X线、CT、SPECT、PET在评估小鼠的骨成像中的作用

目的利用各种影像诊断设备对正常小鼠的骨进行成像,观察其在小鼠骨成像中最佳成像参数。方法分别使用X线、CT、SPECT、PET对小鼠的骨进行拍摄成像。结果X线和CT均可以清楚地对小鼠的骨组织成像,而SPECT、PET由于其分辨率和特异性不高,成像较模糊。结论X线和CT检查对小鼠的骨成像明显,对小鼠疾病的观察有重要意义。而SPECT、PET对诊断小鼠的骨疾病意义不是很大。     

肝脏能谱CT虚拟平扫成像替代传统CT平扫成像可行性研究

目的:探讨肝脏能谱CT虚拟平扫成像替代传统CT平扫成像可行性,以供参考。方法:随机选取2013年6月至2014年6月我院已确诊的肝脏疾病患者49例作为研究对象,将2种不同的扫描成像方法分为2组,对照组:对49例患者采用传统CT平扫成像的方式进行肝脏扫描成像分析;实验组:对49例患者采用肝脏能谱CT虚拟平扫成像的方式进行肝脏扫描成像分析。2组成像结果出来之后统一交给经验丰富的影像诊断小组,并由诊断小组对2种影像进行噪声、伪影、病灶检测能力三方面进行主观对比评价、分析。结果:肝脏能谱CT虚拟平扫成像的平均噪声为2.18±0.58,平均伪影为1.57±0.38,而患者的平均吸收剂量为10.16±2.57;传统CT平扫成像的平均噪声为1.68±0.37,平均伪影为1.44±0.24,而患者的平均吸收剂量为20.06±4.47。且2组差异具有统计学意义(p0.05)。结论:肝脏能谱CT虚拟平扫成像可以代替传统CT平扫成像进行肝脏检查,且具有良好的诊断价值。     

640 层CT 对肝癌碘油栓塞沉积不良的临床分析

目的:探讨640层CT对肝癌碘油栓塞沉积不良患者治疗方案的临床指导。方法:21例富血供肝癌碘油动脉栓塞后,复查肝脏CT病灶内碘油沉积不良患者,用640层螺旋CT行CT灌注成像、CT动脉成像检查。结果:21例碘油沉积不良病灶内仍有动脉血供18例,坏死3例,18例有动脉血供病灶由肝动脉供血6例,膈下动脉供血3例,肠系膜上动脉供血4例,右侧副肾动脉供血1例,胃左动脉供血2例,右肾动脉供血2例。结论:640层螺旋CT灌注成像、CT动脉成像,可以准确显示肿瘤病灶碘油栓塞后肿瘤的残留与坏死,特别能精确判断肿瘤病灶血供起源情况,对再次介入治疗具有重要价值。     

CT全肝灌注的临床应用及进展

随着影像技术的发展和后处理功能的完善,肝灌注成像以研究组织、器官血流动力学变化已成为影像界关注的热点,然而CT灌注成像在肝脏等实质性器官中的应用尚处于探索阶段。肝脏具有双重血供,在各种病理生理情况下,肝脏动静脉之间及门静脉之间的血流动力学发生着复杂的变化。CT被认为是诊断肝脏病变最有价值的影像学方法,CT灌注成像能反映组织器官微循环内的血流动力学变化,是一种快速、准确、无创的功能成像方法。肝脏灌注CT检查可以同时获得形态和功能两方面的信息,使我们有可能早于形态学变化之前发现肝脏病变,有助于肝脏疾病的早期诊断和治疗,并能评价各种治疗手段对肝脏血流动力学变化的影响。本文针对全肝灌注CT扫描在临床的应用进行综述。     

肾脏肿瘤患者CT灌注参数与肾功能生化检测指标的相关性研究

目的:探讨肾脏肿瘤患者CT灌注参数与肾功能生化检测指标的相关性。方法:选取河北省第六人民医院2013年3月至2018年1月期间收治的35例肾脏肿瘤患者作为观察组,另选取同期来我院体检的35例健康者作为对照组,均对两组受试者实施CT灌注成像,获取等效血容量(Equiv BV)、表面渗透性(Ps)、血流量(BF)等CT灌注参数,并检测两组受试者血尿素氮(BUN)、血肌酐(Scr)、总胆固醇(TC)、甘油三酯(TG)等肾功能生化指标,对比两组受试者上述指标检测结果,采用Pearson相关分析CT灌注参数与肾功能生化指标的相关性。结果:与对照组相比,观察组CT灌注参数Equiv BV、Ps、BF均降低,肾功能生化指标BUN、Scr、TC、TG水平均升高,有统计学差异(P0.05)。Pearson相关分析结果显示,CT灌注参数Equiv BV、Ps、BF与肾功能生化指标TC、BUN均呈负相关(P0.05),与Scr、TG无相关性(P0.05)。结论:肾脏肿瘤患者的CT灌注参数Equiv BV、Ps、BF均较低,BUN、Scr、TC、TG水平均较高,且CT灌注参数与BUN、TC水平呈负相关性,可作为评估肾脏肿瘤患者肾功能的辅助方法。     

