Diagnostic value of rapid parathyroid hormone combined with 99Tc m-MIBI SPECT dual-phase imaging in suspected parathyroid tumor / 中华内分泌外科杂志

Objective:To investigate the diagnostic efficacy of 99Tc m-MIBI SPECT dual-phase imaging combined with rapid parathyroid hormone detection in thyroid cancer with suspected parathyroid mass. Methods:Data of 76 cases of thyroid cancer with suspected cervical parathyroid gland tumors receiving colorectal ultrasonography or CT examination in Thyroid Surgery Department of the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. Blood samples were taken before surgery to detect parathyroid hormone. Parathyroid hormone was quickly detected after clamping the tumor blood vessels during surgery. Based on the postoperative pathological results, the sensitivity, specificity, accuracy and consistency of various diagnostic methods were evaluated. The ROC curve was drawn by measuring the value of the parathyroid gland concentration after reduction of the tumor blood vessels by clamping the tumor.Results:The sensitivity and accuracy of the 99Tc m-MIBI SPECT dual-phase imaging combined with the rapid detection of parathyroid hormone in diagnosis of suspected parathyroid tumors were (96.5%, 93.4%) better than the 99Tc m-MIBI SPECT dual-phase imaging methods (77.6%, 78.9%) and intraoperative rapid detection methods (86.2%, 82.8%) , and had a high consistency with the results of pathological examination, Kappa value of 0.81. The combined detection rate of suspected parathyroid tumors was significantly higher than that of 99Tc m-MIBI SPECT dual-phase imaging and rapid intraoperative detection, but there was no significant difference between 99Tc m-MIBI SPECT dual-phase imaging and intraoperative rapid detection. The area under the ROC curve of the reduction ratio a value after clamping the blood vessels of the tumor was 0.774, and the standard error was 0.073. The difference was statistically significant ( P<0.001,95% CI:0.631-0.918) . According to the results obtained by the ROC, the index (sensitivity + specificity-1) was plotted on the ordinate and a was the abscissa. The maximum value of the Jordan index was 0.584. The a value corresponding to this point was 0.52. 0.52 is the DCP value. The corresponding sensitivity, specificity, accuracy was 86.2%,72.2%,and 82.9%. Conclusion:99Tc m-MIBI SPECT dual-phase imaging combined with rapid parathyroid hormone detection during surgery has good diagnostic value for thyroid cancer with suspected parathyroid mass, and is completely consistent with pathological diagnosis.

Correlation between biochemical parameters and 99Tcm-MIBI SPECT/CT imaging in patients with hyperparathyropathy / 中国辐射卫生

Objective To explored the correlation between levels of serum calcium, phosphorus PTH and 99Tcm -MIBI in patients with hyperparathyropathy as well as to find cut off valve of serum calcium, phosphorus and PTH. Methods A total of 234 patients with hyperparathyroidism that confirmed by operation and pathology were collected from September 2017 to September 2019. Results The median PTH levels in PHPT group and SHPT group were 210.93 (122.60～529.20) pg/ml and 1842.50 (1342.50～2345.00) pg/ml, respectively. There was significant difference between the two groups (Z = − 10.83, P = 0.000). SHPT group was significantly higher than that in PHPT group. The median of Ca level of PHPT group and SHPT group was 2.86 (2.65～3.15) mmol/L and 2.43 (2.32～2.58) mmol/L, respectively. There was significant difference between the two groups (Z = −7.52, P = 0.000). The level of Ca in PHPT group was significantly higher than that in SHPT group. The median of P level in PHPT group and SHPT group was 0.80 (0.64～1.03) mmol/L and 2.26 (1.97～2.63) mmol/L respectively. There was significant difference between the two groups (Z = − 10.15, P = 0.000), and the PHPT group was significantly lower than the SHPT group. The age, gender, PTH and Ca and P value were taken as independent variables, and the results of MIBI imaging were used as dependent for logistic regression analysis. After screening, the influencing factor of PHPT group was PTH value (OR: 1.012, 95% CI: 1.002～1.023), and correlation analysis showed that r = 0.60 (P = 0.000). No related factors were found in SHPT group. ROC curves of 99Tcm-MIBI imaging results in PHPT group were drawn, corresponding to the areas under the maximum curve of 0.91, and the calculated cutoff value was 113.1 pg/mL. simple scatter plot of Ca value, P value and PTH value was drawn in PHPT group and SHPT group, and correlation analysis was performed. In PHPT group, Ca value and PTH value had moderate correlation (r = 0.64, P = 0.000), P value and PTH value had low correlation (r = − 0.28, P = 0.032); in SHPT group: Ca value and PTH value had low correlation (r = 0.17, P = 0.03), P value and PTH value had no correlation (P = 0.15). Conclusion The serum PTH level of PHPT was moderately correlated with MIBI imaging results. The higher the serum PTH level, the higher the positive rate of MIBI imaging, and the corresponding cutoff value of MIBI imaging was 113.1 pg/mL. There was a moderate correlation between serum Ca level and serum PTH level in PHPT, while in SHPT group low correlation between serum Ca level and serum PTH level.

