Value of low-dose and optimized-length computed tomography(CT)scan in CT-guided percutaneous transthoracic needle biopsy of pulmonary nodules

Objective:To investigate the value of application of low-dose and optimized length CT scan on puncture results,complications and patients’radiation dosage during CT-guided percutaneous biopsy of pulmonary nodules(PTNB).Methods:A total of 231 patients with PTNB under CT guidance were collected.Low dose scanning utilized tube current of 20 mA as compared with 40 mA in conventional dosage.Optimized length in CT is defined as intentionally narrowing the range of CT scanning just to cover 25 mm(5 layers)around the target layer during needle adjustment.According to whether low-dose scans and optimized length scans techniques were utilized,patients were divided into three groups:conventional group(conventional sequence+no optimization),optimized length group(conventional sequence+optimized length),and low-dose optimized length group(low dose sequence+optimized length).The ED(effective dose),the DLP(dose length product),the average CTDIvol(Volume CT dose index),total milliampere second between subgroups were compared.Results:Compared with the conventional group,ED,intraoperative guidance DLP,total milliseconds and operation time in the optimized length group were reduced by 18.2%(P=0.01),37%(P=0.003),17.5%(P=0.013)and13.3%(P=0.021)respectively.Compared with the optimized length group,the ED was reduced by 87%,preoperative positioning,intraoperative guidance and postoperative review DLP were also reduced by 88%,total milliampere second was reduced by 79%,with an average CTDIvol was reduced by 86%,in the low-dose optimized length group(P<0.001 for all).Conclusion:Optimizing the length during CT scanning can effectively reduce the intraoperative radiation dose and reduce the operation time compared with conventional plan;low-dose and optimized length CT scan can further reduce the total radiation dose compared with optimized length group with no differences on intraoperative complications,biopsy results and operation time.

Precise localization of small pulmonary nodules using Pre-VATS with Xper-CT in combination with real-time fluoroscopy-guided coil:report of 15 patients

Purpose: This study aimed to evaluate the value of precise localization of nodules using pre-video-assisted thoracic surgery(VATS) Xper–CT in combination with real-time fluoroscopy-guided coil in the resection of pulmonary nodules using VATS. Materials and Methods: Precise localization of nodules using Xper-CT in combination with real-time fluoroscopy-guided coil and wedge resection using VATS were conducted on 15 patients with 17 small pulmonary nodules(diameter 0.5–1.5 cm) from April 2015 to January 2016. The value of localization was evaluated in terms of procedure time, type of coils, associated complications of localization, and VATS success rate. Results: The success rate of coil localization was found to be 100% in the primary stage(as shown by the CT scan), and the average procedure time was 30–45 min(35.6 ± 3.05 min). No deaths or major complications occurred. Minor complications included five incidents of pneumothorax(the morbidity was 29.4%, 5/17; no patient required chest tube drainage). The dislocation of coil was found in one patient. The results of pathological examination of 17 small pulmonary nodules revealed 11 primary lung cancers, 1 mesenchymal tumor, 3 nonspecific chronic inflammations, 1 hamartoma, and 1 tuberculosis. Two patients with primary lung cancer underwent lobectomy with mediastinal lymph node dissection. Conclusion: The preoperative precise localization of small pulmonary nodules using Xper-CT-guided coil is an effective and safe technique. It helps in the resection of nodules using VATS. It increases the rate of lung wedge resection with few complications and allows for proper diagnosis with a low thoracotomy conversion rate.

Contrast-Enhanced CT-Guided Core Biopsy of Retroperitoneal Masses

Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was performed in 26 patients. Histopathological diagnosis was obtained and accuracy was calculated. Two blinded radiologists determined feasibility of biopsy procedures on routine CT-guidance, and compared accessibility of target lesions using contrast-enhanced and non-contrast-enhanced CT. Results: Satisfactory samples were obtained in all 26 patients and pathological diagnosis was made in 24. Accuracy was 95.5%. Routine CT-guided biopsy punctures were not satisfaction in 4/26 patients, and contrast-enhanced CT scans rendered the target lesions more accessible in 16 patients. Conclusion: Contrast-enhanced CT-guided biopsy increases the feasibility of biopsy of retroperitoneal masses.

