2019 Vol. 43, No. 1
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2019, 43(1): 3-9.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.002
Abstract:
Objective To investigate the image features of breast specific gamma imaging(BSGI) in the differential diagnosis of breast lesions. Methods A total of 272 Chinese female patients(including 293 lesions) who underwent BSGI between July 2014 to June 2015 were included. Several characteristics of the shape of the lesion, clarity of the boundary, grey scale distribution(the existence of a decentered core), breast imaging reporting and data system(BIRADS), and maximum tumor to non-tumor ratio(T/NT) were recorded. The correlation of each feature with the pathology was evaluated by rank correlation analysis and binary logistic regression analysis. All features were used in the diagnosis of the 293 lesions. Each independent lesion-based diagnostic performance as well as the combined diagnostic efficacy of statistically significant features were evaluated. Using MedCalc software, Z test based on receiver operating characteristic curve was used between each pair of image features to figure out their possible differences. Results Three imaging features including the shape of the lesion(OR=0.013, 95%CI: 3.664–21.846, P=0.000), the clarity of boundary(OR=2.121, 95%CI: 1.061–4.239, P=0.033), and grey scale distribution(the existence of a decentered core)(OR=12.927, 95%CI: 5.415–30.863, P=0.000) were significantly related with the pathology. The sensitivity and specificity of the three former characteristics were 92.0%(172/187) and 58.5%(62/106), 66.8%(125/187) and 71.7%(76/106), and 95.7%(179/187) and 27.4%(29/106), respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the combined diagnosis of the three former image characteristics were 88.2%(165/187), 81.1%(86/106), 89.2%(165/185), 79.6%(86/108), and 85.7%(251/293), respectively. With the best performance of all, this combined diagnosis has a higher diagnostic performance than BIRADS and maximum T/NT(cutoff ratio:1.75)(Z=4.079 and 4.090, both P<0.05). Conclusions The shape of the lesion, the clarity of boundary, and the grey-scale distribution(the existence of a decentered core) could be three important differential diagnostic standards of breast lesions in BSGI. With the combined diagnosis of the three features, the efficacy of independent diagnosis of BSGI in breast lesions could be improved.
2019, 43(1): 10-16.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.003
Abstract:
Objective To summarize the 18F-FDG PET/CT findings of subcutaneous pannic ulitis-like T cell lymphoma(SPTCL) and to evaluate the clinical application of 18F-FDG PET/CT in patients with SPTCL. Methods Imaging results of four patients with pathologically proved SPTCL were analyzed retrospectively. The morphology, distribution, and metabolic information of the lesions were observed, and the relevant literatures were reviewed. Results 18F-FDG PET/CT imaging showed irregular shape, increased density, and increased 18F-FDG uptake in the corresponding site. A wide range of lesions were involved: 2 cases in the face and neck, 4 cases in the trunk, 4 cases in the extremities, and 2 cases in abdominal and pelvic cavity. Semiquantitative analysis showed that the maximum standardized uptake value of subcutaneous fat lesions ranged from 3.5 to 14.6. Conclusion SPTCL lesions are widely distributed with varied 18F-FDG uptake, but 18F-FDG PET/CT whole body imaging is conducive to the overall evaluation of SPTCL patients and plays an important role in monitoring the curative effect.