Hiperplasia de las 4 glándulas paratiroides en hiperparatiroidismo terciario, una imagen infrecuente visualizada en la gammagrafía con Tc-99m MIBI

RESUMEN El hiperparatiroidismo terciario es una complicación presentada en pacientes con enfermedad renal crónica llevados a trasplante renal cuyo manejo quirúrgico requiere de la ubicación mediante imágenes diagnosticas para garantizar el éxito de esta intervención. Se presenta caso de mujer en hemodiálisis crónica que presentó hiperparatiroidismo terciario por hiperplasia paratiroidea confirmada con Tc-99m MIBI SPECT.

ABSTRACT Tertiary hyperparathyroidism is a complication presented in patients with chronic kidney disease subjected to renal transplantation whose surgical management requires location through diagnostic images to guarantee the success of this intervention. We present the case of a woman on chronic hemodialysis who presented tertiary hyperparathyroidism due to parathyroid hyperplasia confirmed by Tc-99m MIBI SPECT.

SPECT cerebral con 99Tc- MIBI para discriminar entre infiltración tumoral y absceso cerebral en casos de tomografía computarizada y resonancia magnética no concluyentes. Presentación de un caso / 99mTc-MIBI Brain SPECT to discriminate between tumor infiltration and brain abscess in cases of computed tomography and magnetic resonance unconvincing. Case Presentation

La diferenciación entre abscesos y metástasis cerebrales en pacientes con algún grado de inmunosupresión y con neoplasias hematológicas resulta en ocasiones difícil. Los estudios funcionales como la tomografía de emisión de fotón único (SPECT) y la tomografía por emisión de positrones (PET) son herramientas diagnósticas eficaces para este propósito. Presentamos el caso de una paciente con diagnóstico de leucemia mieloide crónica en crisis blástica a quien se le informó múltiples abscesos cerebrales; diagnóstico basado en que no existió captación de 99mTc - MIBI en SPECT cerebral y en la buena respuesta al tratamiento antimicrobiano en ocasión en que los estudios de tomografía computarizada (TC) cerebral y resonancia magnética (RM) cerebral no fueron concluyentes. Teniendo en cuenta los resultados de la SPECT se decidió postergar el esquema de quimioterapia, ya que esta podría desencadenar complicaciones probablemente fatales en la paciente.

The differentiation between brain abscess and brain metastasis in patients with some grade of immune suppression and hematological neoplasm is difficult in some situations. Functional studies like Single-Photon Emission Tomography (SPECT) and Positron Emission Tomography (PET) are useful for this purpose. We present the case of a patient with diagnosis of chronic myelogenous leukemia in blast crisis that a diagnosis of brain abscess was made. The diagnosis had a base in 99mTc - MIBI brain SPECT did not show MIBI uptake and the good treatment response to antibiotics when brain CT scan and MRI were not conclusive. Attending to the SPECT result, chemotherapy was postponed because of probably fatal complications in this patient with brain abscess.