Percutaneous CT-Guided Drainage of Gastric Leaks Post-Sleeve Gastrectomy

Objectives: The aim of this study was to assess the safety and efficacy of percutaneous CT-guided drainage of gastric leaks post sleeve gastrectomy. Methods: For this single-center retrospective study, we reviewed the clinical data of 78 patients (44 men and 34 women with an average age of 34.6 &plusmn;10.5 years and a body mass index (BMI) of 45 kg/m2 &plusmn;3.2) that underwent percutaneous CT-guided drainage of gastric leaks due to sleeve gastrectomy from September 2011 to September 2018. The outcome measurements were technical and clinical success, complications, and the need for revisional surgery. Results: The technical success rate of drain insertion was 97.5% (76/78 patients). All of the patients (76/76 patients) exhibited early clinical and laboratory improvement, and no emergency surgery was required. However, six patients underwent revisional surgery after 3 - 5 months for non-healing gastric leaks/fistulas. One patient had a major complication of active bleeding due to arterial injury;this was managed by transcatheter coil embolization. All patients underwent endoluminal stent placement and received antimicrobial therapy and nutritional support. Conclusion: Percutaneous CT-guided drainage of gastric leaks after sleeve gastrectomy is a safe, effective, and minimally invasive alternative to surgery. This technique is in line with other conservative measures (endoluminal stent placement, antimicrobial therapy, and nutritional support), which heal most gastric leaks due to sleeve gastrectomy and prevent the need for revisional surgery.

Effectiveness and Therapeutic Impact of CT-Guided Percutaneous Drainage for Deep Neck Abscesses

Objective: The purpose of this study is to evaluate the effectiveness and safety of CT-guided percutaneous drainage (CPD) in the management of deep neck abscesses. Factors associated with successful treatment in patients with DNA will be identified. Methods: We retrospectively studied 29 patients who presented to the department of otolaryngology with deep neck abscesses between April 2011 and April 2015. These 29 patients were managed with CPD after antibiotic therapy or needle aspiration failed. Data on patient demographics, location of infection, existing comorbidity, duration of hospitalization, treatment received, and complications were reviewed. Results: The average age of 29 patients, including 18 men and 11 women, was 56 years old. Abscess was found in parapharyngeal space (n = 16), submandibular space (n = 7), retropharyngeal space (n = 5) and pretracheal space (n = 1). The maximum transverse diameter of abscess ranged from 4.8 cm to 8.0 cm (mean 6.03 cm). Positive cultures were found in 24 cases and the most common pathogen found was Streptococcus viridans. Average hospital stay was 6.7 days. Deep neck abscesses were completely removed without residual in all patients. No one had complications and no one died during and after CPD. Conclusion: CPD is a safe and highly effective procedure for treating patients with deep neck abscesses who do not respond to antibiotics therapy. This technique can also provide reliable evidence on pathogens responsible for deep neck abscesses and help otolaryngologists choose effective treatment to achieve better clinical success rate. We recommend that most deep neck abscesses should be managed initially by CPD before resorting to open surgery.

Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study

AIM： Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies. METHODS： Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of ^18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square （RMS） was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS： In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions. CONCLUSION： Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

Biological effects of human lung cells MRC-5 in CBCT positioning for image-guided radiotherapy

Image-guided radiotherapy(IGRT) provides precise positioning for the tumor target, but it may bring extra irradiation dose in the target positioning with a cone beam CT(CBCT) which has been increasingly used in IGRT. In this work, we focused on biological effects of the low-dose irradiation in IGRT, which have not been considered so far. Primary human fibroblasts cells from the lung and MRC-5 were irradiated by a CBCT. DNA doublestrand breaks(c-H2 AX foci) and micronucleus frequency of the irradiated samples were analyzed. Compared to the control, the c-H2 AX foci yields of the samples irradiated to 16 m Gy increased significantly, and the micronuclei rate of the samples irradiated for 3 days increased notably. The dose by imaging guidance device can be genotoxic to normal tissue cells, suggesting a potential risk of a secondary cancer. The effects, if confirmed by clinical studies,should be considered prudentially in designing IGRT treatment plans for the radiosensitive population, especially for children.

