SPECT V/Q断层显像半定量分析联合测定血浆D-二聚体诊断肺栓塞的价值

研究V/Q断层显像半定量分析联合测定血浆D-二聚体早期、准确诊断肺栓塞的价值,尤其在小面积肺栓塞诊断中的应用优势。疑诊肺栓塞来核医学科行V/Q断层显像患者共156例,以CT肺血管造影（computed tomographic pulmonary angiography, CTPA）检查及临床诊断为分组标准,肺栓塞组患者101例,非肺栓塞组患者55例。比较SPECT V/Q断层显像、血浆D-二聚体测定以及SPECT V/Q断层显像联合血浆D-二聚体测定三种方法对肺栓塞的诊断效能。应用Philips公司Oasis图像后处理软件对栓塞面积进行半定量分析,进一步评估对于肺栓塞面积占双肺容积≤15%的小面积肺栓塞的诊断价值。结果显示,血浆D-二聚体测定对于肺栓塞的诊断有较高的灵敏度（70.3%）,但是特异性（61.8%）差;SPECT V/Q断层显像半定量分析对于肺栓塞的诊断具有较高的灵敏度和特异性,分别为85.1%、90.9%;而二者联合应用,诊断肺栓塞效能最高,灵敏度和特异性分别为91.1%、98.2%。 其中SPECT V/Q断层显像半定量分析对于肺栓塞面积小于15%的小面积肺栓塞诊断有优势。放射性核素SPECT V/Q断层显像联合测定血浆D-二聚体能显著提高肺栓塞的诊断效能,是临床实用、安全有效的肺栓塞疑诊患者诊断策略。     

18F-FDG SPECT探测心肌的活力

探讨了18F-FDG单光子发射型计算机断层(SPECT)探测心肌活力的原理及显像技术的进展等,并将其与其它显像技术进行了比较.结果表明,18F-FDG SPECT可以作为18F-FDG正电子发射断层(PET)的替代方法并比其它一些显像方法优越.     

脑SPECT在癫痫儿童中的应用

对１５例儿童癫痫进行发作间期ＳＰＥＣＴ脑局部血流显像，部分患者同时进行了ＥＥＧ、ＣＴ、ＭＲＩ检查。结果显示ＳＰＥＣＴ阳性率最高，ＥＥＧ次之，ＣＴ、ＭＲＩ检出率的低于前二者，表明ＳＰＥＣＴ脑血流显像是诊断儿童癫痫灶的有效方法，且对癫痫儿童的预后，局部脑血流变化与临床表现的演变之间关系等研究有帮助。     

Evaluation of suspected local recurrence in lung cancer and head & neck cancer: A comparison between 99mTc-HL91 SPECT and CT for biopsy proven lesions

CT has rather low accuracy for the follow-up of rumors after therapy. This study was to determine whether the diagnostic accuracy can be improved with 99mTc-HL91 SPECT in comparison with parallel results of CT imaging. Thirty patients of lung cancer or head & neck cancer, suspected of recurrences on clinical symptoms and CT during clinical follow-up after therapy, underwent 99mTc-HL91 SPECT. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest technique. Results of 99mTc-HL91 SPECT were verified by histopathology. The 99mTc-HL91 average uptake ratios of T/NT in the group of recurrent lesions and non-recurrent lesions were 1.58±0.16 and 1.18±0.14, respectively. A significant difference was found between T/NT data of the two phases (t=4.87, P<0.001). The 99mTc-HL91 SPECT shows sensitivity of 72.73%, specificity of 89.47% and accuracy of 83.83% for differentiating recurrent lesion, while the CT shows sensitivity of 63.63%, specificity of 84.21% and accuracy of 76.67%. A combination of 99mTc-HL91 SPECT and CT for 21 patients with lung cancers or head & neck cancers with congruent results shows sensitivity of 100%, specificity of 94.12% and accuracy of 95.23%. It is concluded that 99mTc-HL91 SPECT may play a role in differentiating recurrent lesions in patients with lung cancer and head & neck cancer. Furthermore, the combination of CT and 99mTc-HL91 SPECT is a more effective method for diagnosing recurrence of lung cancer and head & neck cancer.     