2019, 43(1): 17-21.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.004
Abstract:
Objective To compare the efficacy of the CT and 18F-FDG PET/CT models in predicting the malignant risk of pulmonary nodules and to verify the predictive accuracy of model. Methods A retrospective analysis of 120 patients with pulmonary nodules confirmed by pathological diagnosis or follow-up were conducted in this study. Among these patients, 59 patients with suspected malignancy received 18F-FDG PET/CT. The corresponding receiver operating characteristic curve for each model was plotted, and the area under the curve(AUC) was calculated. The malignant risk of patients with pulmonary nodules(4–30 mm in diameter) was measured. Model accuracy was verified based on the exclusion criteria for each model and the total cohort of all patients. MedCalc software was used for correlation analysis, and DeLong method was used for two-way comparison. Results All 120 patients with pulmonary nodules were examined. Among them, 49(40.8%) had malignant nodules(31.6% primary lung cancer and 8.2% metastatic disease). The AUC of the Brock and VA models were 0.887 and 0.758, respectively, the difference was statistically significant(Z=6.483, P=0.006). In patients receiving 18F-FDG PET/CT, the AUC of the Herder model was 0.937, which was significantly more accurate than those of the other two models. When testing the model for all patients in the cohort(i.e., patients including the original model’s inclusion criteria), the AUC value decreased but was not significant. For the Herder model, the AUC was 0.923, and the two types of cohorts were not significant(Z=21.357, P=0.121). For subcentimeter nodules, the AUC values for the Brock and VA models were 0.846 and 0.536, respectively, and the Brock model was significantly better than the VA model(Z=8.768, P=0.0026). Conclusion The Brock model showed good accuracy and was used to predict the likelihood of malignancy in nodules detected by CT scan. The Herder model was the most accurate for patients who underwent 18F-FDG PET/CT for nodule evaluation.
2019, 43(1): 22-26.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.005
Abstract:
Objective To investigate the effects of automatic tube current modulation (ATCM) on CT image quality and effective dose(ED) of PET/CT of 90 patients. Methods PET/CT of 90 patients from October 2017 to July 2018 were randomly divided into three groups, A, B, and C by systematic sampling(30 cases in each group), and CT was scanned by ATCM. The tube current interval of group A and B was 60–240 mA, and the noise index(NI) was 10 and 15; the tube current interval of group C was 60–180 mA, and the NI was 15. The CT volume dose index(CTDIvol) and dose length product(DLP) were recorded, and the ED was estimated according to the formula. The CT image quality of neck, chest, abdomen, and pelvis were evaluated blindly by two and above attending physicians in nuclear medicine to calculate signal-to-noise ratio(SNR) by measuring CT value and noise value of the CT image. Noise value and SNR were compared with variance analysis. CTDIvol, DLP, and ED were compared with Kruskal-Wallis and with Nemenyi in pairs. Results Differences in noise value[(11.90±2.83)–(26.03±3.74)] and SNR [(2.03±0.34)–(4.35±0.71)] among three groups were statistically significant (F=38.01–64.20, F=32.09–81.62, and all P<0.05), and the CT image quality met the clinical diagnostic requirements. CTDIvol were (12.44±0.53), (9.39±2.01), and (7.05±1.03) mGy, DLP were (998.45±96.04), (741.60±168.87), and (571.29±97.41) mGy·cm, and ED were (14.98±1.44), (11.12±2.53), and (8.57±1.46) mSv among three groups, with statistically significant differences(χ2=62.18, 57.19, 57.16, and all P<0.05). Group C was lower than group A(χ2=56.55, P<0.05) with statistically significant differences. Conclusion ATCM technology can ensure the image quality while reducing the ED effectively by modulating the current interval and NI reasonably.
2019, 43(1): 27-31.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.006
Abstract:
Objective To evaluate the value of CT-guided percutaneous biopsy for diagnosis of solitary ground glass nodules(GGO) around the lung. Methods Fifty-nine patients with solitary frosted glass nodules around the lungs who underwent CT examinations from January 2017 to December 2017 were enrolled in the study. All patients underwent CT-guided percutaneous biopsy, which was confirmed by surgery, clinical, or follow-up, in accordance with the maximum diameter of the lung GGO axial position, the proportion of solid components, the location of the lesion, the distance from the pleura, the angle of the needle-pleural, and the number of needle adjustments. Univariate analysis was used to determine the diagnostic accuracy, sensitivity, specificity, and incidence of complications. A chi-square test was used to compare the benign and malignant between solid components ≤50% and >50% in mixed GGO. Results The accuracy, sensitivity, and specificity of the diagnosis of 59 patients with solitary pulmonary GGO were 89.8%(53/59), 84.2%(32/38), and 100%(21/21), respectively, thereby confirming the disease as adenocarcinoma. According to different groups used in the method, the accuracy of the diagnosis is higher than 80%, the sensitivity is higher than 75%, and the specificity is 100%, but the incidence of overall complications is also higher. The difference between the mixed GGO solid components ≤50% and >50% was statistically significant ( χ2=6.13, P<0.05). Conclusions CT-guided percutaneous biopsy has high diagnostic value for isolated GGO. The proportion of solid components in GGO has a certain correlation with the degree of malignancy.