磁共振成像对乳腺肿瘤的诊断价值

乳腺癌是危及女性健康的常见恶性肿瘤之一,病死率较高,且发病年龄呈年轻化趋势。目前临床对乳腺疾病的检查方法很多,既往检查主要包括钼靶、超声等,因价格便宜、操作方便,已成为常规的乳腺疾病检查方法,但两者的敏感性和特异性较低并有自身的局限性。CT软组织分辨率较高,但检查过程中的X线剂量较大,并且动态增强时间较长,故作为乳腺钼靶的补充检查手段。这些检查方法对乳腺疾病均有不同的诊断意义,在当前众多诊断乳腺疾病方法中,具有无辐射,较高软组织分辨力及可多方位多层面成像的乳腺磁共振(MRI)成像有其独到的优势,某些方面能弥补超声和钼靶检查的局限性,乳腺磁共振可提供病灶形态学和增强血流动力学表现,可用于常规检查方法不能确诊病灶的鉴别诊断。乳腺肿瘤MRI成像对临床诊断、鉴别诊断及手术方案的选择有着极其重要的作用。本文就乳腺MRI影像技术、MRI影像学表现及其临床应用予以综述,探讨MRI在乳腺肿瘤中的应用。     

早期动态18F-FDG PET/CT成像在实体肿瘤评估中的应用

~(18)F-FDG PET/CT常规代谢成像反应肿瘤的葡萄糖代谢及乏氧情况,而~(18)F-FDG PET/CT早期动态成像能反映PET/CT成像早期肿瘤的灌注情况。由于肿瘤的异质性,在早期动态~(18)F-FDG PET/CT成像,即~(18)F-FDG PET/CT灌注成像中,存在独立于常规60 min~(18)F-FDG PET/CT代谢成像的SUVmax(最大标准摄取值)高摄取区。因此,在临床工作中应用~(18)F-FDG PET/CT早期动态成像,能够进一步对实体肿瘤的活性区域进行评估,能够更好评价患者预后、完善治疗方案。当前~(18)F-FDG早期动态成像已经应用在肝癌、肾癌以及膀胱癌等实体肿瘤诊断中。早期动态~(18)F-FDG PET/CT成像结合常规标准~(18)F-FDG PET/CT代谢成像,对实体肿块进行一站式成像方法,能够更好的对肿瘤进行评估。     

肾动脉CT血管造影在肾脏肿瘤出血介入栓塞治疗中的应用

目的:探讨肾动脉CT血管造影(Computed Tomography angiography,CTA)在-肾脏肿瘤出血介入栓塞治疗中应用的临床效果.方法:28例肾脏患者在介入栓塞治疗前行肾动脉CTA检查.在介入手术中寻找所有的肿瘤供血动脉,并逐一进行栓塞治疗.栓塞治疗一周后复查肾动脉CTA检查.对肾动脉CTA在介入栓塞治疗中应用效果进行回顾性总结评价.结果:28例肾脏肿瘤出血患者在介入栓塞治疗前行肾动脉CTA检查,共找到32支肿瘤供血动脉,介入手术中共找到34支肿瘤供血动脉并成功栓塞治疗.介入手术前肾动脉CTA检查诊断的准确率为94.12％(32/34).栓塞治疗后复查肾动脉CTA检查证实所有已栓塞的肿瘤供血动脉栓塞效果良好.结论:介入栓塞治疗前肾动脉CTA检查可以为肾脏肿瘤出血介入栓塞治疗提供准确的定位作用.栓塞治疗后肾动脉CTA检查有利于对栓塞疗效的准确判定.     

US、CT、MRI诊断妇科肿瘤的评价

超声(US)、电子计算机X线体层摄影(CT)、磁共振成像(MRI)等非创伤性诊断手段已能清晰显示妇科盆腔结构,对妇科盆腔肿瘤的定位与定性、病变范围提供了可靠的信息。目前,影像诊断已成为妇科盆腔肿瘤诊断、提供治疗方案及观察治疗效果极其重要的手段。本文就US、CT、MRI诊断妇科最常见的子宫和卵巢肿瘤的状况及评价作一综述。     

