ObjectiveTo investigate the significance of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT in the diagnosis of primary hyperparathyroidism, and its relationship with the level of serum calcium (CA). MethodsThe clinical data of 73 patients with parathyroid dysfunction (serum parathyroid hormone (PTH) > 130 pg/mL) were retrospectively analyzed. The 99Tcm-MIBI SPECT double phase imaging were performed in 73 cases, 63 cases underwent cervical B-ultrasound examination, and 16 cases underwent CT examination. According to the serum calcium (CA) levels, the patients were divided into CA < 2.7 mmol/L group and CA > 2.7 mmol/L group, and the postoperative pathological examination and followed-up results were as the standard, the sensitivity, specificity, positive predictive value, and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT for diagnosis of PHPT in different serum CA levels were compared. ResultsThe sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.6%, 81.8% and 35.7%, respectively; the specificity was 87.5%, 75.5% and 50.0%, respectively; the positive predictive value was 98.2%, 93.7% and 83.3%, respectively; and the negative predictive value was 46.7%, 33.3% and 10%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT were significantly higher than those of CT examination(P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging for diagnosis of PHPT were higher than those of B-ultrasound examination, but the difference was not statistically significant (P > 0.05). In the CA < 2.7 mmol/L group, the sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 91.1%, 84.7% and 37.9%, respectively; the specificity was 80.2%, 72.9% and 49.7%, respectively; the positive predictive value was 96.8%, 96.0% and 79.4%, respectively; and the negative predictive value was 50.0%, 37.5% and 10.0%. In the CA > 2.7 mmol/L group, The sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.9%, 83.9% and 42.8%, respectively; the specificity was 83.3%, 79.2% and 50.0%, respectively; the positive predictive value was 96.9%, 94.1% and 75.0%, respectively; and the negative predictive value was 50.0%, 40.5% and 20.0%. There were no significant difference in the diagnostic accuracy between the 3 methods and the level of serum CV in different levels. ConclusionsThe diagnostic accuracy of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT patients with PTH > 130 pg/mL (especially parathyroid adenoma) were higher than that of CT examination, and it is not associated with the serum CA concentration.
【摘要】目的探讨Fahr病的临床表现和影像学的诊断价值。方法回顾性分析1999年2008年就诊的11例经Fahr病的不同临床表现和CT、MRI及SPECT资料。结果所有患者都接受CT检查,9例MRI检查,8例SPECT扫描。CT可清晰地显示钙化病灶的大小范围；在显示钙化方面,MRI不如CT敏感,但MRI能显示病灶内和周围胶质增生、囊变与脱髓鞘的范围及程度;亦能较清晰的显示小脑齿状核的病变情况;SPECT能早期监测到双侧基底节和双侧大脑皮质的局部脑血流灌注下降程度。结论Fahr病临床表现各异,易误诊。CT、MRI和SPECT对其诊断具有协同作用。