2019, 43(1): 32-39.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.007
Abstract:
Objective To investigate the expression of nitric oxide(NO), inflammatory mediators(TNF-a, IL-6) in serum and nitric oxide synthase(NOS) protein in aortic endothelial cells of rats with hypothyroidism induced by radioactive 131I, in order to find a safe dose of 131I for the prevention of hypothyroidism heart disease. Methods Forty-five male rats were selected. The hypothyroidism model was established by intraperitoneal injection of 2.775, 5.550, 11.100, 16.650 MBq 131I + 0.5 mL saline into 36 male rats, with 9 rats in each group. The remaining 9 rats were taken as normal control group and only 0.5 mL saline was injected to each rat. Three rats were sacrificed in each group at 4, 8, and 16 weeks after 131I administration. The serum levels of IL-6, TNF-α and the aortal content of total-NOS activity were determined with chemiluminescence immunoassay. Western blotting was used to analyze the expression of rat aortic specimens of eNOS, nNOS, and iNOS, and count data were analyzed by the t test. A value of P<0.05 was considered statistically significant. Results The serum levels of FT3, FT4 and TSH showed that all the groups of hypothyroidism model of rats were successfully constructed except 2.775 MBq group, and 5.550 MBq was regarded as an optimum dosage. The serum level of NO in rats(5.550 MBq) at 4 week increased to 24.01 mol/L and then reduced gradually; the level of serum IL-6 in 4, 8, and 16 were 209.23, 291.87, and 302.97 pg/mL, respectively. Compared with nomal control, statistical differences were observed at 8 and 16 week(t=8.841, 14.224, both P<0.05). The levels of TNF- alpha were 1441.23, 1601.85, and 1521.51 pg/mL, respectively, with statistical differences at different time points(t=21.021, 17.578, 14.498, all P<0.05). The expression of aortic endothelial NOS(eNOS) at different time points was 25 985, 16 306, and 6248. Compared with nomal control, the levels of protein in each group decreased, no statistical significance was observed at 4 week(t=3.546, P>0.05) and statistical differences were observed at 8 and 16 week(t=8.841, 14.224, both P<0.05). The expression of NOS(nNOS) was 24 562, 36 114 and 58 211, down at 4 week(t=3.546, P>0.05), and gradually increased at 8 and 16 week(t=5.751, 7.251, both P>0.05). The expression of inducible nitric oxide synthase(iNOS) was 55 973, 50 575 and 62 364, and all groups increased statistically(t=21.017, 16.412, 24.981, all P<0.05). Conclusion The hypothyroidism induced by 131I has certain effect on the heart, and our study can provide a new idea for prevention of hypothyroid heart disease for clinical practice and reduction of cardiovascular disease.