容积减影成像计算机自动化技术与实现

探讨在PC机上对容积CT灌注（CTP）源影像全自动生成减影CTP源影像的方法。首先在WindowsXP操作系统中使用Matlab,对4层螺旋CTP源影像进行DICOM文件格式解析,获得CT成像设备的球管每转一周扫描层数及容积减影方法需要的其它参数信息,然后经过容积的CT值集合读、容积的CT值集合减以及容积的CT值集合写等几个步骤,生成减影CTP源影像的DICOM文件序列。使用该容积减影方法得到的减影CTP源影像,在定性肉眼观察和定量CT值矩阵比对上,与使用CT影像工作站上的减影软件手工逐层半自动减影得到的结果类同。容积减影方法实现了容积CTP源影像的自动化减影处理与成像,为最终形成一个一站式的减影CTP软件奠定了基础。     

影像学在肾癌靶向治疗中的临床应用价值-现状与展望

肾癌为最常见的肾脏恶性肿瘤,其易复发及易出现远隔转移,靶向治疗已逐渐成为肾癌治疗中不可或缺的治疗手段。由于RECIST标准评价实体瘤疗效具有明显的局限性,临床实践中常使用电子计算机断层扫描(CT)、磁共振成像(MRI)评价疗效。随着技术的不断发展,很多新颖的影像学手段如动态增强超声(DCE-US)、正电子发射断层显像(PET-CT)等可以更准确更早期地评价及预测靶向治疗的疗效。本文对肾癌靶向治疗的影像学现状及展望进行综述。     

Intratumoral Administration of Holmium-166 Acetylacetonate Microspheres: Antitumor Efficacy and Feasibility of Multimodality Imaging in Renal Cancer

Purpose

The increasing incidence of small renal tumors in an aging population with comorbidities has stimulated the development of minimally invasive treatments. This study aimed to assess the efficacy and demonstrate feasibility of multimodality imaging of intratumoral administration of holmium-166 microspheres (¹⁶⁶HoAcAcMS). This new technique locally ablates renal tumors through high-energy beta particles, while the gamma rays allow for nuclear imaging and the paramagnetism of holmium allows for MRI.

Methods

¹⁶⁶HoAcAcMS were administered intratumorally in orthotopic renal tumors (Balb/C mice). Post administration CT, SPECT and MRI was performed. At several time points (2 h, 1, 2, 3, 7 and 14 days) after MS administration, tumors were measured and histologically analyzed. Holmium accumulation in organs was measured using inductively coupled plasma mass spectrometry.

Results

¹⁶⁶HoAcAcMS were successfully administered to tumor bearing mice. A striking near-complete tumor-control was observed in ¹⁶⁶HoAcAcMS treated mice (0.10±0.01 cm³ vs. 4.15±0.3 cm³ for control tumors). Focal necrosis and inflammation was present from 24 h following treatment. Renal parenchyma outside the radiated region showed no histological alterations. Post administration CT, MRI and SPECT imaging revealed clear deposits of ¹⁶⁶HoAcAcMS in the kidney.

Conclusions

Intratumorally administered ¹⁶⁶HoAcAcMS has great potential as a new local treatment of renal tumors for surgically unfit patients. In addition to strong cancer control, it provides powerful multimodality imaging opportunities.     

MSCT 灌注成像在肾细胞癌临床应用价值研究*

目的:探讨肾细胞癌多层螺旋CT(MSCT)灌注成像特征,并研究其临床应用价值。方法:肾癌患者69例,采用64排多层螺旋CT对其肾脏进行平扫及灌注增强扫描,使用renal tumor perfusion软件对图像进行后处理,自动生成时间-密度曲线(TDC),各种灌注图像及感兴趣区(ROI)内的灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)及表面通透性(PS),将得到的灌注参数分别进行统计分析。结果:肾癌肿块灌注参数与已测得的正常肾皮质各灌注参数值均存在显著性差异(P值均<0.01),其中,正常肾皮质的BF值、BV值及PS值均高于肾癌组织,MTT值则相反;肾癌肿块灌注参数与已测得的正常肾髓质各灌注参数值同样存在显著性差异(p值均<0.01),正常肾髓质各灌注参数值均低于肾癌组织,而PS值二者之间差别不显著(P<0.05);肾癌患者健侧肾皮髓质灌注参数值与已测得的正常肾皮髓质各灌注参数值及肾癌患者癌旁正常肾皮髓质各灌注参数值,三者之间差异无统计学意义(P>0.05)。结论:多层螺旋CT(MSCT)灌注成像在显示肾脏形态的同时,还可定量测量皮髓质的血流灌注情况,间接反映肾脏生理特征。     

Tumeurs du grêle et du côlon : importance de l’anatomie en coupes

The aim of this article is to describe the anatomic specificities of each different digestive tumors in CT imaging and to show the interest of contrast-enhanced CT and bowel opacification. Some specific points about lymph nodes of the abdomen and peritoneum anatomy will be discussed.     

