, MRI and radionuclide imaging.X-ray plain film is less sensitive to early acute osteomyelitis.Ultrasound can detect abscesses in the soft tissues and subperiosteal space earlier, but there are variations in image quality based on the different operators'levels of proficiency.High-resolution CT can find minimal lesions on bone, but it has a low sensitivity to predict acute osteomyelitis.MRI is superior to other imaging techniques at visualizing bone marrow lesions, but it is less sensitive in detecting sequestrum and calcification than CT.A variety ofradionuclide imaging agents have been used in the early diagnosis of acute osteomyelitis in order to find a more sensitive and specific imaging technique.In this paper, different imaging diagnostic techniques of acute osteomyelitis are reviewed.
The imaging diagnostic techniques include X-ray plain film, ultrasound, CT, MRI and radionuclide imaging.X-ray plain film is less sensitive to early acute osteomyelitis.Ultrasound can detect abscesses in the soft tissues and subperiosteal space earlier, but there are variations in image quality based on the different operators'levels of proficiency.High-resolution CT can find minimal lesions on bone, but it has a low sensitivity to predict acute osteomyelitis.MRI is superior to other imaging techniques at visualizing bone marrow lesions, but it is less sensitive in detecting sequestrum and calcification than CT.A variety ofradionuclide imaging agents have been used in the early diagnosis of acute osteomyelitis in order to find a more sensitive and specific imaging technique.In this paper, different imaging diagnostic techniques of acute osteomyelitis are reviewed.
2011, 35(5): 269-274.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.004
Abstract:
Objective To evaluate the clinical value of 18F-FDG SPECT-CT in detecting recurrence and metastasis of gastric cancer. Methods Analyzed the SPECT-CT imaging data in 122 cases with gastric cancer retrospectively, and then combined with the results of pathological examination, of which 79 cases compared with the same period of enhanced CT and the joint inspection of the two by each other in the remnant stomach or anastomotic recurrence of diagnostic performance; 109 cases with the comparison of stomach tumor markers and the joint inspection of the two by each other in the diagnosis of metastatic evaluation of performance.SPSS13.0 software package was used to perform χ2test and fisher's exact probability. Results ① The sensitivity, specificity, positivity predicitive value(PPV), negativepredictivevalue(NPV), andaccuracy of 18F-FDG SPECT-CT in diagnosing residual stomach or anastomotic recurrence was 84.0%, 96.3%, 91.3%, 92.9%and 92.4%respectively.Those of enhanced CT was 58.3%, 78.2%, 53.8%, 81.1%and 72.2%respectively.The former of which the sensitivity, specificity, PPV and accuracy were significantly higher than enhanced CT, and the difference was statistically significant(χ2=3.953~11.805, all P < 0.05).Although theNPV is higher than enhanced CT, the difference was not statistically significant(χ2=3.344, P > 0.05).Joint diagnosis of the two indicators was 88.0%, 98.1%, 95.7%, 94.6%and 94.9%respectively, significantly higher than the enhanced CT, and the difference was statistically significance(χ2=4.732~10.341, all P < 0.05).Although the indicators were higher than 18F-FDG SPECT-CT, the difference was not statistically significant(all χ2=0.000, P > 0.05).②The sensitivity, specificity, PPV, NPV, and accuracy of 18F-FDG SPECT-CT in diagnosing metastasis of gastric cancer was 92.9%, 87.5%, 96.3%, 80.8%and 91.7%respectively.Those of gastric tumor markers was 81.2%, 75.0%, 92.0%, 52.9%and 79.8%.Where the former sensitivity, NPV and accuracy were significantly higher than the stomach tumor markers, the difference was statistically significant(χ2=4.026~6.355, all P < 0.05). Although specificity and PPV were higher than the gastric tumor markers, the difference was not statistically significant(χ2=0.574, 0.681, P > 0.05).The two combined diagnostic indicators was 96.5%, 83.3%, 95.3%, 87.0%and 93.6%respectively, similarly with the 18F-FDG SPECT-CT, and the difference was not statistically significant(χ2=4.026~6.355, all P > 0.05), but significantly higher than the gastric tumor markers, and the sensitivity, NPV and accuracy of the difference was statistically significant(χ2=7.143~10.014, all P < 0.05). Conclusion 18F-FDG SPECT-CT has greater clinical value in detecting recurrence and metastasis of gastric cancer.
