Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of pro...Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of prognostication. In patients with heart failure, nuclear cardiology techniques are useful to establish the etiology and the severity of the disease, while fewer studies have explored the potential capability of nuclear cardiology to guide cardiac resynchronization therapy(CRT) and to select patients for implantable cardioverter defibrillators(ICD). Left ventricular synchrony may be assessed by radionuclide angiography or gated singlephoton emission computed tomography myocardial perfusion scintigraphy. These modalities have shown promise as predictors of CRT outcome using phase analysis. Combined assessment of myocardial viability and left ventricular dyssynchrony is feasible using positron emission tomography and could improve conventional response prediction criteria for CRT. Preliminary data also exists on integrated positron emission tomography/computed tomography approach for assessing myocardial viability, identifying the location of biventricular pacemaker leads, and obtaining left ventricular functional data, including contractile phase analysis. Finally, cardiac imaging with autonomic radiotracers may be useful in predicting CRT response and for identifying patients at risk for sudden cardiac death, therefore potentially offering a way to select patients for both CRT and ICD therapy. Prospective trials where imaging is combined with image-test driven therapy are needed to better define the role of nuclear cardiology for guiding device therapy in patients with heart failure.展开更多
BACKGROUND： Literatures have reported that the density changes of dopamine transporter is negatively correlated with the severity degree and grading of disease condition of Parkinson disease （PD）. However, the dist...BACKGROUND： Literatures have reported that the density changes of dopamine transporter is negatively correlated with the severity degree and grading of disease condition of Parkinson disease （PD）. However, the distribution ofdopamine transporter in each nucleus of corpora striatum at each period is still unclear. OBJECTIVE： To observe the radioactive uptake distribution of dopamine transporter in bilateral corpora striata of patients with different stages of PD using single photon emission computed tomography （SPECT）, and make a comparison with healthy controls. DESIGN： Case-control analysis. SETTING： Department of Imageology, Second Hospital Affiliated to Guangzhou University of Chinese Medicine. PARTICIPANTS： Thirty patients with PD admitted to Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and December 2005 were recruited. The involved patients, 19 male and 11 female, were aged from 36 to 80 years and with disease course of 2.5 months to 10 years. They all met the clinical diagnosis criteria of Britain Parkinson＇s disease Association Think Tank; Following Hoehn-Yahr grading： grade Ⅰ ： unilateral morbidity; grade Ⅱ： bilateral morbidity, but without balance disorder; grade Ⅲ： bilateral morbidity, accompanied with early posture balance disorder; grade Ⅳ： severe morbidity, needs more help; grade V ： without help, only in bed or wheelchair. There were 11 patients with mild PD （grade Ⅰ - Ⅱ ）, 9 patients with moderate PD （grade Ⅲ） and 10 patients with advanced PD （grade Ⅳ - Ⅴ ）. Meanwhile, 6 healthy persons were selected as normal controls. Informed consents were obtained from all the subjects. METHODS： Twenty-four hours after withdrawal of PD drugs, 30 patients with PD and 6 healthy controls took kalium perchloricum 400 mg orally. After lying down for 30 minutes, all the subjects were intravenously injected with 740 MBq 99Tc m-TRODAT-1 （Jiangsu Institute of Atomic Medicine, Batch No. 20040310） at elbow part. Following injection, image was collected using scanner for single photon emission computed tomography （ADAC Company, USA）. Matrix was 64 × 64, each detecting head revolved 180 ° , 1 frame/60 s. Sixty-four frames were collected with double detecting heads, 50 K/frame. Faultages with clearest image of corpora striatum were selected. Regions of interest （ROI） of caudate nucleus, anterior and posterior putamen and thalamic region in bilateral corpora striata were radioactively counted, and mean value of radioactive counting of ROI was used as the mean value ofpixel in each region of bilateral corpora striata. MAIN OUTCOME MEASURES： Comparison of radioactive uptake in each region of brain between healthy persons and patients with PD. RESULTS： Thirty patients with PD and six healthy persons who received body examination participated in the final result. Comparison of radioactive uptake in each region between healthy persons and patients with PD： ①In the healthy persons, high-density radioactive uptake was found in bilateral corpora striata; Structures of caudate nucleus, anterior and posterior putamen, and thalamus were clear with eudipleural radioactive distribution, and the background of peripheral brain tissue was very low. ②Radioactive intakes in opposite anterior and posterior putamen of patients with mild PD were significantly inferior to those in homolateral ones（70.45±3.35, 87.64±2.65, t =15.82, P 〈 0.05）. Structures of bilateral caudate nucleus and thalamus were clear with eudipleural radioactive distribution （P 〉 0.05）. ③Radioactive intakes in anterior and posterior putamen and thalamus of patients with moderate PD were significantly reduced as compared with