ObjectiveTo investigate the significance of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT in the diagnosis of primary hyperparathyroidism, and its relationship with the level of serum calcium (CA). MethodsThe clinical data of 73 patients with parathyroid dysfunction (serum parathyroid hormone (PTH) > 130 pg/mL) were retrospectively analyzed. The 99Tcm-MIBI SPECT double phase imaging were performed in 73 cases, 63 cases underwent cervical B-ultrasound examination, and 16 cases underwent CT examination. According to the serum calcium (CA) levels, the patients were divided into CA < 2.7 mmol/L group and CA > 2.7 mmol/L group, and the postoperative pathological examination and followed-up results were as the standard, the sensitivity, specificity, positive predictive value, and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT for diagnosis of PHPT in different serum CA levels were compared. ResultsThe sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.6%, 81.8% and 35.7%, respectively; the specificity was 87.5%, 75.5% and 50.0%, respectively; the positive predictive value was 98.2%, 93.7% and 83.3%, respectively; and the negative predictive value was 46.7%, 33.3% and 10%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT were significantly higher than those of CT examination(P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging for diagnosis of PHPT were higher than those of B-ultrasound examination, but the difference was not statistically significant (P > 0.05). In the CA < 2.7 mmol/L group, the sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 91.1%, 84.7% and 37.9%, respectively; the specificity was 80.2%, 72.9% and 49.7%, respectively; the positive predictive value was 96.8%, 96.0% and 79.4%, respectively; and the negative predictive value was 50.0%, 37.5% and 10.0%. In the CA > 2.7 mmol/L group, The sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.9%, 83.9% and 42.8%, respectively; the specificity was 83.3%, 79.2% and 50.0%, respectively; the positive predictive value was 96.9%, 94.1% and 75.0%, respectively; and the negative predictive value was 50.0%, 40.5% and 20.0%. There were no significant difference in the diagnostic accuracy between the 3 methods and the level of serum CV in different levels. ConclusionsThe diagnostic accuracy of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT patients with PTH > 130 pg/mL (especially parathyroid adenoma) were higher than that of CT examination, and it is not associated with the serum CA concentration.
Intraoperative frozen pathology is critical when a breast tumor is not diagnosed before surgery. However, frozen tumor tissues always present various microscopic morphologies, leading to a high misdiagnose rate from frozen section examination. Thus, we aimed to identify breast tumors using bioimpedance spectroscopy (BIS), a technology that measures the tissues' impedance. We collected and measured 976 specimens from breast patients during surgery, including 581 breast cancers, 190 benign tumors, and 205 normal mammary gland tissues. After measurement, Cole-Cole curves were generated by a bioimpedance analyzer and parameters R-0/R-infinity, f(c), and alpha were calculated from the curve. The Cole-Cole curves showed a trend to differentiate mammary gland, benign tumors, and cancer. However, there were some curves overlapped with other groups, showing that it is not an ideal model. Subsequent univariate analysis of R-0/R-infinity, f(c), and alpha showed significant differences between benign tumor and cancer. However, receiver operating characteristic (ROC) analysis indicated the diagnostic value of f(c) and R-0/R-infinity were not superior to frozen sections (area under curve [AUC]= 0.836 and 0.849, respectively), and a was useless in diagnosis (AUC= 0.596). After further research, we found a scatter diagram that showed a synergistic effect of the R-0/R-infinity, and f(c), in discriminating cancer from benign tumors. Thus, we used multivariate analysis, which revealed that these two parameters were independent predictors, to combine them. A simplified equation, RF' = 0: 2f (c) + 3: 6R(0)/R-infinity, based on multivariate analysis was developed. The ROC curve for RF' showed an AUC= 0.939, and the sensitivity and specificity were 82.62% and 95.79%, respectively. To match a clinical setting, the diagnostic criteria were set at 6.91 and 12.9 for negative and positive diagnosis, respectively. In conclusion, RF' derived from BIS can discriminate benign tumor and cancers, and integrated criteria were developed for diagnosis.