99mTc-tetrofosmin SPECT显像在肺癌和纵膈淋巴结转移的临床研究

对３２例手术病理证实的肺癌和肺结核病人（其中鳞状上皮癌１６例,腺癌８例,小细胞肺癌４例,肺转移癌２例,肺结核２例）,进行＾９９ｍＴｃ－ＴＦ ＳＰＥＣＴ显像和ＣＴ检查,将结果直接与手术结果对比,来评价肺和纵膈淋巴结病变。结果在肺癌原发灶,＾９９ｍＴｃ－ＴＦ ＳＰＥＣＴ显像具有较高的灵敏度（９３％,２８／３０）,但２例肺结核病灶也显示＾９９ｍＴｃ－ＴＦ的摄取增高。有５例手术证实伴有肿瘤中心坏死的肺癌病     

SPECT脑血流灌注显像的临床应用价值及对缺血性脑血管病支架植入术后的疗效评价

采用SPECT脑血流灌注显像法对缺血性脑血管病支架植入术患者术后的疗效进行了评价。27例患者经数字减影血管造影(Digital Subtraction Angiography,DSA)证实存在脑血管狭窄,并行脑CT、MR及99Tcm-ECD SPECT检查。10例患者施行狭窄处支架成形术,其中7例患者于术后3~6个月复查SPECT脑血流灌注显像,通过半定量分析法对比手术前后缺血灶感兴趣区局部脑血流量(rCBF)与小脑rCBF比值的改变,评价术后局部脑血流改善状况。结果显示,SPECT脑血流灌注显像较MR、CT显像能显示出更多的缺血区域,但基底节和室旁白质除外;7例进行介入治疗手术的患者,其术前SPECT反映17处缺血区与同侧小脑rCBF比均数为73.42%,术后为80.67%,较术前有显著改善,P0.01。以上结果提示,99Tcm-ECD SPECT脑血流灌注显像对脑缺血病灶反映较为敏感,并能很好地评价施行支架植入术后患者的脑血流状况。     

SPECT的质量控制及有关参数的五年前后对比

选择能反映ＳＰＥＣＴ性能的九项指标（平面显像部分：固有空间分辨率，系统空间分辨率，固有均匀性，能量分辨率，线性度，最大计数率；断层显像部分：断层分辨率，断层均匀性，旋转中心漂移），用组织等效材料制备了点源、线源和断层分辨率模型，并应用断层均匀性模型、四象限铅栅模型和线性模型对我院１９８８年５月引进的Ｅｌｓｃｉｎｔ公司的ＡＰＥＸ４０９ＡＧＳＰＥＣＴ进行了测试，并将测试结果与１９８８年有关测试结果相比较。     

SPECT脑灌注显像探测SLE脑内损伤的价值

为探讨SPECT脑血流灌注显像诊断SLE脑部受损的价值,分别对18例SLE患者和11例正常对照组进行了SPECT脑血流灌注显像,采用肉眼读片分析及半定量分析进行评价。其中5例患者进行CT和／或MRI检查。结果表明,肉眼读片分析SPECT诊断SLE脑以损的灵敏度为67．7％,半定量分析的灵敏度达70％,CT灵敏度只有20％。不配对t检验示扣带回、颞顶吉等部位最常受累。说明SPECT及脑血流灌注显像有助于发现SLE患者脑部血流受损情况。     

SPECT脑血流灌注显像应用于脑血管疾病

７０例脑血管疾病患者（脑梗塞、ＴＩＡ、ＶＢＩ）行＾９９ｍＴｃ－ＥＣＤ ＳＰＥＣＴ脑血流灌注显像，并与ＣＴ、ＭＲＩ对照，结果ＳＥＰＣＴ诊断脑血管病的阳性率为９０％。ＣＴ为８８．２％（４５／５１），ＭＲＩ为９０％（２７／３１）。脑梗塞５５例中５１例ｒＣＢＦ图像上出现血流灌注减低区，４例发现交叉性小脑神经机能失联络证。诊断ＴＩＡ、ＶＢＩ的阳性率为７５％。ＳＰＥＣＴｒＣＢＦ显像发现病灶较ＣＴ、ＭＲＩ多；可