healthy persons. There were significant differences in mean radioactive counting of ROI between patients with PD and healthy persons （t =5.20, P 〈 0.05： t =3.95, P 〈 0.05）; The structure of opposite caudate nucleus was not very clear, radioactive distribution of opposite caudate nucleus was significantly reduced as compared with homolateral one （81.11±4.25, 104.56±3.64, t = 14.65, P 〈 0.05）. ④As for patients with advanced PD, the structure of bilateral corpora striata was not clear, radioactive intake was significantly reduced and peripheral background was heightened, even higher than the distribution of the whole corpora striatum. CONCLUSION： SPECT DAT imaging of brain can show the distribution of radioactive uptake in each region of bilateral corpora striata of patients with different stages of PD, which is helpful to diagnose and evaluate the severity of PD.展开更多
Objective:To investigate the role of18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma.Methods:A retrospective analysis was carried out on 48 patients in Haikou Hospital from January 2015 to June 2018,...Objective:To investigate the role of18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma.Methods:A retrospective analysis was carried out on 48 patients in Haikou Hospital from January 2015 to June 2018,who were eventually pathologically diagnosed with lymphoma and had undergone18F-FDG SPECT/PET before definite diagnosis.(1)Patients were divided into Hodgkin's lymphoma group,diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group according to Pathological classification;and were divided into nodal lymphoma group and extranodal lymphoma group according to the presence of invasion to the tissues beyond lymph node;and were divided into stage I+Ⅱgroup and stageⅢ+IV group according to clinical Ann Arbor staging.The diagnostic consistencies of18F-FDG SPECT/PET and conventional imaging(CI)in each group were calculated,the T/N ratios of the lymphoma lesion were analyzed as well.(2)Clinical Ann Arbor staging,SPECT/PET staging and CI staging were performed in 48 patients,respectively.Then the efficacy of SPECT/PET staging and CI staging was compared,and the consistency of SPECT/PET staging and clinical Ann Arbor staging was compared as well.Results:(1)In this study,the diagnostic consistent rates of18F-FDG SPECT/PET and CI were 45.8%(22/48)and 16.6%(8/48),respectively(χ2=9.503,P=0.002<0.01).(2)The diagnostic consistent rate of18F-FDG SPECT/PET in diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group was higher than that of CI(P<0.05).There was no statistical significance between the diagnostic consistent rates of18F-FDG SPECT/PET in the Hodgkin's lymphoma group,diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group(χ2=1.067,P=0.448>0.05).(3)The diagnostic consistent rates of18F-FDG SPECT/PET in nodal group and extranodal group were 100.0%(19/19)and 21.1%(4/19)(χ2=24.783,P=0.000<0.01),respectively.(4)The diagnostic consistent rates of18F-FDG SPECT/PET and CI were 25%(2/8)and 0(0/8)in lymphoma with early stage(stage I+Ⅱgroup)(χ2=2.268,P=0.131>0.05),and 50%(20/40)and 20%(8/40)in lymphoma with late stage(stageⅢ+IV group)(χ2=7.912,P=0.002<0.01),respectively.(5)There was no statistical significance in T/N ratios of lymphoma lesions between different pathological groups,between nodal group and extranodal group,or between the stage I+Ⅱgroup and the stageⅢ+IV group(P>0.05).(6)The total consistent rates of18F-FDG SPECT/PET and CI for initial lymphoma staging were 79.2%(38/45)and 64.4%(31/48)(χ2=18.774,P=0.000<0.01).SPECT/PET staging was well consistent with clinical Ann Arbor staging in initial lymphoma staging(Kappa=0.696,P=0.000<0.01).Conclusion:The research has showed that the consistent rates of18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma are relatively high,and18F-FDG SPECT/PET plays an important role in the diagnosis and initial staging of lymphoma.展开更多
文摘Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of prognostication. In patients with heart failure, nuclear cardiology techniques are useful to establish the etiology and the severity of the disease, while fewer studies have explored the potential capability of nuclear cardiology to guide cardiac resynchronization therapy(CRT) and to select patients for implantable cardioverter defibrillators(ICD). Left ventricular synchrony may be assessed by radionuclide angiography or gated singlephoton emission computed tomography myocardial perfusion scintigraphy. These modalities have shown promise as predictors of CRT outcome using phase analysis. Combined assessment of myocardial viability and left ventricular dyssynchrony is feasible using positron emission tomography and could improve conventional response prediction criteria for CRT. Preliminary data also exists on integrated positron emission tomography/computed tomography approach for assessing myocardial viability, identifying the location of biventricular pacemaker leads, and obtaining left ventricular functional data, including contractile phase analysis. Finally, cardiac imaging with autonomic radiotracers may be useful in predicting CRT response and for identifying patients at risk for sudden cardiac death, therefore potentially offering a way to select patients for both CRT and ICD therapy. Prospective trials where imaging is combined with image-test driven therapy are needed to better define the role of nuclear cardiology for guiding device therapy in patients with heart failure.