Minioptical Navigation System for CT-Guided Percutaneous Liver Procedures

Purpose: To evaluate a new miniature optical navigation system for CT-guided liver interventions. Material and Methods: A two-center, prospective study was performed with four interventional radiologists. A total of 20 patients had CT-guided liver biopsy or ablation interventions utilizing the CT-Guide? navigation system (ActiViews Inc., Wakefield, MA) between July 2011 and December 2011. The navigation system consists of a self-adhesive patientsticker printed with coincident colored and radio-opaque reference markers, a miniature disposable video camera that clips on and off an interventional instrument, and software loaded on a computer to display the navigation information. The primary end point was the frequency of a satisfactory instrument position for the intended intervention. Results: The cohort consisted of 13 males and 7 females with an average age of 63.1 years (range of 38 to 80). Most of the patients, 70%, underwent CT-guided liver biopsy while the remainder had CT-guided ablation therapy. The average lesion size was 3.1 cm (range of 1.1 - 6.9 cm). All of the interventions, regardless of lesion size, met the primary end point of satisfactory instrument positioning. There were no device-related or unexpected adverse events recorded. Only one patient had a mild adverse event and it resolved without intervention. Conclusions: This study demonstrated the safety and effectiveness of the CT-Guide? navigation system for CT-guided liver interventions, for both biopsies and ablations. The targeting success rate for a satisfactory intervention was 100% with the system.

SOSNet:一种非对称编码器-解码器结构的非小细胞肺癌CT图像分割模型

非小细胞肺癌严重损害人类健康,早期非小细胞肺癌CT(Computed Tomography)图像中的肿瘤结节体积小,不易发现,极易造成漏诊和误诊.为了精确分割非小细胞肺癌CT图像中的小体积肿瘤结节,本文提出SOSNet(Small Object Segmentation Networks)自动分割模型,利用ResNet(Residual Network)基础层和空洞卷积构造非对称编码器-解码器结构作为分割主网络,利用轴向取反注意力模块ARA(Axial Reverse Attention)逐步擦除背景中对分割有影响的结构,再使用结构细化模块SR(Structure Refinement)对主网络输出的粗略特征图进行结构细化,从而实现非小细胞肺癌肿瘤结节分割.在非小细胞肺癌公开数据集的实验测试表明,本文提出的小目标自动分割模型SOSNet可以有效分割出非小细胞肺癌CT图像中的小体积肿瘤结节,其mDice(mean-Dice)、mIoU(mean Intersection over Union)、Sensitivity、F1、Specificity、平均绝对误差MAE(Mean Absolute Error)均优于当前最先进的小目标分割模型CaraNet(Context Axial Reverse Attention Network).

CT肺动脉血管造影联合血清Apelin-13、IL-38在急性肺栓塞诊断中的临床价值

目的探究CT肺动脉血管造影(CTPA)联合血清Apelin-13、白细胞介素-38(IL-38)在急性肺栓塞(APE)诊断中的临床价值。方法选取2021年5月-2023年5月本院收治的116例疑似APE患者,患者均行CTPA,根据其检测结果分为APE组和非APE组;酶联免疫吸附法检测Apelin-13、IL-38水平;APE的影响因素采用多因素Logistic回归分析;绘制ROC曲线分析血清Apelin-13、IL-38对APE的诊断价值。结果116例患者经过CTPA诊断出APE 49例(42.24%),主要包括23例中心型,82例偏心型,15例附壁血栓型,19例完全堵塞型。APE组血清Apelin-13、IL-38水平显著高于非APE组(P<0.05)。多因素Logistic回归分析得知Apelin-13、IL-38为影响APE的危险因素(P<0.05)。根据ROC曲线得知,血清Apelin-13诊断APE的AUC为0.859,血清IL-38诊断APE的AUC为0.864,二者联合诊断APE的AUC为0.952,二者联合优于各自单独诊断(Z_(联合vs Apelin-13)=2.681、Z_(联合vs IL-38)=2.739,P均<0.05)。结论Apelin-13、IL-38在APE患者血清中明显升高,CTPA可显示APE的部位和类型,CTPA联合血清Apelin-13、IL-38可提高APE的诊断价值。