The high absorption rate of transplanted fat has limited the application of autogenous fat grafts in the clinical setting. Therefore, this study aimed to evaluate the effects of platelet-rich plasma (PRP) and adipose-derived stem cells (ASCs) on fat regeneration by investigating the impact of PRP and conditioned medium on the biological characteristics of ASCs. Fat grafts were prepared with ASCs at densities of 10(7)/ml, 10(6)/ml, 10(5)/ml, 10(4)/ml and 0/ml with and without PRP and injected subcutaneously into nude mice. Liquid overflow method, haematoxylin and eosin staining, and immunohistochemical analyses were used to examine the fat grafts. The residual fat volume of the 10(5)/ml ASC+PRP group was significantly higher than that of other treatment conditions after 90days. Furthermore, histological examination revealed that in 10(5)/ml ASCs-treated grafts normal adipocyte area and capillary formation were increased dramatically compared with other treatment conditions. It is concluded that fat grafts consisting of PRP and 10(5)/ml ASCs constitute an ideal transplant strategy, which may result in decreased absorption and accelerated fat regeneration. This simple and reliable method could provide a valuable and needed tool in plastic and reconstructive surgery. Copyright (c) 2014 John Wiley & Sons, Ltd.
目的 探討單光子計算機斷層掃描儀(SPECT)對抑郁癥的療效評估價值。 方法 2006年5月-2007年12月，選取32例未經治療的原發性中、重度抑郁癥患者，給予氟西汀治療10周。治療后根據臨床療效總評量表和漢密爾頓抑郁量表(HAMD)減分率作為療效評定指標，將患者分為有效組21例，無效組11例。對所有患者于治療前和治療后分別進行99m锝-雙半胱乙酯(99mTc-ECD)腦灌注顯像。靜脈注射99mTc-ECD 1 110 MBq，30 min后行腦斷層顯像，對顯像結果分別進行目測及半定量分析兩種方法進行判斷。 結果 抑郁癥患者出現的腦血流灌注減低區主要集中在前額葉、扣帶回，經過治療后好轉的抑郁癥患者腦血流灌注明顯改善。可通過腦血流灌注顯像評估抗抑郁治療的療效，左前額葉血流灌注越低，對氟西汀治療效果越好。 結論 SPECT顯像技術可視性較好，可用于評估抗抑郁治療的療效。
目的：研究心肌灌注顯像（MPI）經CT衰減校正（CTAC）后偽影的產生及其對臨床診斷的影響。方法：回顧性分析按Bayesian理論，冠心病患病率＜5%的48例受檢者所行的72例次MPI（負荷41例次，靜息31例次），圖像在未行CTAC時顯示正常者進行研究。將左心室心肌劃分為20個節段，半定量分析（0分=放射性分布正常；1分=放射性分布輕度減低；2分=放射性分布中度降低；3分=放射性分布重度減低；4分=放射性分布缺損）各心肌節段在CTAC后放射性分布變化情況。結果：72例次MPI中，16例次（22.2%）的75個心肌節段（均在左心室心尖、前壁、前間壁區域）在CTAC后出現了放射性分布不同程度的減低。75個受累節段中分別有51、21和3個節段評分增加了1、2和3分，平均每個心肌節段評分增加了1.3分。41例次負荷MPI和31例次靜息MPI中，分別有9例次（21.9%）的39個心肌節段、7例次（22.6%）的36個心肌節段在CTAC后出現了放射性分布減低，負荷與靜息MPI相比，CTAC后發生心肌節段放射性分布減低的概率（χ2＝2.84，P＞0.05）與程度（u＝0.54，P＞0.05）均無顯著統計學差異。10例負荷/靜息MPI都滿足納入標準而納入研究者中，4例的負荷/靜息MPI在CTAC后，出現了相同部位（尖前壁、尖下壁）、相同程度（評分均增加了2分）的灌注降低；3例出現了同一部位，但不同程度的灌注減低；另有3例出現了不同部位心肌節段的灌注減低。CTAC后出現心肌節段灌注減低者與未出現者相比年齡、性別構成無統計學差異。結論：分析SPECT/CT心肌灌注圖像時，應同時分析CTAC前后的灌注圖像。對于只在CTAC后出現的灌注缺損，需要考慮可能存在CT與SPECT圖像配位不準。
【Abstract】 Objective To evaluate the detection and localization of obscure lower gastrointestinal bleeding by using SPECT/CT and intraoperative endoscopy. Methods Twenty-six cases of patients with obscure lower gastrointestinal bleeding were analyzed retrospectively. Results The positive detection rate of SPECT/CT was 88.5%. All 26 patients (100%) were identified the bleeding source by using intraoperative endoscopy. No recurrence was found during 1-24 months follow-up. Conclusion SPECT/CT examination should be chosen firstly for patients with obscure lower gastrointestinal bleeding in order to localize the bleeding site roughly. Intraoperative endoscopy can localize the bleeding site accurately in patients who undergoes operation.