目的 探讨单光子计算机断层扫描仪(SPECT)对抑郁症的疗效评估价值。 方法 2006年5月-2007年12月，选取32例未经治疗的原发性中、重度抑郁症患者，给予氟西汀治疗10周。治疗后根据临床疗效总评量表和汉密尔顿抑郁量表(HAMD)减分率作为疗效评定指标，将患者分为有效组21例，无效组11例。对所有患者于治疗前和治疗后分别进行99m锝-双半胱乙酯(99mTc-ECD)脑灌注显像。静脉注射99mTc-ECD 1 110 MBq，30 min后行脑断层显像，对显像结果分别进行目测及半定量分析两种方法进行判断。 结果 抑郁症患者出现的脑血流灌注减低区主要集中在前额叶、扣带回，经过治疗后好转的抑郁症患者脑血流灌注明显改善。可通过脑血流灌注显像评估抗抑郁治疗的疗效，左前额叶血流灌注越低，对氟西汀治疗效果越好。 结论 SPECT显像技术可视性较好，可用于评估抗抑郁治疗的疗效。
【摘要】 目的 探讨SPECT及CT对鼻咽癌颅底骨侵犯的检测能力。 方法 2006年5月-2009年12月对159例经病理确诊的初治鼻咽癌患者行颅底SPECT断层显像，同期行CT检查，分别计算颅底受侵的阳性率。 结果 ①159例鼻咽癌SPECT颅底断层阳性率46.5%（74/159），CT阳性率25.2%（40/159），SPECT检测敏感性高于CT（Plt;0.001）。 ②鼻咽癌伴颅神经损害SPECT检测敏感性高于CT（P=0.004）。 结论 SPECT对鼻咽癌颅底骨侵犯的检测敏感性优于CT。【Abstract】 Objective To compare the results of single-photon emission computed tomography (SPECT) and CT in skull base invasion in nasopharyngeal carcinoma (NPC). Methods A total of 159 patients with nasopharyngeal carcinoma were examined by SPECT and CT of nasopharynx and skull base from May 2006 to December 2009. The positive rates were compared by McNemar test. Results The positive rate of skull base invasion detected by SPECT and CT were 46.5% and 25.2% respectively (Plt;0.001). SPECT appeared to be superior to CT in the detection of skull base invasion in NPC with cranial nerve palsy (P=0.004). ConclusionsThe detection ability of SPECT in skull base invasion is superior to that of CT.
目的：研究心肌灌注显像（MPI）经CT衰减校正（CTAC）后伪影的产生及其对临床诊断的影响。方法：回顾性分析按Bayesian理论，冠心病患病率＜5%的48例受检者所行的72例次MPI（负荷41例次，静息31例次），图像在未行CTAC时显示正常者进行研究。将左心室心肌划分为20个节段，半定量分析（0分=放射性分布正常；1分=放射性分布轻度减低；2分=放射性分布中度降低；3分=放射性分布重度减低；4分=放射性分布缺损）各心肌节段在CTAC后放射性分布变化情况。结果：72例次MPI中，16例次（22.2%）的75个心肌节段（均在左心室心尖、前壁、前间壁区域）在CTAC后出现了放射性分布不同程度的减低。75个受累节段中分别有51、21和3个节段评分增加了1、2和3分，平均每个心肌节段评分增加了1.3分。41例次负荷MPI和31例次静息MPI中，分别有9例次（21.9%）的39个心肌节段、7例次（22.6%）的36个心肌节段在CTAC后出现了放射性分布减低，负荷与静息MPI相比，CTAC后发生心肌节段放射性分布减低的概率（χ2＝2.84，P＞0.05）与程度（u＝0.54，P＞0.05）均无显著统计学差异。10例负荷/静息MPI都满足纳入标准而纳入研究者中，4例的负荷/静息MPI在CTAC后，出现了相同部位（尖前壁、尖下壁）、相同程度（评分均增加了2分）的灌注降低；3例出现了同一部位，但不同程度的灌注减低；另有3例出现了不同部位心肌节段的灌注减低。CTAC后出现心肌节段灌注减低者与未出现者相比年龄、性别构成无统计学差异。结论：分析SPECT/CT心肌灌注图像时，应同时分析CTAC前后的灌注图像。对于只在CTAC后出现的灌注缺损，需要考虑可能存在CT与SPECT图像配位不准。
【Abstract】 Objective To evaluate the detection and localization of obscure lower gastrointestinal bleeding by using SPECT/CT and intraoperative endoscopy. Methods Twenty-six cases of patients with obscure lower gastrointestinal bleeding were analyzed retrospectively. Results The positive detection rate of SPECT/CT was 88.5%. All 26 patients (100%) were identified the bleeding source by using intraoperative endoscopy. No recurrence was found during 1-24 months follow-up. Conclusion SPECT/CT examination should be chosen firstly for patients with obscure lower gastrointestinal bleeding in order to localize the bleeding site roughly. Intraoperative endoscopy can localize the bleeding site accurately in patients who undergoes operation.