电磁导航支气管镜引导下肺结节定位和CT引导下Hook-wire穿刺定位在肺癌根治术中的应用效果及安全性比较

目的对比电磁导航支气管镜(ENB)引导下肺结节定位和CT引导下Hook-wire穿刺定位在肺癌根治术中的应用效果和安全性。方法将87例行肺癌根治术患者根据定位方式的不同分为CT组(n=45,行CT引导下Hook-wire穿刺定位)和ENB组(n=42,行ENB引导下肺结节定位)。比较两组患者手术情况、切缘阳性率、心肺功能指标、应激指标和并发症发生情况。结果ENB组患者定位时间、定位后等待时间均短于CT组,差异均有统计学意义(P﹤0.05)。术后7天,两组患者左心室射血分数(LVEF)、每搏量(SV)、用力肺活量(FVC)均较术前降低,但ENB组患者LVEF、SV、FVC均高于CT组,差异均有统计学意义(P﹤0.05)。术后1天,两组患者白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C反应蛋白(CRP)、皮质醇(Cor)水平均较术前升高,但ENB组患者IL-6、IL-8、CRP、Cor水平均低于CT组,差异均有统计学意义(P﹤0.05)。两组患者并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论相比于CT引导下Hook-wire穿刺定位,ENB引导下肺结节定位的定位时间和定位后等待时间更短,能够更加有效地改善患者的心肺功能,减轻应激反应。

基于CT征象和血清巨噬细胞集落刺激因子、β-连环蛋白构建的联合模型对孤立性肺结节的评估价值

目的探讨基于CT征象和血清巨噬细胞集落刺激因子(M-CSF)、β-连环蛋白(β-Catenin)构建的联合模型对孤立性肺结节的评估价值。方法选取2020年2月至2023年2月萍乡市人民医院病理结果显示孤立性肺结节的105例患者作为研究对象,以孤立性肺结节性质为结局指标,软件计算建模组所需样本量为75例,故随机抽取75例作为建模组、其余30例作为验证组,分析建模组孤立性肺结节不同性质患者一般资料、CT征象、生化指标,多因素logistic回归分析法筛选影响孤立性肺结节性质的独立影响因子,并建立预测模型。用验证组临床资料进行验证并将验证组临床资料代入预测模型,根据预测概率绘制ROC曲线评估该预测模型的效能。结果建模组75例病例中,良性肺结节43例(57.33%)、恶性肺结节32例(42.67)。单因素分析结果显示,良性、恶性肺结节患者毛刺征、分叶征、血管集束征、胸膜凹陷征、磨玻璃密度、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)、M-CSF、β-Catenin水平与建模组孤立性肺结节性质有关,差异有统计学意义(P<0.05)。多因素logistic回归分析显示:毛刺征(β=1.572,OR=1.612,95%CI=1.475~2.159)、分叶征(β=1.484,OR=1.650,95%CI=1.408~2.184)、血管集束征(β=1.292,OR=1.674,95%CI=1.466~2.198)、磨玻璃密度(β=1.307,OR=1.785,95%CI=1.501~2.263)、CEA(β=0.915,OR=1.797,95%CI=1.505~2.199)、NSE(β=0.920,OR=1.824,95%CI=1.618~2.218)、M-CSF(β=0.859,OR=1.765,95%CI=1.506~2.301)、β-Catenin(β=0.867,OR=1.806,95%CI=1.542~2.325)是影响建模组孤立性肺结节性质的独立危险因素(P<0.05),据此建立的联合模型ROC曲线结果显示:该模型评估孤立性肺结节良恶性的灵敏度为90.50%、特异度为75.26%、AUC为0.880(95%CI=0.802~0.935)、阳性似然比为4.05、阴性似然比为0.12、阳性预测值为82.80%、阴性预测值为89.90%。结论毛刺征、分叶征、血管集束征、磨玻璃密度及CEA、NSE、M-CSF、β-Catenin水平升高是影响孤立性肺结节良恶性的独立影响因素,据此构建的联合模型评估孤立性肺结节良恶性的效能较高。