Characteristics of 99Tcm-MIBI hepatobiliary scintigraphy in biliary atresia model and its association with the expression of P-glycoprotein in intestinal tissues / 中华核医学与分子影像杂志

Objective To establish rat models of extrahepatic biliary atresia,and to observe the characteristics of 99Tcm-MIBI hepatobiliary scintigraphy and evaluate its association with the expression Pglycoprotein (P-gp) in intestinal tissues.Methods A total of 12 SD rats were randomly divided into the normal control group (3 rats) and the group of common bile duct ligation (CBDL;9 rats).CBDL was used to establish the rat model of extrahepatic biliary atresia.99Tcm-MIBI hepatobiliary scintigraphy was performed at 2,3 and 4 weeks after ligation in the CBDL group and normal control group with continuous dynamic acquisition (3 min/frame) for 30 min and then delaying imaging at 30 min,1,2 and 3 h.After that,all rats were sacrificed,and the blood samples were taken out for the determination of serum ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA,and the tissues of duodenum,jejunum,ileum,colon and cecum were taken out for analyzing the expression level of P-gp by immunohistochemistry.Two-sample t test and one-way analysis of variance were used.Results Compared with the normal control group,the serum levels of ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA were significantly increasing at 2,3,4 weeks after ligation in CBDL group (t:-3.04 to-44.54,all P＜0.05).99Tcm-MIBI hepatobiliary imaging showed that there was radioactive accumulation in colon or cecum area,excluding the duodenum,jejunum and ileum area,at 3 h after intravenous injection of 99Tcm-MIBI in CBDL group.The results of immunohistochemistry showed that with the obstruction time prolonged,the expression levels of P-gp in duodenum,jejunum and ileum segments were gradually decreased (F=5.17,9.07,23.52;all P＜0.05),while the expression levels in the colon and cecum segments were not changed obviously (F=2.00,3.17;both P＞0.05).Conclusion 99Tcm-MIBI can be excreted through intestinal mucosa,and this process may be associated with P-gp expression.

Application of 18F-FDG/99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage / 实用医学杂志

Objective To explore the diagnostic value of 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage. Methods 32 patients with diabetes and 26 healthy volunteers received 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging for assessing myocardial ischemia, viability status, and cardiac function. Results Myocardial perfusion abnormalitieswere observed in 47 regions on myocardial perfusion imagingin 21 of 32 (65.6%)patients with diabetes, showing perfusion/metabolism mismatched and suggesting viable myocardium. All the volunteers were normal on DISA. As compared with the normal control group, the positive rate of DISA in diabetic patients was significantly higher (P < 0.01). Left ventricular ejection fraction (LVEF) was (54.3 ± 7.2%) and (67.3±4.9%) respectively, the difference was statistically significant (P < 0.05). Conclusions 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging can assess myocardial ischemia ,viability and cardiac function in diabetic patients, and it is helpful for the early diagnosis of cardiac damage in patients with diabetes mellitus.

Incremental value of 99Tcm-MIBI SPECT/CT imaging on the preoperative diagnosis of primary hyperparathyroidism / 中华核医学与分子影像杂志