2019, 43(1): 40-46.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.008
Abstract:
Objective To preparation a99Tcm labeled caspase -3 polypeptide apoptosis molecular probe(99Tcm-CP3-peptide) based on aspartic glutamic acid-valine-aspartic acid(DEVD) as the core and study the biodistribution and SPECT imaging of lung adenocarcinoma cell line(A549) after chemotherapy. Methods 99Tcm-cp3-peptide was synthesized by bifunctional chelate method, and the radiochemical purity was detected by HPLC at the time points of 0, 1, 2, 4, 6 hours after the labeling. An in vitro binding assay was performed in A549 cells treated with paclitaxel.In the control group, without chemotherapy, the intracellular and extracellular radioactive ratio(Cin/Cout) was measured, and the cell apoptosis rate was detected by flow cytometry. 99Tcm-CP3-peptide was injected via tail vein of tumor bearing nude mice treated with paclitaxel(3.7 MBq for each mouse), to detect the biological distribution of 5, 15, 30, 60, 120, 240 min respectively. Static SPECT imaging was performed, ROI outlined, and the ratio of tumor/contralateral normal muscle tissue was calculated. HE staining was performed to observe the morphological changes of tumor tissues after imaging. Test was used for comparison between the two groups, and bivariate correlation analysis was used for correlation study, P<0.05 was considered statistically significant. Results The radiochemical purity of 99Tcm-CP3-peptide at 0, 1, 2, 4 and 6 h was greater than 97%. The synthesis rate was(64.5+5.2)%. An in vitro investigation showed that the Cin/Cout in the tumor cell chemotherapy group was 10.27±2.02 vs. 1.09±0.03 in control group 24 h after paclitaxel chemotherapy. The chemotherapy group of Cin/Cout was 7.3 times as high as that of the control group. Flow cytometric detection of tumor cells in the same state, the rate of apoptosis in the chemotherapy group was(75.62±2.57)% vs.(3.42±0.32)% in contorl group. The ratio of Cin/Cout in the chemotherapy group and the control group was positively correlated with the percentage of apoptotic cells detected by flow cytometry(r=0.970, P<0.05). Invivo distribution of tumor bearing mice showed that: 99Tcm-CP3-peptide is rater fast in blood clearance, and mainly metabolized through kidney. The values of radioactive uptake were low for important organs such as heart, spleen and lung etal, but it is slightly higher in the liver and slower in metabolism. The value of tumor tissue uptake reached a peak(4.26±1.03)%ID/g after injection of 1 h. Clear images of the tumor bearing mice can be obtained 1h after injection of drugs. The ROI showed that the ratio of T/NT in the chemotherapy group was 3.83±0.11, which was significantly higher than that of the control group(1.57±0.09, t=16.19, P<0.05). After imaging, HE staining of tumor tissue showed that a large number of nuclear retraction, nuclear fragmentation and apoptotic cells were found in the tumor tis-sue of the chemotherapy group and only a small amount of that were in control group. Conclusions 99Tcm-CP3-peptide, a kind of imaging agent targeting caspase-3 activity,which has good biological distribution, and can be applied to apoptosis imaging of animal models, it has a potential clinical value in monitoring tumor cell apoptosis after chemotherapy.
2019, 43(1): 47-52.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.009
Abstract:
Objective To label N-[N-(3,5-difluorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester(DAPT), an inhibitor of the Notch signaling pathway, with 11C and perform preliminarily dynamic imaging in normal rabbit. Methods Proliferation of human pancreatic cancer cell line MiaPaCa-2 were assessed by cell counting kit-8 method after treatment with various concentrations of DAPT and CH3-DAPT. Half-maximal inhibitory concentration(IC50) was calculated. DAPT was then used as a precursor to prepare 11C-N-methyl-DAPT(11C-DAPT) with a fully automatic synthesizer. The final product was purified through semipreparative high performance liquid chromatography(HPLC). After intravenous injection of 125.8 MBq(3.4 mCi) 11C-DAPT, a normal New Zealand rabbit was subjected to dynamic whole-body PET/CT scanning. The dynamic changes in radioactivity were measured by drawing regions of interest over different organs. Results DAPT and CH3-DAPT concentration-dependently inhibited the growth of the human pancreatic cancer cell line MiaPaCa-2. The IC50 values were 64.2 and 180.0 μmol/L at 72 h after administration, respectively. 11C-DAPT was synthesized for approximately 30 min. The uncorrected radiochemical yield was 25%–35%. Radiochemical purity was above 95%. 11C-DAPT was mainly excreted through the kidney, the highest uptake was in the kidneys, and the uptake in the liver, intestine, lung, and brain was relatively low. The tracer uptake in the kidneys and liver peaked at 7 min after injection and decreased to >50% at 28 min. Conclusions 11C-DAPT can be easily and rapidly synthesized with high radiochemical purity. Preliminary PET/CT imaging can lay a foundation for further investigating 11C-DAPT as a novel molecular probe.