Computed tomography in the diagnosis of malignant renal neoplasms and their dissemination]

CT, performed in 66 patients with suspected renal tumors, showed renal cell carcinoma in 36. Tumor spreading was correctly established in 80.6%. Accurate diagnosis was made in 64 of 66 cases. The authors regard CT as an effective method for the recognition of sizable processes and differential diagnosis of solid tumors. Among the visual methods of investigation, used to define a tumor stage, CT turned out to be the most effective one.     

腹壁肿瘤及瘤样病变的CT 诊断（附44 例报道）

目的:分析腹壁肿瘤及瘤样病变的CT表现,旨在提高医师对腹壁肿瘤及瘤样病变的认识,并评价CT在腹壁肿瘤诊断及鉴别诊断中的价值。方法:回顾性分析44例经病理证实的腹壁肿瘤及肿瘤样病变的CT表现,并与病理结果对照。结果:(1)CT扫描对腹壁肿瘤及瘤样病变的定位诊断率达到100%(44/44),定性诊断率约84.1%(37/44)。(2)良恶性病变在边界清晰与否、大小等方面并没有差异,边界不清的29例病例中,14例为良性,15例为恶性。(3)腹壁病变呈较高密度影者均为良性(7/7),血管源性多见。(4)血管瘤、纤维肉瘤、韧带样纤维瘤亦为渐进性强化,腹壁脓肿、结核为环状强化,转移瘤为不均匀强化。结论:CT是目前诊断腹壁肿瘤及肿瘤样病变的主要手段,能较准确定位病变,但对病变定性仍有一定的困难,最终需要病理证实。     

Performances de la TEP-TDM à la 6-Fluoro-[18F]-L-Dihydroxyphénylalanine (FDOPA) et de l’imagerie radiologique conventionnelle dans la prise en charge des patients avec maladie tumorale endocrine dont le primitif est inconnu

IntroductionDespite the extensive diagnostic work-up performed by conventional morphologic and functional imaging in patients with endocrine metastatic malignancies, the primary tumor remains often unknown. Knowledge of the primary tumor improves patients’ management in case of metastatic disease, and allows curative surgical debulking. At present, few studies have focused on the detection of the primary lesion.AimsTo retrospectively assess the FDOPA PET/CT accuracy in the detection of primary endocrine tumors and to evaluate the incremental value of FDOPA PET/CT over conventional imaging.Patients and methodsFourteen patients with biopsy-proven or clinically and biologically suspected endocrine tumors underwent FDOPA PET/CT. Results were compared with conventional imaging, and related to a pathologic or follow-up gold standard.ResultsFDOPA PET/CT detected the primary tumor in four out of 14 patients. Conventional imaging detected the primary tumor in three out of 14 patients. The association of FDOPA PET/CT and morphologic imaging allowed the identification of five out of 14 primary tumors. On an organ-based analysis, FDOPA PET/CT detected more metastasis than morphologic imaging (respective sensitivities of 92% and 58%).ConclusionIn our study, FDOPA PET/CT seemed more sensitive than conventional imaging for the detection of primary endocrine tumors and metastatic spread assessment. Physiological pancreatic uptake hampers FDOPA PET/CT accuracy for the detection of islet cell primary malignancies. Moreover, some pathologic characteristics of the endocrine phenotype, such as cellular differentiation, may influence FDOPA tumoral uptake.     

Multimodality imaging of somatostatin receptor-positive tumors with nuclear and bioluminescence imaging

Multimodal bioluminescence (BLI) and single-photon emission computed tomography/computed tomography (SPECT/CT) imaging were investigated as means to monitor somatostatin receptor subtype 2 (SST2)-positive neuroendocrine tumors as both a subcutaneously implanted and a liver metastasis animal model in mice and rats. Ultimately, such a model will be of use for studying SST2-targeted peptide receptor radionuclide therapy (PRRT). CA20948 cells were transfected with a green fluorescent protein/luciferase plasmid construct. Cells were inoculated subcutaneously in the shoulder of nude mice: nontransfected cells in the left shoulder and transfected cells in the right shoulder. BLI, SPECT/CT imaging, biodistribution analysis, and ex vivo autoradiography of the tumors were performed. BLI and SPECT/CT imaging were also performed on an intrahepatic tumor model in the rat. Caliper volume measurement of transfected tumors could be correlated with BLI measurements (R2 = .76). SPECT/CT imaging showed high levels of accumulation of 111In-DTPA-octreotide in control and transfected tumors, which was confirmed by biodistribution analysis and autoradiography. Subcapsular inoculation of transfected cells in rat liver resulted in an intrahepatic tumor, which could be visualized by both SPECT/CT and BLI. Transfection of CA20948 tumor cells did not alter the growth properties of the cell line or the expression of SST2. Transfected tumors could be clearly visualized by BLI and SPECT/CT imaging. The transfected SST2-positive tumor cell line could represent a novel preclinical model for tumor monitoring in studies that aim at further optimizing PRRT for neuroendocrine tumors.