Objective To investigate the incremental value of 99Tcm-MIBI SPECT/CT imaging in the preoperative diagnosis of PHPT.Methods Forty-one patients (13 males,28 females,age range:14-82 (50.0± 13.2) years)with PHPT were retrospectively enrolled.99Tcm-MIBI dual-phase planar scan,SPECT/CT imaging,CT and neck ultrasound were performed before surgery.All patients had pathological results.McNemarx2 test was used to compare the detection rates of the four imaging methods.ROI method was applied to calculate the uptake ratio (T/NT) and Pearson correlation analysis was used to evaluate correlation between T/NT and serum intact PTH,Ca,the lesion volume measured after parathyroidectomy.Results A total of 42 parathyroid lesions were confirmed by pathology.There were 39 patients with parathyroid adenoma (2 with double adenomas,and 37 with single adenoma containing 2 ectopic adenomas) and 1 patient with parathyroid carcinoma.The detection rate of planar scan,SPECT/CT imaging,CT and neck ultrasound were 78.0％ (32/41),92.7％ (38/41),73.2％ (30/41) and 70.7％ (29/41) respectively.Detection rate of SPECT/CT imaging was significantly higher than that of planar scan,CT or ultrasonography (x2 =4.17,4.90,5.82,all P＜0.01).However there were no remarkable differences between the detection rate of planar scan and that of CT or ultrasonography (x2=0.08,0.36,both P＞0.05).Detection rates of CT and ultrasonography were not significantly different either (x2 =1.90,P＞0.05).T/NT in delayed planar imaging were significantly correlated with PTH,Ca and the lesion volume measured after parathyroidectomy (r =0.56,0.54,0.56,all P＜0.01).Conclusions Compared with 99Tcm-MIBI dual-phase planar scan,CT and ultrasonography,SPECT/CT imaging could be of important clinical value for preoperative localization of PHPT because of its higher detection rate and accurate anatomical localization ability.

Diagnostic value of dual-phase 99Tcm-MIBI scintigraphy in patients with ectopic secondary hyperparathyroidism / 中华核医学与分子影像杂志

Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9％(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2％(1 375/1 415) and 53.1％(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4％ (940/1 415) and 46.9％ (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1％ (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P ＜ 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.

Experimental Study on 99mTc-MIBI Imaging Evaluating Multidrug Resistance of Mice Lewis Lung Cancer / 昆明医科大学学报

Objectives 99mTc-methoxyisobutylisonitrile (MIBI) SPECT imaging technology was used to observe the condition of tumor cell in-taking imaging agent in the C57BL/6J mice Lewis lung cancer model before and after using Ginsenoside Rg3 (short for Rg3).We aimd so as to discuss the feasibility of using this method to evaluate tumor multidrug resistance (MDR) status.Methods Mice Lewis lung cancer models were randomly divided into Rg3 group and the control group.After applying Rg3,semi-quantitative analysis was made on 99mTc-MIBI SPECT imaging and region of interest (ROI) to observe the multidrug resistance state of tumor and then the results were compared with the detection results of flow cytometry.Results The tumor intake ratio (T/N) difference between the control group and the Rg3 group in imaging,imaging before applying Rg3 and imaging after applying Rg3 were separately 15,60 and 120 min.The differences were statistical significant (P ＜ 0.01).The eliminate indexes (WR) of the control group and Rg3 group were positively related to P-gp protein expression positive cells detected by flow cytometry (P ＜ 0.05).Conclusions 99mTc-MIBI imaging is negatively related to P-glycoprotein (P-gp) expression in mice Lewis lung cancer cells,which can clearly show the multidrug resistance state of tumors and dynamically monitor the effect of Rg3 on multidrug resistance reversion of mice Lewis lung cancer.

Diagnostic value of dobutamine-stressed cardiac morphing myocardial perfusion imaging for coronary artery disease in middle-aged patients / 中华核医学与分子影像杂志

