目的研究鼻咽癌患者^(99)Tc^(m)-MDP全身骨断层显像较全身骨平面显像在探测颅底骨质侵犯中的增益价值,并比较两种方法间不同医师对鼻咽癌颅底骨质侵犯的诊断一致性。方法选择2019年12月至2021年6月期间初诊为鼻咽癌并行^(99)Tc^(m)-MDP...目的研究鼻咽癌患者^(99)Tc^(m)-MDP全身骨断层显像较全身骨平面显像在探测颅底骨质侵犯中的增益价值,并比较两种方法间不同医师对鼻咽癌颅底骨质侵犯的诊断一致性。方法选择2019年12月至2021年6月期间初诊为鼻咽癌并行^(99)Tc^(m)-MDP全身骨平面显像及头颅部断层显像的患者171例,其中男性125例,女性46例,年龄为51.9±10.4岁,以鼻咽部MRI及临床随访≥6个月作为诊断标准,^(99)Tc^(m)-MDP全身骨平面显像及骨断层显像由两名主治及以上的医师进行判断,若同种方法二者结果不一致,则由两位医师进行协商讨论得出最终影像诊断结果,计算并比较两种显像方法对鼻咽癌颅底骨质侵犯的诊断效能,并比较两种显像方法间不同医生诊断的一致性。采用SPSS 25.0软件进行统计学分析,四格表χ^(2)检验比较两种方法间诊断效能,P<0.05为差异有统计学意义。Kappa分析评估两名医师间诊断一致性。结果通过鼻咽部MRI及随访≥6个月最终诊断为颅底骨质侵犯者118例,其余53例患者未发生颅底骨质侵犯。(1)鼻咽癌患者发生颅底骨质侵犯组与未发生颅底骨质侵犯组在年龄、性别、病理类型上差异均无统计学意义(t=1.236、χ^(2)=0.077,P=0.218、0.782、0.312)。(2)^(99)Tc^(m)-MDP骨断层显像诊断鼻咽癌患者颅底骨质侵犯的灵敏度、准确度、假阴性率优于全身骨平面显像,差异具有统计学意义(χ^(2)=11.030、4.212、11.030,P=0.001、0.04、0.001);而两者之间诊断的特异性、假阳性率、阳性预测值、阴性预测值差异无统计学意义(χ^(2)=3.433、3.433、1.070、2.259,P=0.064、0.064、0.301、0.133)。(3)^(99)Tc^(m)-MDP骨断层显像两位医生间的诊断一致性优于全身骨平面显像两位医生间诊断一致性(Kappa=0.820 vs 0.668)。结论^(99)Tc^(m)-MDP骨断层显像在探测鼻咽癌颅底侵犯时,相较全身骨平面显像提升了诊断灵敏度、准确度及降低了假阴性率,导致其诊断效能优于全身骨平面显像,对诊断此类患者侵犯范围及指导后续治疗具有重要的意义,同时^(99)Tc^(m)-MDP骨断层显像不同医师间诊断一致性优于全身骨平面显像,使其增强了医师的诊断信心及减少了诊断分歧。展开更多
Objective:To investigate the role of ^(99m)Tc-TRODAT-1 SPECT in diagnosis and assessing severity of idiopathicParkinson's disease(PD).Methods:Thirty-eight patients with primary,tentative diagnosis of PD and eighte...Objective:To investigate the role of ^(99m)Tc-TRODAT-1 SPECT in diagnosis and assessing severity of idiopathicParkinson's disease(PD).Methods:Thirty-eight patients with primary,tentative diagnosis of PD and eighteen age-matchednormal controls were studied with ^(99m)Tc-TRODAT-1 SPECT imaging.The regions of interests(ROIs)were drawn manually oncerebellum(CB),occipital cortex(OC)and three transverse plane slice-views of striatums,the semiquantitative BG(back-ground)/[(OC+CB)/2]were then calculated.Results:A lower uptake of ^(99m)Tc-TRODAT-1 in striatums were displayed inthirty-six out of thirty-eight PD patients by visual inspection,compared to controls.In twenty-four PD cases with HYS(Hoehn andYahr scale)stage Ⅰ,a greater loss of DAT uptake was found in striatum and its subregions contralateral striatum to the affectedlimbs than in the same regions of the controls,although