2019, 43(1): 53-60.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.010
Abstract:
Objective To evaluate the effect of TSH-suppressive therapy on bone mineral density(BMD) in patients with differentiated thyroid carcinoma(DTC). Methods The cross-sectional, cohort, prospective controlled, and case-control studies on the BMD change in patients with DTC after TSH-suppressive therapy from databases were searched, including PubMed, Medline, Wanfang Database, VIP, China National Knowledge Infrastructure, and CBM. The effect of TSH-suppressive therapy on the BMD of lumbar, femoral neck, femoral greater trochanter, and Ward triangle were analyzed. Data from the date of database establishment to October 2017 were all reviewed. Meta-analysis was performed with RevMan 5.3 software after two reviewers independently screened the date. The categorical variables were expressed as odds ratios, and numerical variables were expressed as weighted mean or standardized mean differences. Based on the heterogeneity of the study, a comprehensive analysis was performed by using fixed or random effect models. Results A total of 14 studies involving 588 patients with differentiated thyroid cancer were included. No significant difference in the BMD of lumbar indications between the experimental and control groups was observed: SMD=−0.00, 95%CI [−0.26, 0.26],P=0.98. The BMD of femoral neck indications: SMD=−0.00, 95%CI [−0.15, 0.14],P=0.96. A significant difference between the experimental and control groups in the BMD of femoral trochanter indications was observed: SMD=−0.30, 95%CI [−0.53, −0.06],P=0.01. The BMD of Ward's triangle indications: SMD=−0.35, 95%CI [−0.63, −0.08],P=0.01. Conclusions TSH-suppressive therapy in patients with DTC mainly reduces proximal femur BMD, and BMD must be followed-up regularly.
2019, 43(1): 61-67.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.011
Abstract:
Autophagy is a vital catabolic process in which cells maintain their homeostasis by digesting and circulating their own cytoplasmic contents. Autophagy could promote and inhibit the development of cancer through various signal pathways. Autophagy has been explored from different aspects. However, few summaries systematically illuminate the relationship between autophagy and radiotherapy. Thus, this review aims to elucidate the effects of autophagy modulations on radio sensitivity and radiotherapy efficacy in various types of cancer. The future development of autophagy modifications for improving radiotherapy efficacy and prognosis of cancer will also be discussed.
Autophagy is a vital catabolic process in which cells maintain their homeostasis by digesting and circulating their own cytoplasmic contents. Autophagy could promote and inhibit the development of cancer through various signal pathways. Autophagy has been explored from different aspects. However, few summaries systematically illuminate the relationship between autophagy and radiotherapy. Thus, this review aims to elucidate the effects of autophagy modulations on radio sensitivity and radiotherapy efficacy in various types of cancer. The future development of autophagy modifications for improving radiotherapy efficacy and prognosis of cancer will also be discussed.