Objective To evaluate the diagnostic value of dobutamine?stressed cardiac morphing ( CM) MPI ( CMMPI) for coronary artery disease ( CAD) in middle?aged patients. Methods A total of 97 middle?aged patients (52 males, 45 females, age 40-65 (52.98±7.74) years) from March 2011 to Febru?ary 2015 with chest distress, cardiopalmus and chest pain symptoms ( suspected CAD) were retrospectively studied. Informed consents were signed by patients before examination. All patients underwent one?day dobu?tamine?stressed/rest CMMPI and CAG within one month. The diagnostic value of CMMPI was assessed and compared with CAG. Results CMMPI revealed 42 abnormal cases and 9 normal cases in 51 cases with cor?onary artery stenosis by CAG. CMMPI found 11 abnormal cases and 35 normal cases in 46 cases with normal coronary artery by CAG. In comparison with CAG, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CMMPI were 82.35%(42/51), 76.09%(35/46), 79.38%(77/97), 79.25%(42/53)and 79.55%(35/44) respectively. The side effect was slight and transient with an inci?dence of 82.47%(80/97). Conclusion The dobutamine?stressed CMMPI has an important value for the diagnosis of CAD and the assessment of myocardial damage in middle?aged patients.

Left ventricular systolic synchrony of patients with hypertensive heart failure but preserved ejection fraction and its impact on left ventricular function / 中华核医学与分子影像杂志

Objective To investigate the systolic synchrony of the left ventricle in patients with left ventricular hypertrophy (LVH) or with heart failure but preserved ejection fraction (HF-PEF),and to evaluate the impact of systolic dyssynchrony on left ventricular function.Methods During June 2011 to May 2014,a total of 352 patients(160 males,192 females,average age:(67.6±7.8)years) with essential hypertension (EH) were enrolled in this retrospective study.Ultrasonic and G-MP1 were performed for assessment of left ventricular remodeling and systolic synchrony and the results were statistically analyzed by oneway analysis of variance and x2 test.Relationship between BNP and synchronic parameters as well as other clinical factors were analyzed by partial correlation analysis.Results The EH patients were divided into hypertension group (rt =182),LVH group (n =74) and HF-PEF group (n =96).In comparison to hypertension group,significant LVH developed in LVH and HF-PEF groups although the LVEF was still preserved.The LVMI of the 3 groups were (94.4±10.1),(121.1±9.8) and (123.2±10.9) g/m2,respectively(F=8.66,P＜0.05).The LVEF was (58.6±7.3)％,(60.8±10.4)％ and (55.1±4.6)％,respectively(F=2.89,P＞0.05).Diastolic dysfunction was identified in LVH and HF-PEF groups with significantly reduced E/A ratio (1.19±0.23,0.80±0.28,0.67±0.17;F=13.46,P＜0.05).Remarkable left ventricular systolic dyssynchrony with phase histogram bandwidth (PHB) of (88.4±8.6) ° and phase standard deviation (PSD) of (23.6±1.9)° and increased BNP of (228.4±69.7) ng/L were revealed in HF-PEF group.The BNP in HF-PEF group was significantly higher than that in LVH group((92.5±13.6) ng/L;q=8.63,P＜0.05).Positive correlation was found between BNP level and PHB,PSD,LVMI,respectively (r=0.277-0.331,all P＜0.05).Conclusion Left ventricular systolic dyssynchrony is concomitant with HF-PEF patients induced by EH,and this dyssynchrony might be one of the factors leading to diastolic dysfunction.

Effects of Intracoronary Administration of Autologous Adipose Tissue-Derived Stem Cells on Acute Myocardial Infarction in a Porcine Model

PURPOSE: Adipose-derived stem cells (ADSCs) are known to be potentially effective in regeneration of damaged tissue. We aimed to assess the effectiveness of intracoronary administration of ADSCs in reducing the infarction area and improving function after acute transmural myocardial infarction (MI) in a porcine model. MATERIALS AND METHODS: ADSCs were obtained from each pig's abdominal subcutaneous fat tissue by simple liposuction. After 3 passages of 14-days culture, 2 million ADSCs were injected into the coronary artery 30 min after acute transmural MI. At baseline and 4 weeks after the ADSC injection, 99mTc methoxyisobutylisonitrile-single photon emission computed tomography (MIBISPECT) was performed to evaluate the left ventricular volume, left ventricular ejection fraction (LVEF; %), and perfusion defects as well as the myocardial salvage (%) and salvage index. At 4 weeks, each pig was sacrificed, and the heart was extracted and dissected. Gross and microscopic analyses with specific immunohistochemistry staining were then performed. RESULTS: Analysis showed improvement in the perfusion defect, but not in the LVEF in the ADSC group (n=14), compared with the control group (n=14) (perfusion defect, -13.0+/-10.0 vs. -2.6+/-12.0, p=0.019; LVEF, -8.0+/-15.4 vs. -15.9+/-14.8, p=0.181). There was a tendency of reducing left ventricular volume in ADSC group. The ADSCs identified by stromal cell-derived factor-1 (SDF-1) staining were well co-localized by von Willebrand factor and Troponin T staining. CONCLUSION: Intracoronary injection of cultured ADSCs improved myocardial perfusion in this porcine acute transmural MI model.