the striatal uptake was bilaterally reduced.Using Spearman correlationanalysis showed that the reduction of the uptake ratios significantly correlated with the UPDRS in striatum and all its subregions inthe PD group(P<0.05),a similar change was also found in the putamen by using the rating scale of Hoehn and Yahr (P<0.05).However,analysis of variance(ANOVA)did not show any relationship between the decreasing uptake of ^(99m)Tc-TRODAT-1 andincreasing severity of PD patients,although the specific uptake of ^(99m)Tc-TRODAT-1 was continuously decreased in the striatumby visual inspection with the progress of PD from HYS stage Ⅰ to Ⅲ.Conclusion:^(99m)Tc-TRODAT-1 SPECT imaging may serve asa useful method for improving the correct diagnosis of PD.In assessing the role of ^(99m)Tc-TRODAT-1 SPECT in disease severity ofPD,UPDRS can offer a comprehensive index,although the Hoehn and Yahr assessment may be available in part.展开更多
文摘目的探讨^(99m)Tc-3PRGD2 SPECT/CT显像半定量参数对可疑乳腺病变的诊断价值,并根据乳腺癌分子分型进行分类比较,分析其与临床病理的相关性。方法收集2020年12月~2022年8月于我院接受检查的70例可疑乳腺病变患者病例资料。根据病理结果,分析乳腺癌Luminal阳性型、Her-2阳性型和三阴性型3种分子亚型与T/N值的相关性;分析雌激素受体、孕激素受体、Her-2及Ki67表达情况与影像学检查指标的关系。结果70例患者病理检查结果证实乳腺癌51例(72.86%),病理分型为Luminal阳性型22例,Her-2阳性型20例,三阴性型9例。乳腺良性病变24例(27.14%)。乳腺癌患者病变侧T/N值高于良性病变患者(3.96±0.82 vs 1.16±0.32),差异有统计学意义(t=14.426,P<0.05)。诊断特异性为84.21%(16/19),敏感度为82.35%(42/51),准确率为82.86%(58/70),ROC曲线下面积为0.834(0.755~0.913),诊断临界值为1.56,即T/N值≥1.56时判定为恶性病变。Her-2阳性型的T/N值高于三阴性型(P<0.05)。Her-2表达阳性患者的T/N值高于Her-2表达阴性的患者(P<0.05)。雌激素受体、孕激素受体和Ki67表达阳性和表达阴性患者的T/N值相比,差异均无统计学意义(P>0.05)。结论^(99m)Tc-3PRGD2 SPECT/CT显像半定量指标在诊断乳腺病变良恶性方面有较高的敏感度,并且Her-2阳性型患者T/N值明显升高,有助于早期发现和诊断乳腺病变,为预测乳腺癌分子分型和治疗有相应的指导作用。
文摘目的研究鼻咽癌患者^(99)Tc^(m)-MDP全身骨断层显像较全身骨平面显像在探测颅底骨质侵犯中的增益价值,并比较两种方法间不同医师对鼻咽癌颅底骨质侵犯的诊断一致性。方法选择2019年12月至2021年6月期间初诊为鼻咽癌并行^(99)Tc^(m)-MDP全身骨平面显像及头颅部断层显像的患者171例,其中男性125例,女性46例,年龄为51.9±10.4岁,以鼻咽部MRI及临床随访≥6个月作为诊断标准,^(99)Tc^(m)-MDP全身骨平面显像及骨断层显像由两名主治及以上的医师进行判断,若同种方法二者结果不一致,则由两位医师进行协商讨论得出最终影像诊断结果,计算并比较两种显像方法对鼻咽癌颅底骨质侵犯的诊断效能,并比较两种显像方法间不同医生诊断的一致性。采用SPSS 25.0软件进行统计学分析,四格表χ^(2)检验比较两种方法间诊断效能,P<0.05为差异有统计学意义。Kappa分析评估两名医师间诊断一致性。结果通过鼻咽部MRI及随访≥6个月最终诊断为颅底骨质侵犯者118例,其余53例患者未发生颅底骨质侵犯。(1)鼻咽癌患者发生颅底骨质侵犯组与未发生颅底骨质侵犯组在年龄、性别、病理类型上差异均无统计学意义(t=1.236、χ^(2)=0.077,P=0.218、0.782、0.312)。