CT引导下Hook-wire定位辅助胸腔镜手术对早期肺癌患者的疗效分析

目的探讨CT引导下Hook-wire定位辅助胸腔镜手术对早期肺癌患者的疗效。方法选取92例早期肺癌患者,按随机数字表法分为两组,各46例。对照组行常规胸腔镜手术治疗,观察组行CT引导下Hook-wire定位辅助胸腔镜手术治疗。比较两组手术情况、创伤应激指标、肿瘤标志物水平及并发症。结果观察组手术时间、术后引流时间及住院时间为(138.52±10.52)min、(3.12±0.45)d、(10.35±1.25)d,短于对照组,术中出血量为(105.41±12.36)ml,少于对照组,差异有统计学意义(P<0.05);观察组术后皮质醇(Cor)、去甲肾上腺素(NE)、C反应蛋白(CRP)水平分别为(118.52±8.36)ng/ml、(185.93±14.52)ng/L、(32.41±4.25)mg/L,低于对照组,差异有统计学意义(P<0.05);观察组术后癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)水平为(8.96±1.15)ng/ml、(3.88±0.42)ng/ml、(12.63±1.54)U/ml,低于对照组,并发症少于对照组,差异有统计学意义(P<0.05)。结论CT引导下Hook-wire定位辅助胸腔镜手术治疗早期肺癌效果更佳,可减轻手术创伤,降低创伤应激反应,加快肿瘤标志物复常,减少并发症发生。

低温加氢催化剂CT6-13在硫磺尾气处理系统的应用

中国石油四川石化有限责任公司硫磺回收装置采用加氢还原吸收工艺及专用加氢催化剂进行尾气处理。将低温加氢催化剂CT6-13与常规加氢催化剂CT6-5B从物性、装填方法及预硫化、技术性能等方面进行了对比。深入对比分析CT6-5B和CT6-13在尾气加氢反应器的应用情况,发现采用CT6-13催化剂,节能降耗效果明显,尾气排放满足总硫不大于50μL/L、SO_(2)排放浓度不大于100 mg/m^(3)的设计要求。配套高效脱硫剂CT8-26及烟气洗涤技术,可实现开工过程尾气达标排放及日常运行过程尾气SO_(2)排放浓度不大于5 mg/m^(3)的超低排放。在节能降耗的同时解决了开停工及异常工况下的绿色生产及制约硫磺回收装置尾气焚烧炉长周期运行瓶颈问题。

心肌桥-壁冠状动脉血管形态学诊断中螺旋CT血管造影的应用研究

研究螺旋CT血管造影应用在心肌桥-壁冠状动脉血管形态学诊断中的有效性。方法 2021.3-2021.12月中医院受诊的130例疑似出现心肌桥-壁冠状动脉患者被纳入观察范围,对这些患者均采取螺旋CT血管造影检查,金标准以冠状动脉造影的诊断为核心,得到100例为确诊患者。了解螺旋CT血管造影和冠状动脉造影诊断结果的匹配性,记录患者病症基本情况。结果 在130例疑似患有心肌桥-壁冠状动脉的患者中,冠状动脉造影显示100例患者为阳性,占比76.92%,记作金标准。螺旋CT血管造影诊断结果表明96例为阳性,准确率为96.0.%,即螺旋CT血管造影诊断准确性较高;浅在型心肌桥-壁冠状动脉的患者,冠状动脉造影诊断心肌桥平均长度指标(4.52±0.71)mm、壁冠状动脉狭窄均值(31.26±4.28)%,螺旋CT血管造影诊断心肌桥平均长度指标(6.50±0.61)mm、壁冠状动脉狭窄均值(30.66±2.43)%,心肌桥平均长度的指标比较p<0.05,且壁冠状动脉狭窄指标比较p>0.05。深在型心肌桥-壁冠状动脉的检查,冠状动脉造影诊断心肌桥平均长度指标(9.01±1.40)mm、壁冠状动脉狭窄均值(47.45±4.39)%,与螺旋CT血管造影的心肌桥平均长度的指标比较p<0.05,且壁冠状动脉狭窄指标比较p>0.05;心肌桥-壁冠状动脉100例患者,属于轻度病症有43例、37中度病症有例、重度病症有20例。结论 对于心肌桥-壁冠状动脉血管形态学的临床诊断,和金标准结果比较相一致,准确率较高,便于患者有效预后,存在临床推广意义。