2011, 35(5): 275-278.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.005
Abstract:
Objective To explore the relationship between homocysteine(HCY)and C-reactive protein(CRP)in obstructive sleep apnea/hypopnea syndrome(OSAHS)patients and OSAHS patients complicated with coronary heart disease by detecting the scrum level of HCY and CRP on the mechanism of OSAHS complicated with coronary heart disease. Methods Ninety-one patients were divided into three groups, 30 patients as control group, 36 patients as OSAHS group, and 25 patients as OSAHS complicated with CHD group.Serum HCY level was detected through chemiluminescence.Serum CRP level was detected through radioimmunity.The serum level of HCY and CRP was compared among these groups.OSAHS patients were divided into mild OSAHS subgroup, moderate OSAHS subgroup and severe OSAHS subgroup.The morbidity rate of CHD and the serum level of HCY and CRP were compared among these subgroups.Meanwhile the parameters of polysomnogram such as activity apnea-hypopnea index(AHI)and blood oxygen saturation (SaO 2)were compared between OSAHS group and OSAHS complicated with coronary heart disease group. Results ① There was significant difference among the serum level of HCY and CRP of control group, OSAHS group and OSAHS complicated with CHD group(FHCY=15.80, FCRP=19.21, P all < 0.01).The serumlevel of HCY and CRP of OSAHS complicated with CHD group was significantly higher than that of OSAHS group(tHCY=4.74, tCRP=5.14, P all < 0.01).The serum level of HCY and CRP of OSAHS group was significantly higher than that of control group(tHCY=7.31, tCRP=8.17, P all < 0.01).②The morbidity rate of CHD of severe OSAHS subgroup was significantly higher than that of mild OSAHS subgroup and that of moderate OSAHS subgroup(χ2=6.96, χ2=4.18, P < 0.05).The serum level of HCY and CRP were correlated with the severity of OSASH(FHCY=16.38, FCRP=12.97, P all < 0.01).③There were significant difference between apnea hyponea index and SaO2of OSAHS group and OSAHS complicated with CHD group(tAHI=5.46, percentage of SaO2 < 90%in total sleep time: t=1.88, P all < 0.01;percentage of disordered breathing event in the total sleep time: t=2.47, P < 0.05;lowest SaO2: t=4.68, average lowest SaO2: t=3.65, longest duration of disordered breathing events: t=4.73, P all < 0.01). Conclusion The serum level of HCY and CRP rose because of hypoxia in OSAHS patients, and might play an important role in the mechanism of OSAHS complicated with CHD.
2011, 35(5): 279-281.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.006
Abstract:
Objective To evaluate 18F-FDG coincidence imaging for the detection of benign and malignant tumor diagnosis. Methods Retrospectively analyzing 13518F-FDG dual head coincidence imaging results whose patients had unknown lesions, and comparing with conventional radiographic examination results.The diagnosis of lesion is based on surgical pathology and clinical follow-up. Results Eighty-six of all the 135 patients were diagnosed as malignant lesions(of 95 niduses), 49 of all the cases were benign lesion (of 53 niduses).18F-FDG coincidence imaging detected 38 more niduses than conventional radiographic examination, where the niduses reduced by only eight.The sensitivity, specificity and accuracy of the 18FFDG coincidence imaging in diagnosing carcinoma were 90.7%(78/86), 87.8%(43/49)and 89.6%(121/ 135). Conclusion 18F-FDG coincidence imaging is more sensitive, accurate in detecting benign and malignant tumor, and helps to clinical diagnosing and selecting patients to provide reliable basis for treatment options.
2011, 35(5): 281-284.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.007
Abstract:
Objective To compare the efficacy of 99Tcm-sulfur colloid and combined 99Tcm-sulfur colloid/methylene blue methods for detection of sentinel lymph node(SLN)in early breast cancer. Methods Seventy-six patients with early breast cancer were dived into two groups.In group 1(n=25), 99Tcm-sulfur colloid detection was used alone.In group 2(n=51), both 99Tcm-sulfur colloid detection and methylene blue methods were used.The pathological findings of resected axillary lymph nodes were regarded as evaluation standard. Results In 76 patients SLN was successfully detected in 74 cases.The SLN detection rate, accuracy, sensitivity and the false negative rate for 99Tcm-sulfur colloid group and combined group were 92.0%vs. 100%, 95.7%vs.98.0%, 90.0%vs.95.2%, and 10.0% vs.4.8% respectively. Conclusion SLN detection in early breast cancer may accurately predict axillary lymph node metastasis, thus providing important information for surgery.Combined use of 99Tcm-sulfur colloid and methylene blue methods may improve the SLN detection accuracy and reduce false negative rate.