【摘要】目的探討Fahr病的臨床表現和影像學的診斷價值。方法回顧性分析1999年2008年就診的11例經Fahr病的不同臨床表現和CT、MRI及SPECT資料。結果所有患者都接受CT檢查,9例MRI檢查,8例SPECT掃描。CT可清晰地顯示鈣化病灶的大小范圍；在顯示鈣化方面,MRI不如CT敏感,但MRI能顯示病灶內和周圍膠質增生、囊變與脫髓鞘的范圍及程度;亦能較清晰的顯示小腦齒狀核的病變情況;SPECT能早期監測到雙側基底節和雙側大腦皮質的局部腦血流灌注下降程度。結論Fahr病臨床表現各異,易誤診。CT、MRI和SPECT對其診斷具有協同作用。
【摘要】 目的 探討SPECT及CT對鼻咽癌顱底骨侵犯的檢測能力。 方法 2006年5月-2009年12月對159例經病理確診的初治鼻咽癌患者行顱底SPECT斷層顯像，同期行CT檢查，分別計算顱底受侵的陽性率。 結果 ①159例鼻咽癌SPECT顱底斷層陽性率46.5%（74/159），CT陽性率25.2%（40/159），SPECT檢測敏感性高于CT（Plt;0.001）。 ②鼻咽癌伴顱神經損害SPECT檢測敏感性高于CT（P=0.004）。 結論 SPECT對鼻咽癌顱底骨侵犯的檢測敏感性優于CT。【Abstract】 Objective To compare the results of single-photon emission computed tomography (SPECT) and CT in skull base invasion in nasopharyngeal carcinoma (NPC). Methods A total of 159 patients with nasopharyngeal carcinoma were examined by SPECT and CT of nasopharynx and skull base from May 2006 to December 2009. The positive rates were compared by McNemar test. Results The positive rate of skull base invasion detected by SPECT and CT were 46.5% and 25.2% respectively (Plt;0.001). SPECT appeared to be superior to CT in the detection of skull base invasion in NPC with cranial nerve palsy (P=0.004). ConclusionsThe detection ability of SPECT in skull base invasion is superior to that of CT.
Cancer is the second most common cause of death in the USA. Its symptoms are often not specific and absent, until the tumors have already metastasized. Therefore, there is an urgent demand for developing rapid, highly accurate and noninvasive tools for cancer screening, early detection, diagnostics, staging and prognostics. Saliva as a multi-constituent oral fluid comprises secretions from the major and minor salivary glands, extensively supplied by blood. Molecules such as DNAs, RNAs, proteins, metabolites, and microbiota, present in blood, could be also found in saliva. Recently, salivary diagnostics has drawn significant attention for the detection of specific biomarkers, since the sample collection and processing are simple, cost-effective, and precise and do not cause patient discomfort. Here, we review recent salivary candidate biomarkers for systemic cancers by dividing them according to their origin into: genomic, transcriptomic, proteomic, metabolomic and microbial types.