2019, 43(1): 68-75.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.012
Abstract:
Malignant melanoma is prone to metastasis and recurrence. It has become one of the seriously health-threatening malignant tumors. Early diagnosis and accurate staging are very important for prognosis and long-term survival. 18F-FDG PET/CT is a novel imaging technique that combines the functional data of PET with the morphological information of CT. It has been widely used in the diagnosis and staging, local recurrence, and therapeutic response evaluation of malignant tumour including melanonma. With the successful clinical application of integrated-PET/MR imaging system, It has taken a great step forward in multi-modal imaging technology field, thereby realizing synchronous data acquisition. To understand new progress of multimodal imaging technology in malignant melanoma, this article provides a review of the value of 18F-FDG PET/CT and PET/MR in the staging, local recurrence, chemotherapy response evaluation of melanoma.
Malignant melanoma is prone to metastasis and recurrence. It has become one of the seriously health-threatening malignant tumors. Early diagnosis and accurate staging are very important for prognosis and long-term survival. 18F-FDG PET/CT is a novel imaging technique that combines the functional data of PET with the morphological information of CT. It has been widely used in the diagnosis and staging, local recurrence, and therapeutic response evaluation of malignant tumour including melanonma. With the successful clinical application of integrated-PET/MR imaging system, It has taken a great step forward in multi-modal imaging technology field, thereby realizing synchronous data acquisition. To understand new progress of multimodal imaging technology in malignant melanoma, this article provides a review of the value of 18F-FDG PET/CT and PET/MR in the staging, local recurrence, chemotherapy response evaluation of melanoma.
2019, 43(1): 82-87.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.014
Abstract:
Pheochromocytoma(PCC) is a rare neuroendocrine tumor(NET), and accurate diagnosis is the key to treatment. At present, including radioactive iodine markers of iodine benzyl(MIBG) guanidine scanning, positron emission tomography(PET), radioactive nuclide labeled somatostatin analogue nuclear medicine functions such as scanning imaging in the diagnosis of pheochromocytoma have higher value. At the same time, the radionuclide therapy mediated by iodide and peptide receptor also has certain value in the palliative treatment of pheochromocytoma. The application of radionuclides in the diagnosis and treatment of pheochromocytoma was reviewed in order to provide help for the development of individualized treatment.
Pheochromocytoma(PCC) is a rare neuroendocrine tumor(NET), and accurate diagnosis is the key to treatment. At present, including radioactive iodine markers of iodine benzyl(MIBG) guanidine scanning, positron emission tomography(PET), radioactive nuclide labeled somatostatin analogue nuclear medicine functions such as scanning imaging in the diagnosis of pheochromocytoma have higher value. At the same time, the radionuclide therapy mediated by iodide and peptide receptor also has certain value in the palliative treatment of pheochromocytoma. The application of radionuclides in the diagnosis and treatment of pheochromocytoma was reviewed in order to provide help for the development of individualized treatment.
2019, 43(1): 88-90.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.015
Abstract:
A case of severe bone marrow inhibition in the treatment of differentiated thyroid cancer (DTC) by radionuclide 131I was reported. The characteristics of the case were analyzed based on clinical diagnosis, changes in bone marrow hematopoietic system, and whether the patient's treatment process was standardized. The therapeutic effect of radionuclide 131I in the diagnosis and treatment of DTC bone metastasis and the effect of bone marrow hematopoiesis were reviewed. Radionuclide 131I had considerable clinical effect on the diagnosis and treatment of DTC bone metastasis. However, with the increase of cumulative dose and the difference of sensitivity of patients to 131I treatment, white blood cells or platelets in the bone marrow hematopoietic system may decrease. For the treatment of 131I patients with extensive bone metastasis, the occurrence of bone marrow inhibition should be on highly alert and the cumulative treatment dose should be considered. The interval between retreatment should be maximized. When bone marrow inhibition occurs in patients with extensive bone metastasis, 131I treatment should be used selectively.