^(124)I的制备、抗体标记及标记化合物的Micro-PET/CT显像

为使用医用回旋加速器生产^(124)I及研究^(124)I标记提供方法,本研究通过124Te(p,n)^(124)I核反应制备^(124)I,首先压制得到124TeO_(2)/Al_(2)O_(3)靶片,利用回旋加速器轰击3~8 h后,放置12 h去除副反应产生的杂质核素,最后通过碘升华-放化分离法得到Na^(124)I溶液。分析Na^(124)I的纯度并且标记抗间皮素(mesothelin,MSLN)抗体后,对KM小鼠进行尾静脉注射观察^(124)I-anti-MSLN的分布。结果显示,压制得到的124TeO_(2)/Al_(2)O_(3)靶片经过12.5 MeV能量,20μA质子束轰击后得到340.4~1121.1 MBq核素产品,经纯化后得274.2~758.5 MBq高纯度Na^(124)I溶液,其放射性浓度>54840 Bq/μL。使用该Na^(124)I溶液对抗MSLN抗体标记得到放化纯度>99%的^(124)I-anti-MSLN探针,经尾静脉注射入KM小鼠体内,通过Micro-PET/CT显像可以观察到小鼠甲状腺部位有明显的探针摄取,且该摄取可以被提前3 d喂食0.5%KI溶液阻断,代谢行为符合^(124)I标记的抗体探针在KM鼠体内的代谢规律。本研究总结了25次^(124)I的制备过程中涉及的设备、方法及纯化后Na^(124)I的使用等情况,结果表明,经过纯化得到的^(124)I具有较高的核纯度和化学纯度,满足放射性标记的需求,且平均回收率高于70%,自动纯化过程安全可靠。

甲壳质酶蛋白-40、半胱氨酸蛋白水解酶-1及ASPECTS预测前循环大面积脑梗死介入取栓患者预后的价值研究

目的探讨甲壳质酶蛋白-40(chitinase protein-40,YKL-40)、半胱氨酸蛋白水解酶-1(cysteine proteolytic enzyme-1,Caspase-1)水平及ASPECTS对前循环大面积脑梗死介入取栓患者预后的预测价值。方法回顾性分析2020年6月—2023年2月于河北医科大学第一医院接受介入取栓治疗的180例前循环大面积脑梗死患者的病历资料。按照介入取栓3个月后的预后情况分为死亡组(41例)与存活组(139例),比较两组基线资料及介入取栓前YKL-40、Caspase-1水平。采用Cox回归分析探讨大面积脑梗死介入取栓预后的影响因素。利用ROC曲线分析探讨YKL-40、Caspase-1水平及ASPECTS预测大面积脑梗死介入取栓预后的效能。结果死亡组患者年龄及梗死灶面积大于存活组,ASPECTS低于存活组(均P<0.001)。死亡组患者的血清YKL-40水平([141.37±12.40)μg/L vs.(115.05±11.40)μg/L]、Caspase-1水平([13.05±1.15)ng/L v s.(8.61±0.64)n g/L]均高于存活组(均P<0.001)。C ox回归分析结果显示,梗死灶面积大(HR 1.011,95%CI 1.001~1.022)、YKL-40水平高(HR 1.033,95%CI 1.001~1.066)、Caspase-1水平高(HR 1.576,95%CI 1.264~1.966)均是前循环大面积脑梗死介入取栓后死亡的独立危险因素,ASPECTS高(HR 0.887,95%CI 0.794~0.991)是前循环大面积脑梗死介入取栓后死亡的保护因素。ROC曲线分析结果显示,血清YKL-40、Caspase-1水平及ASPECTS联合预测前循环大面积脑梗死介入取栓后死亡的效能(AUC 0.940,95%CI 0.890~0.990)优于上述3项指标单独预测[AUC分别为0.869(95%CI 0.806~0.933)、0.897(95%CI 0.828~0.966)、0.724(95%CI 0.642~0.806)]。结论YKL-40、Caspase-1水平及ASPECTS均与前循环大面积脑梗死介入取栓患者预后密切相关,可作为患者预后的预测指标。