The high absorption rate of transplanted fat has limited the application of autogenous fat grafts in the clinical setting. Therefore, this study aimed to evaluate the effects of platelet-rich plasma (PRP) and adipose-derived stem cells (ASCs) on fat regeneration by investigating the impact of PRP and conditioned medium on the biological characteristics of ASCs. Fat grafts were prepared with ASCs at densities of 10(7)/ml, 10(6)/ml, 10(5)/ml, 10(4)/ml and 0/ml with and without PRP and injected subcutaneously into nude mice. Liquid overflow method, haematoxylin and eosin staining, and immunohistochemical analyses were used to examine the fat grafts. The residual fat volume of the 10(5)/ml ASC+PRP group was significantly higher than that of other treatment conditions after 90days. Furthermore, histological examination revealed that in 10(5)/ml ASCs-treated grafts normal adipocyte area and capillary formation were increased dramatically compared with other treatment conditions. It is concluded that fat grafts consisting of PRP and 10(5)/ml ASCs constitute an ideal transplant strategy, which may result in decreased absorption and accelerated fat regeneration. This simple and reliable method could provide a valuable and needed tool in plastic and reconstructive surgery. Copyright (c) 2014 John Wiley & Sons, Ltd.
Intraoperative frozen pathology is critical when a breast tumor is not diagnosed before surgery. However, frozen tumor tissues always present various microscopic morphologies, leading to a high misdiagnose rate from frozen section examination. Thus, we aimed to identify breast tumors using bioimpedance spectroscopy (BIS), a technology that measures the tissues' impedance. We collected and measured 976 specimens from breast patients during surgery, including 581 breast cancers, 190 benign tumors, and 205 normal mammary gland tissues. After measurement, Cole-Cole curves were generated by a bioimpedance analyzer and parameters R-0/R-infinity, f(c), and alpha were calculated from the curve. The Cole-Cole curves showed a trend to differentiate mammary gland, benign tumors, and cancer. However, there were some curves overlapped with other groups, showing that it is not an ideal model. Subsequent univariate analysis of R-0/R-infinity, f(c), and alpha showed significant differences between benign tumor and cancer. However, receiver operating characteristic (ROC) analysis indicated the diagnostic value of f(c) and R-0/R-infinity were not superior to frozen sections (area under curve [AUC]= 0.836 and 0.849, respectively), and a was useless in diagnosis (AUC= 0.596). After further research, we found a scatter diagram that showed a synergistic effect of the R-0/R-infinity, and f(c), in discriminating cancer from benign tumors. Thus, we used multivariate analysis, which revealed that these two parameters were independent predictors, to combine them. A simplified equation, RF' = 0: 2f (c) + 3: 6R(0)/R-infinity, based on multivariate analysis was developed. The ROC curve for RF' showed an AUC= 0.939, and the sensitivity and specificity were 82.62% and 95.79%, respectively. To match a clinical setting, the diagnostic criteria were set at 6.91 and 12.9 for negative and positive diagnosis, respectively. In conclusion, RF' derived from BIS can discriminate benign tumor and cancers, and integrated criteria were developed for diagnosis.
Cancer is the second most common cause of death in the USA. Its symptoms are often not specific and absent, until the tumors have already metastasized. Therefore, there is an urgent demand for developing rapid, highly accurate and noninvasive tools for cancer screening, early detection, diagnostics, staging and prognostics. Saliva as a multi-constituent oral fluid comprises secretions from the major and minor salivary glands, extensively supplied by blood. Molecules such as DNAs, RNAs, proteins, metabolites, and microbiota, present in blood, could be also found in saliva. Recently, salivary diagnostics has drawn significant attention for the detection of specific biomarkers, since the sample collection and processing are simple, cost-effective, and precise and do not cause patient discomfort. Here, we review recent salivary candidate biomarkers for systemic cancers by dividing them according to their origin into: genomic, transcriptomic, proteomic, metabolomic and microbial types.