文摘BACKGROUND： Literatures have reported that the density changes of dopamine transporter is negatively correlated with the severity degree and grading of disease condition of Parkinson disease （PD）. However, the distribution ofdopamine transporter in each nucleus of corpora striatum at each period is still unclear. OBJECTIVE： To observe the radioactive uptake distribution of dopamine transporter in bilateral corpora striata of patients with different stages of PD using single photon emission computed tomography （SPECT）, and make a comparison with healthy controls. DESIGN： Case-control analysis. SETTING： Department of Imageology, Second Hospital Affiliated to Guangzhou University of Chinese Medicine. PARTICIPANTS： Thirty patients with PD admitted to Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and December 2005 were recruited. The involved patients, 19 male and 11 female, were aged from 36 to 80 years and with disease course of 2.5 months to 10 years. They all met the clinical diagnosis criteria of Britain Parkinson＇s disease Association Think Tank; Following Hoehn-Yahr grading： grade Ⅰ ： unilateral morbidity; grade Ⅱ： bilateral morbidity, but without balance disorder; grade Ⅲ： bilateral morbidity, accompanied with early posture balance disorder; grade Ⅳ： severe morbidity, needs more help; grade V ： without help, only in bed or wheelchair. There were 11 patients with mild PD （grade Ⅰ - Ⅱ ）, 9 patients with moderate PD （grade Ⅲ） and 10 patients with advanced PD （grade Ⅳ - Ⅴ ）. Meanwhile, 6 healthy persons were selected as normal controls. Informed consents were obtained from all the subjects. METHODS： Twenty-four hours after withdrawal of PD drugs, 30 patients with PD and 6 healthy controls took kalium perchloricum 400 mg orally. After lying down for 30 minutes, all the subjects were intravenously injected with 740 MBq 99Tc m-TRODAT-1 （Jiangsu Institute of Atomic Medicine, Batch No. 20040310） at elbow part. Following injection, image was collected using scanner for single photon emission computed tomography （ADAC Company, USA）. Matrix was 64 × 64, each detecting head revolved 180 ° , 1 frame/60 s. Sixty-four frames were collected with double detecting heads, 50 K/frame. Faultages with clearest image of corpora striatum were selected. Regions of interest （ROI） of caudate nucleus, anterior and posterior putamen and thalamic region in bilateral corpora striata were radioactively counted, and mean value of radioactive counting of ROI was used as the mean value ofpixel in each region of bilateral corpora striata. MAIN OUTCOME MEASURES： Comparison of radioactive uptake in each region of brain between healthy persons and patients with PD. RESULTS： Thirty patients with PD and six healthy persons who received body examination participated in the final result. Comparison of radioactive uptake in each region between healthy persons and patients with PD： ①In the healthy persons, high-density radioactive uptake was found in bilateral corpora striata; Structures of caudate nucleus, anterior and posterior putamen, and thalamus were clear with eudipleural radioactive distribution, and the background of peripheral brain tissue was very low. ②Radioactive intakes in opposite anterior and posterior putamen of patients with mild PD were significantly inferior to those in homolateral ones（70.45±3.35, 87.64±2.65, t =15.82, P 〈 0.05）. Structures of bilateral caudate nucleus and thalamus were clear with eudipleural radioactive distribution （P 〉 0.05）. ③Radioactive intakes in anterior and posterior putamen and thalamus of patients with moderate PD were significantly reduced as compared with healthy persons. There were significant differences in mean radioactive counting of ROI between patients with PD and healthy persons （t =5.20, P 〈 0.05： t =3.95, P 〈 0.05）; The structure of opposite caudate nucleus was not very clear, radioactive distribution of opposite caudate nucleus was significantly reduced as compared with homolateral one （81.11±4.25, 104.56±3.64, t = 14.65, P 〈 0.05）. ④As for patients with advanced PD, the structure of bilateral corpora striata was not clear, radioactive intake was significantly reduced and peripheral background was heightened, even higher than the distribution of the whole corpora striatum. CONCLUSION： SPECT DAT imaging of brain can show the distribution of radioactive uptake in each region of bilateral corpora striata of patients with different stages of PD, which is helpful to diagnose and evaluate the severity of PD.
