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Objective To assess the application of sonoCT in the diagnosis of biliary tract tumor.

目的 探讨实时复合超声成像技术在胆系肿瘤诊断中的应用价值。

Results: Non Contrast MRI appearance of tumor-like cerebritis is of long T1 and long T2 signal but has no characteristic features.

结果:肿瘤样脑炎的非增强磁共振成像表现为长T1、长T2信号,缺乏特征性,其CEMRI表现为(1)斑片状高信号,大小不一,强弱不一,散在分布。

Results Spatial relations of the tumors to the lamina terminalis, anterior commissure and anterior communicating artery complex were clearly shown in T2R images. The optic nerves, optic chiasm and optic tracts were detected in 93.3%, 100% and 86.7% of the patients on T2R images and 66.7%, 93.3% and 66.7% on T1 weighted images, respectively. Detection rate of optic pathway on T2R images was higher than that on T1 weighted images.

结果 重T2加权灰阶反转成像可清晰显示肿瘤与终板、前连合及前交通动脉丛的空间关系;其视神经、视交叉和视束的检测率分别为93.3%、100%和86.7%,而在T1加权成像中则分别为66.7%、93.3%和66.7%,前者对视路的检测率显著性高于后者。

Sensitive range from 49.1% to 100%, specificity range from 18.2% to 90%,accurate range from 45.5% to 88.3%, PPV range from 34.1% to 95.2,NPV range from 22.2% to 100%,the combine sensitive was 82.7%,specificity was 63.3%;there were not obvious publish bias in the 9 articles, and there was heterology of the 9 articles, the forest figure show RR was 2.34[1.43,3.05],and its 95% confidence interval did not include 1,the chance of malignancy nodules'SUV above 2.5 were more than benign nodules.

文献报道的敏感性49.1-100%,特异性18.2-90.0%,准确性45.5-88.3%,阳性预测值34.1-95.2%,阴性预测值22.2-100%,Meta分析合并后的敏感性82.7%,特异性为63.3%,准确性为71.8%,阳性预测值80.8%,阴性预测值57.0%;漏斗图成近似倒三角形,认为文献无明显发表偏移;对文献异质性检验,P小于0.05,认为文献来源存在异质性;选用随机效应模式得到森林图,RR为2.34[1.43,3.05],其95%的可信区间不包括1,认为肿瘤病人最大SUV 2.5法呈阳性的可能性大于非肿瘤病人,二者之间具有统计学差异;两篇来源于日本的文献显示日本国的18F-FDG PET肺占位显像假阴性率高于我国。

Curvilinear calcification suggests an aneurysm but is a less specific finding because it can also occur in craniopharyngiomas and sphenoidal masses. The intense enhancement of the residual lumen is relatively specific, but differentiation from other masses may be difficult on CT scans depending on the timing and degree of vascular enhancement. The MR imaging features are usually diagnostic, although they can be very subtle [2]. Significant signal heterogeneity is seen with T1 hyperintense signal due to subacute thrombus or flow related enhancement. Areas of T2 hypointensity can be seen due to intracellular deoxy or methemoglobin, calcification, or flow void.

线样钙化提示动脉瘤,但不是一个非常特异的征像,因为这也可以见于颅咽管瘤和蝶骨肿瘤,管腔样明显强化更特异些,但是在CT上与其他肿瘤鉴别可能是困难的,因为这取决与增强的时间与血管强化的程度,MR的特征性表现是更具有诊断意义的,即使有时候可能表现的非常细微,在T1上可以看到明显的不同信号成分,这是由于亚急性的血栓或流动相关增强效应,T2序列上可以看到低信号区域,这是由于细胞内脱氧或高铁血红蛋白,钙化,或流空效应。

Methods: During the April 2003 to December 2004, from the patients with different position colorectal cancer beyond Dukes C stage who were performed laparoscopic radical operation random draw 20 patients as experiment group, and from patients with different position colorectal cancer beyond Dukes C patients who were performed open radical operation 20 patients took randomly as contrast group. We draw thepatients blood about 5 ml from antecubital vein at the time before and after the operation about 30 minutes respectively, preserved the blood in deep hypothermia circumstance,cytrokeratin-20(CK-20) as the micrometastasis maker, using the RT-PCR technique,G3PDH as the intra-contrast gene, quantitatively detect the amounts of CK-20 in the blood with the gelatum imagery system and the computer analyzing software on the gelatum imagery system ,in order to compare the influence of the laparoscopic and the open operation on the micrometastasis.