(2)^(99)Tc^(m)-MDP骨断层显像诊断鼻咽癌患者颅底骨质侵犯的灵敏度、准确度、假阴性率优于全身骨平面显像,差异具有统计学意义(χ^(2)=11.030、4.212、11.030,P=0.001、0.04、0.001);而两者之间诊断的特异性、假阳性率、阳性预测值、阴性预测值差异无统计学意义(χ^(2)=3.433、3.433、1.070、2.259,P=0.064、0.064、0.301、0.133)。(3)^(99)Tc^(m)-MDP骨断层显像两位医生间的诊断一致性优于全身骨平面显像两位医生间诊断一致性(Kappa=0.820 vs 0.668)。结论^(99)Tc^(m)-MDP骨断层显像在探测鼻咽癌颅底侵犯时,相较全身骨平面显像提升了诊断灵敏度、准确度及降低了假阴性率,导致其诊断效能优于全身骨平面显像,对诊断此类患者侵犯范围及指导后续治疗具有重要的意义,同时^(99)Tc^(m)-MDP骨断层显像不同医师间诊断一致性优于全身骨平面显像,使其增强了医师的诊断信心及减少了诊断分歧。
文摘Objective:To investigate the role of ^(99m)Tc-TRODAT-1 SPECT in diagnosis and assessing severity of idiopathicParkinson's disease(PD).Methods:Thirty-eight patients with primary,tentative diagnosis of PD and eighteen age-matchednormal controls were studied with ^(99m)Tc-TRODAT-1 SPECT imaging.The regions of interests(ROIs)were drawn manually oncerebellum(CB),occipital cortex(OC)and three transverse plane slice-views of striatums,the semiquantitative BG(back-ground)/[(OC+CB)/2]were then calculated.Results:A lower uptake of ^(99m)Tc-TRODAT-1 in striatums were displayed inthirty-six out of thirty-eight PD patients by visual inspection,compared to controls.In twenty-four PD cases with HYS(Hoehn andYahr scale)stage Ⅰ,a greater loss of DAT uptake was found in striatum and its subregions contralateral striatum to the affectedlimbs than in the same regions of the controls,although the striatal uptake was bilaterally reduced.Using Spearman correlationanalysis showed that the reduction of the uptake ratios significantly correlated with the UPDRS in striatum and all its subregions inthe PD group(P<0.05),a similar change was also found in the putamen by using the rating scale of Hoehn and Yahr (P<0.05).However,analysis of variance(ANOVA)did not show any relationship between the decreasing uptake of ^(99m)Tc-TRODAT-1 andincreasing severity of PD patients,although the specific uptake of ^(99m)Tc-TRODAT-1 was continuously decreased in the striatumby visual inspection with the progress of PD from HYS stage Ⅰ to Ⅲ.Conclusion:^(99m)Tc-TRODAT-1 SPECT imaging may serve asa useful method for improving the correct diagnosis of PD.In assessing the role of ^(99m)Tc-TRODAT-1 SPECT in disease severity ofPD,UPDRS can offer a comprehensive index,although the Hoehn and Yahr assessment may be available in part.