A case of severe bone marrow inhibition in the treatment of differentiated thyroid cancer (DTC) by radionuclide 131I was reported. The characteristics of the case were analyzed based on clinical diagnosis, changes in bone marrow hematopoietic system, and whether the patient's treatment process was standardized. The therapeutic effect of radionuclide 131I in the diagnosis and treatment of DTC bone metastasis and the effect of bone marrow hematopoiesis were reviewed. Radionuclide 131I had considerable clinical effect on the diagnosis and treatment of DTC bone metastasis. However, with the increase of cumulative dose and the difference of sensitivity of patients to 131I treatment, white blood cells or platelets in the bone marrow hematopoietic system may decrease. For the treatment of 131I patients with extensive bone metastasis, the occurrence of bone marrow inhibition should be on highly alert and the cumulative treatment dose should be considered. The interval between retreatment should be maximized. When bone marrow inhibition occurs in patients with extensive bone metastasis, 131I treatment should be used selectively.
2019, 43(1): 91-93.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.016
Abstract:
A case report where a Takayasu’s arteritis involving pulmonary artery was detected on pulmonary ventilation/perfusion imaging was presented. The characteristics of this case on the basis of clinical symptoms, signs, laboratory examinations and imaging examinations were analyzed. On the pulmonary ventilation/perfusion images, the "mismatches" were observed in the whole right lung, and the upper, posterior lobes, and basal segment of the left lung. Only from the results of pulmonary ventilation/perfusion examination, it is easy to be misdiagnosed as pulmonary embolism. While it is considered as a result of the pulmonary artery involvement in the Takayasu's arteritis, once the patient’s history and other examination results were analyzed, as well as the peer review of related literatures. In this case report, SPECT proved a non-invasive diagnostic tool for Takayasu's arteritis patient involved pulmonary artery. It offered precise diagnosis and thereby appropriate treatment strategies are taken on those patients.
A case report where a Takayasu’s arteritis involving pulmonary artery was detected on pulmonary ventilation/perfusion imaging was presented. The characteristics of this case on the basis of clinical symptoms, signs, laboratory examinations and imaging examinations were analyzed. On the pulmonary ventilation/perfusion images, the "mismatches" were observed in the whole right lung, and the upper, posterior lobes, and basal segment of the left lung. Only from the results of pulmonary ventilation/perfusion examination, it is easy to be misdiagnosed as pulmonary embolism. While it is considered as a result of the pulmonary artery involvement in the Takayasu's arteritis, once the patient’s history and other examination results were analyzed, as well as the peer review of related literatures. In this case report, SPECT proved a non-invasive diagnostic tool for Takayasu's arteritis patient involved pulmonary artery. It offered precise diagnosis and thereby appropriate treatment strategies are taken on those patients.
2019, 43(1): 94-97.
doi: 10.3760/cma.j.issn.1673-4114.2019.01.017
Abstract:
A solitary pulmonary nodule (SPN) is a single, well-circumscribed nodule with diameter less than 3 cm. The clinical manifestations and imaging features of SPN are usually atypical because of the small size and it is often found during physical examination. There are many kinds of benign SPN, including tuberculosis, hamartoma, sclerosing hemangioma, pulmonary inflammatory myofibroblastoma tumor and so on. Tuberculosis and pulmonary inflammatory myofiblastic tumor, which are easily misdiagnosed because of high uptake in PET/CT imaging, were selected. The clinical features and imaging manifestations of the two lesions were analyzed and reviewed in order to get inspiration and improve the diagnostic accuracy of benign SPN in future work.
A solitary pulmonary nodule (SPN) is a single, well-circumscribed nodule with diameter less than 3 cm. The clinical manifestations and imaging features of SPN are usually atypical because of the small size and it is often found during physical examination. There are many kinds of benign SPN, including tuberculosis, hamartoma, sclerosing hemangioma, pulmonary inflammatory myofibroblastoma tumor and so on. Tuberculosis and pulmonary inflammatory myofiblastic tumor, which are easily misdiagnosed because of high uptake in PET/CT imaging, were selected. The clinical features and imaging manifestations of the two lesions were analyzed and reviewed in order to get inspiration and improve the diagnostic accuracy of benign SPN in future work.
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