2011, 35(5): 285-288.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.008
Abstract:
Objective To observe the therapeutic effect of 32P-chromic phosphate colloidal synovectomy combined with routine medication in the treatment of the hip disease of ankylosing spondylitis. Method Eight-two ankylosing spondylitis unilateral hip patients were divided into two groups.Forty-two were enrolled in the routine medication combined with 32P-chromic phosphate colloidal synovectomy group (treatment group)and 42 in conventional medicine group(control group).The efficacy and safety were observed. Resuts The effective rate of treatment group and control group were 73.8%and 52.4%respectively in the following six months.The difference was significant(χ2=4.840, P < 0.05).The effective rate were respectively 53.8%and 47.6%in three-year follow-up, with no significant difference between the two groups(χ2=0.047, P > 0.05).There was progress on the X-ray phases of hip joint in three-year follow-up, for the difference between the treatment group and the control group was significant(χ2=5.516, P < 0.05).During the different follow-up time, six months and three years, there were differences in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)before and after treatment between the treatment group and the control group, but the differences were not statistically significant(t=1.303, t=1.759, P all > 0.05).When followed up for 6 months, the differences in the visual analogue scale(VAS)for hip of the treatment group and the control group were statistically different between before and after treatment(t=2.389, P < 0.05).But when followed up for three years, the differences were not statistically different(t=1.632, P > 0.05).The side effects was observed only in five cases which was transient pain increase in joints. Conclusion 32P-chromic phosphate colloid synovectomy combined with routine medication had a short-term effect in treating the hip jointdisease of ankylosing spondylitis.
2011, 35(5): 288-289, 299.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.009
Abstract:
Objective To investigate the clinical effect of permanent 125I seeds interstitial implants for metastatic cervical cancer. Methods Under the guidance of the B-sonography, 125I seeds were implanted into the eleven cervical lymph nodes of ten patients who had been given tumor resection.The pain relief and tumor size were observed in regular follow-up after one-month treatment. Results All the patients were followed up for 6-14 months, and the postoperative recovery was good with no complication.One month after the implantation, the pain symptom was alleviated entirely in two nodes and partly in nine nodes.The tumorsize shrank in ten nodes while there was no change in one node after one month. Conclusion Permanant 125I seeds interstitial implants for metastatic cervical cancer is a safe, minimally invasive and effective treatment.
2011, 35(5): 290-295.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.010
Abstract:
Molecular imaging is a new era of medical imaging, which can non-invasively monitor biological processes at the cellular and molecular level in vivo, including molecular imaging of nuclear medicine, magnetic resonance molecular imaging, ultrasound molecular imaging, optical molecular imaging and molecular imaging with X-ray.Recently, with the development of multi-subjects amalgamation, multimodal molecular imaging technology has been applied in clinical imaging, such as PET-CT and PET-MRI. We believe that with development of molecular probe and multi-modal imaging, more and more molecular imaging techniques will be applied in clinical diagnosis and treatment.
Molecular imaging is a new era of medical imaging, which can non-invasively monitor biological processes at the cellular and molecular level in vivo, including molecular imaging of nuclear medicine, magnetic resonance molecular imaging, ultrasound molecular imaging, optical molecular imaging and molecular imaging with X-ray.Recently, with the development of multi-subjects amalgamation, multimodal molecular imaging technology has been applied in clinical imaging, such as PET-CT and PET-MRI. We believe that with development of molecular probe and multi-modal imaging, more and more molecular imaging techniques will be applied in clinical diagnosis and treatment.
2011, 35(5): 295-299.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.011
Abstract:
Lung cancer has become one of the leading causes of death from cancer.The mortality and morbidity of lung cancer has been increasing for years in China.Therefore, early diagnosis and accurate clinical staging of lung cancer is critical for guiding the treatment of lung cancer and improving the survival rate of patients with lung cancer.At present, the diagnosis of lung cancer is mainly depends on imaging, such as CT, MRI, SPECT, PET, etc.Besides, the tumor-associated antigen, such as lung tumor-associated antigen, cytokeratin fragment antigen21-1, neuron-specific enolase and carcino embryonic antigen also plays an important role in the diagnosis of lung cancer.
Lung cancer has become one of the leading causes of death from cancer.The mortality and morbidity of lung cancer has been increasing for years in China.Therefore, early diagnosis and accurate clinical staging of lung cancer is critical for guiding the treatment of lung cancer and improving the survival rate of patients with lung cancer.At present, the diagnosis of lung cancer is mainly depends on imaging, such as CT, MRI, SPECT, PET, etc.Besides, the tumor-associated antigen, such as lung tumor-associated antigen, cytokeratin fragment antigen21-1, neuron-specific enolase and carcino embryonic antigen also plays an important role in the diagnosis of lung cancer.
2011, 35(5): 300-306.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.012
Abstract:
MRI has excellent soft tissue resolution, and this technology is more and more widely used in breast disease diagnosis in recent years.Blood supply and perfusion through the microvascular network of tumor can be imaged noninvasively by dynamic contrast-enhanced MRI and perfusion-weighted imaging.Diffusion-weighted imaging and magnetic resonance spectroscopy can provide molecular information of breast lesions.Magnetic resonance ductography provides a new technology for detecting intraductal breast lesions.With MRI technology maturing and the rapid development of software and hardware, MRI shows its unique advantages in breast lesions characterization.