2-18F-氟丁酸的自动化合成及荷前列腺癌裸鼠PET/CT显像评价

目的 研究2-18F-氟丁酸(2-18F-FBA)自动化合成工艺小柱纯化方法,使其能满足GMP生产要求缩短合成时间提高产率,并对其进行荷前列腺癌裸鼠PET/CT显像评价。方法 以GE TRACERlab FX-FN模块为基础,用“一锅法”和“柱水解法”合成2-18F-FBA。两种方案均使用2-溴丁酸甲酯为前体,经氟化、纯化和水解得终产品2-18F-FBA。荷前列腺癌裸鼠尾静脉注射2-18FFBA后于不同时间点行micro-PET/CT显像,PMOD软件勾画感兴趣区并计算最大标准化摄取值。结果“一锅法”和“柱水解法”合成2-18F-FBA的时间分别为35 min和27 min,未校正放化产率为(34±5.2)%和(41±3.7)%。Micro-PET/CT显示,注射2-18FFBA 30 min肿瘤处放射性摄取明显,60 min后,肿瘤/肌肉比相对较高。两种方案均能合成2-18F-FBA,“柱水解法”合成时间相对更短、产率更高。结论 2-18F-FBA荷前列腺癌裸鼠肿瘤处显像清晰,60 min时有较高的靶本比。

CTA技术在心肌桥-壁冠脉血管形态学诊断中的应用价值

目的探讨螺旋CT血管造影(CTA)诊断心肌桥-壁冠状动脉(MB-MCA)血管形态学的价值。方法200例疑似MB-MCA患者均进行CTA和冠状动脉造影(CAG)检查,分析CTA技术对MB-MCA的诊断价值,对比CTA与CAG对浅在型、深在型MB-MCA心肌桥长度、壁冠脉狭窄程度的检查结果。结果CTA诊断MB-MCA的灵敏度为98.14%,特异度为89.74%,准确率为96.50%。CTA显示的浅在型与深在型MB-MCA患者的心肌桥长度均高于CAG(P<0.05),但CTA和CAG的壁冠脉狭窄程度比较,差异均无统计学意义(P>0.05)。结论CTA诊断MB-MCA的灵敏度、特异度及准确率均较高,能够从多个角度对壁冠脉血管、管腔形态以及结构进行观察,明确心肌桥长度、壁冠脉狭窄程度等指标。

256层CT灌注成像联合半乳糖凝集素-3在术前肺癌纵隔淋巴结转移诊断中的应用

目的:分析256层CT灌注成像参数(CTPI)联合半乳糖凝集素-3(Gal-3)在术前肺癌纵隔淋巴结转移诊断中的应用价值。方法:回顾性分析2022年4月-2023年4月收治的87例肺癌患者的临床资料,根据纵隔淋巴结转移情况分为转移组(n=45)和未转移组(n=42)。另选取2022年4月-2023年4月进行体检的健康人群作为对照组(n=40)。对所有受试者进行血清Gal-3水平检测,并采用Brilliance iCT扫描仪进行CT灌注扫描。比较三组CTPI[表面通透性(PS)、灌注值(PV)、肺动脉血流量(PAF)、血容量(BV)、平均通过时间(MTT)、强化峰值(PEI)、支气管动脉血流量(BAF)]和血清Gal-3水平,并采用受试者工作特征(ROC)曲线评估CTPI、血清Gal-3水平及联合检测在术前肺癌纵隔淋巴结转移中的诊断效能。结果:转移组PS,PV和Gal-3均高于未转移组和对照组,未转移组PS,PV和Gal-3均高于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,PS值、PV及Gal-3水平联合检测肺癌纵隔淋巴结转移的线下面积高于各项单独检测,差异有统计学意义(P<0.05)。结论:256层CTPI联合血清Gal-3检测对术前肺癌纵隔淋巴结转移具有较高的诊断价值,可为肺癌患者术前评估提供重要依据。