基金National Natural Science Foundation of China(No.81960556)Hainan Health and Family Planning Industry Research Project(No.18A200179).
文摘Objective:To investigate the role of18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma.Methods:A retrospective analysis was carried out on 48 patients in Haikou Hospital from January 2015 to June 2018,who were eventually pathologically diagnosed with lymphoma and had undergone18F-FDG SPECT/PET before definite diagnosis.(1)Patients were divided into Hodgkin's lymphoma group,diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group according to Pathological classification;and were divided into nodal lymphoma group and extranodal lymphoma group according to the presence of invasion to the tissues beyond lymph node;and were divided into stage I+Ⅱgroup and stageⅢ+IV group according to clinical Ann Arbor staging.The diagnostic consistencies of18F-FDG SPECT/PET and conventional imaging(CI)in each group were calculated,the T/N ratios of the lymphoma lesion were analyzed as well.(2)Clinical Ann Arbor staging,SPECT/PET staging and CI staging were performed in 48 patients,respectively.Then the efficacy of SPECT/PET staging and CI staging was compared,and the consistency of SPECT/PET staging and clinical Ann Arbor staging was compared as well.Results:(1)In this study,the diagnostic consistent rates of18F-FDG SPECT/PET and CI were 45.8%(22/48)and 16.6%(8/48),respectively(χ2=9.503,P=0.002<0.01).(2)The diagnostic consistent rate of18F-FDG SPECT/PET in diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group was higher than that of CI(P<0.05).There was no statistical significance between the diagnostic consistent rates of18F-FDG SPECT/PET in the Hodgkin's lymphoma group,diffuse large B cell lymphoma group and other non-Hodgkin's lymphoma group(χ2=1.067,P=0.448>0.05).(3)The diagnostic consistent rates of18F-FDG SPECT/PET in nodal group and extranodal group were 100.0%(19/19)and 21.1%(4/19)(χ2=24.783,P=0.000<0.01),respectively.(4)The diagnostic consistent rates of18F-FDG SPECT/PET and CI were 25%(2/8)and 0(0/8)in lymphoma with early stage(stage I+Ⅱgroup)(χ2=2.268,P=0.131>0.05),and 50%(20/40)and 20%(8/40)in lymphoma with late stage(stageⅢ+IV group)(χ2=7.912,P=0.002<0.01),respectively.(5)There was no statistical significance in T/N ratios of lymphoma lesions between different pathological groups,between nodal group and extranodal group,or between the stage I+Ⅱgroup and the stageⅢ+IV group(P>0.05).(6)The total consistent rates of18F-FDG SPECT/PET and CI for initial lymphoma staging were 79.2%(38/45)and 64.4%(31/48)(χ2=18.774,P=0.000<0.01).SPECT/PET staging was well consistent with clinical Ann Arbor staging in initial lymphoma staging(Kappa=0.696,P=0.000<0.01).Conclusion:The research has showed that the consistent rates of18F-FDG SPECT/PET in the diagnosis and initial staging of lymphoma are relatively high,and18F-FDG SPECT/PET plays an important role in the diagnosis and initial staging of lymphoma.