MRI has excellent soft tissue resolution, and this technology is more and more widely used in breast disease diagnosis in recent years.Blood supply and perfusion through the microvascular network of tumor can be imaged noninvasively by dynamic contrast-enhanced MRI and perfusion-weighted imaging.Diffusion-weighted imaging and magnetic resonance spectroscopy can provide molecular information of breast lesions.Magnetic resonance ductography provides a new technology for detecting intraductal breast lesions.With MRI technology maturing and the rapid development of software and hardware, MRI shows its unique advantages in breast lesions characterization.
2011, 35(5): 307-310.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.013
Abstract:
Objective To study the reliability and necessity of multi-spiral computed tomography angiography(MSCTA)for non-invasive examination of patients with atherosclerotic renal artery stenosis (ARAS). Method Eighty-two ARAS patients who had taken intraarterial digital subtraction angiography were performed with MSCTA.The obtained image data were analyzed in MPR, MIP, VR and SSD with multi-spiral CT at certain condition and were compared with digital substrction angiography(DSA)images. Results ① MSCTA visualized 95 renal artery stenosis on DSA, 85 of which were detected coordinate(10 were falsepositive cases).The concordance rate of DSA and MSCTA was 89%, and the false positive rate was 6.1%.②The intensity projection reconstruction and volume reconstruction perfectly showed stenosis. Conclusion MSCTA is helpful to accurately display the renal artery variation and lesions, and is also a reliable and accurate screening modality for the evaluation of patients with ARAS.
2011, 35(5): 311-314.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.014
Abstract:
Objective To investigate the effects of radiotherapy on the level of lysophosphatidic acid(LPA)in different patients. Methods Three groups of patients(metastatic brain tumor group, non-brain tumor group and primary brain tumor group)were given external irradiation(by linear accelerator).LPA level, white blood cell count and platelet count in the blood plasma were evaluated pre-irradiation and after irradiation with 40 Gy and 60 Gy respectively. Results The LPA level decreased gradually as irradiation doses increase in metastatic brain tumor group non-brain tumor group(after irradiation with 60 Gy < after irradiation with 40 Gy < pre-irradiation).There was significant statistical difference between them(F=21.230, P < 0.001; F=40.884, P < 0.001).In primary brain tumor group, the level of LPA also decreased gradually, but with no significant statistical difference(F=1.980, P > 0.05), and neoplasm volume changed little.White blood cell count and platelet count gradually decreased with the increasing irradiation doses in metastatic brain tumor group and primary brain tumor group, but there was no significant correlation to LPA level.However, there was a negative correlation to LPA level in non-brain tumor group(r=-0.285 and r=-0.237, both P < 0.05). Conclusions There is a negative correlation between radiotherapy dose and LPA level in metastatic brain tumor patients and non-brain tumor patients.LPA level could be used as a predictor of the effect of the radiotherapy in tumor treatment.
2011, 35(5): 314-317.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.015
Abstract:
Objective To observe the effect and acute radiation pneumonitis of respiratory gatedradiotherapy for non-small cell lung cancer patients. Methods Sixteen non-small cell lung cancer patientsreceived 3D conformal respiratory gating radiotherapy.The total dose is 60 Gy (2Gy/fraction). Results Therecent total effective rate was 68.75%, 5 cases have ll degree acute radiation pneumonitis, the other caseshave no obvious acute radiation pneumonitis. Conclusion Respiratory gated radiotherapy is safe and properfor non-small cell lung cancer patients.
2011, 35(5): 317-319, 321.
doi: 10.3760/cma.j.issn.1673-4114.2011.05.016
Abstract:
Objective To evaluate the clini cal value of X-ray targetpuncture collagenase chemonucleolysis combined with injection of medical ozone for lumbar disc herniation.Method One thousand and sixty-two cases of lumbar disc herniation accepted collagenase chemonucleolysis combined with injection of medical ozone targeted by X-ray.The therapeutic effects after operation were analyzed. Method One thousand and sixty-two cases of lumbar disc herniation accepted collagenase chemonucleolysis combined with injection of medical ozone targeted by X-ray.The therapeutic effects after operation were analyzed. Results Of all the 1062 cases, the effective rate of X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone was 95.3%at 3 months, 92.3%at 12 months, and 91.2%at 24 months after operation. Conclusion X-ray target puncture collagenase chemonucleolysis combined with injection of medical ozone is a simple and safe method for the lumbar disc herniation.It also had fewer adverse reactions and better therapeutic effects.
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