在我院2003年4月—2004年12月间不同部位的临床分期在Dukes C期之内的接受了腹腔镜结直肠癌根治术结直肠癌患者中随机抽取20例作为试验组,另外在同期的接受开腹手术患者中随机抽取20例作为对照组,分别抽取术前30min和术后30min的肘前静脉血5ml,集中低温保存,以细胞角蛋白(cytekeratin-20)CK-20为微转移的标志物,应用RT-PCR技术,以G3PDH为内对照基因,应用凝胶成像系统及其计算机凝胶成像系统分析软件来定量检测手术前、后患者外周静脉血中CK-20含量,比较腹腔镜和开腹的手术方式对肿瘤微转移的影响。

Results:Most of the intracranial chordoma(16 cases in our group,88 9%)were located in the middle area of the skull base such as clivus and/or sellar region and always invaded extensively the nerves and major in tracranial vessels of skull base.All tumors were hypointense on T1- weighted imaging and heterogeneous hyperintense on T2- weighted imaging,On Gd- DTPA contrast- enhanced T1- weighted imaging 8 chordomas enhanced more markedly,but steady heterogeneous.

结果:颅内脊索瘤大部分(本组16例,占889%)发生于颅底中线处的斜坡和/或鞍区,并广泛侵犯颅底的神经和大血管等重要结构;在T1加权像上肿瘤主要表现为低信号,T2加权像上表现为不均匀高信号,Gd-DTPA静脉注射增强后(8例)均出现较明显的不均匀强化。

Copper pyruvaldehyde bis(N -methylthiosemicarbazone) complex, or Cu-PTSM, belonging to a class of neutral, lipophilic complexes ,is a positron emission tomography radiopharmaceutical that can be used to evaluate blood flow in the heart, brain, and tumors without following any side effect .

Cu-PTSM是中性亲脂性复合物,用于PET显像的放射性药物由于该制剂很容易扩散到细胞内,因此注射Cu-PTSM后可以了解心、脑和肿瘤部位的血流灌注状况,它不伴有副反应的发生,且合成比较容易,所以是一种非常有途的新型PET显像剂。

copper pyruvaldehyde bis(n -methylthiosemicarbazone) complex, or cu-ptsm, belonging to a class of neutral, lipophilic complexes ,is a positron emission tomography radiopharmaceutical that can be used to evaluate blood flow in the heart, brain, and tumors without following any side effect .cu-ptsm has been demonstrated the ability of rapid diffusion into cells.also because it can be synthesized,it is a potential tracer for pet imaging.

作者单位:610041 四川成都,四川大学华西医院核医学科 cu-ptsm是一种中性亲脂性复合物,用于pet显像的放射性药物。由于该制剂很容易扩散到细胞内,因此注射cu-ptsm后可以了解心、脑和肿瘤部位的血流灌注状况,它不伴有副反应的发生,且合成比较容易,所以是一种非常有前途的新型pet显像剂。

Conventional imaging technique which unsubtracted bone was used first,use 3D treatment on workstation to reconstruct cerebral vessels,to diagnose aneurysm,vascular malformation and tumor as well as to evaluate the preoperative and postoperative efficacy.Subtract bone techniques including one by one slice subtraction,semi-automatic digital subtraction radiography,matched mask bone elimination and control tube exposure light spot imaging technique can show the vessels more clear without the interference of bone as well as the relationship between vessel and pathological changes more accuracy.

首先是未去骨的常规成像技术,利用工作站进行多平面重建技术、最大密度投影、容积再现、表面遮盖法等多种三维处理得到头部血管及肿瘤图像,对动脉瘤、血管畸形及肿瘤血管进行病变诊断及术前、术后评价;其次是近年出现的逐层减影、半自动数字减影、匹配蒙片骨去除法及控制球管曝光点的减影等去除颅骨的减影技术,没有颅骨的干扰血管显示更加清楚,血管与病变关系显示更准确。

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