Evaluation of reversal effect of 2-DG on multidrug resistance by detecting uptake of 99mTc-MIBI in HNE-1/DDP cells / 中国药理学通报

Aim To evaluate the reversal effect of 2-deoxy-D-glucose ( 2-DG ) on multidrug resistance ( MDR) by observing the uptake change of 99m Tc-MIBI in HNE-1/DDP cells, and to explore its mechanism. Methods The uptake of 99m Tc-MIBI in HNE-1/DDP cells under different concentrations of 2-DG was detec-ted by γ-counter, and the clearance rates of 99m Tc-MI-BI in HNE-1 cells and HNE-1/DDP cells after treated with 2-DG (10 mmol·L-1 ) were compared. The con-tent of ATP in HNE-1/DDP cells was detected after treated with 2-DG. P-glycoprotein ( P-gp ) and multi-drug resistance-associated proteins ( MRP ) expression were measured by Western blot. Apoptotic HNE-1/DDP cells treated with DDP alone or combined with 2-DG (10 mmol·L-1 ) were detected by propidium io-dide ( PI ) staining. Results The clearance rate of 99m Tc-MIBI in HNE-1/DDP cells was 54. 8%, which was significantly higher than that ( - 41. 3%) in HNE-1 cells (P<0. 01). The clearance rate of 99mTc-MIBI in HNE-1/DDP cells was -203. 7% after treat-ment with 2-DG ( 10 mmol · L-1 ) , which could be significantly reduced compared with the control group ( P<0. 01 ) . The level of ATP was 55 . 69% compared with the negative control group and the expression of P-gp and MRP protein decreased dramatically in HNE-1/DDP. With the combination of 2-DG and DDP, the ap-optotic rate of HNE-1/DDP cells reached 49 . 4%which was significantly higher than DDP treated group (22. 5%) . Conclusion Multidrug resistance and the reversal effect of 2-DG on multidrug resistance could be evaluated effectively by detecting the uptake change of 99m Tc-MIBI in HNE-1/DDP cells. The mechanism may be related with the inhibition of ATP level and the re-duced expression of P-gp and MRP protein in cancer cells.

Correlation of 99 Tcm-MIBI gated myocardial perfusion SPECT imaging and two-dimensional speckle tracking imaging in swine model of myocardial infarction / 中华核医学与分子影像杂志

Objective To evaluate the value of speckle tracking imaging( STI) by investigating the correlation and consistency between two?dimensional STI and 99 Tcm?MIBI G?MPI in the assessment of myo?cardial injury and myocardial infarction ( MI) of swine model. Methods Eight healthy and same?age adult female Tibetan swine were used to establish animal models of MI induced by open?chest ligation of the first diagonal branch of the left anterior descending coronary artery. The swine underwent ultrasonic cardiogram and G?MPI before and at 6, 24, 48, 72 and 96 h after the operation. The myocardial perfusion was evalua?ted. Ultrasonic sectional graphs were collected to analyze ultrasonic short?axis horizontal peak values of sys?tolic radial strain ( SR) and systolic circumferential strain ( SC) and local myocardial rotation angle ( Rot) of different segments of the left ventricle with off?line STI. Left ventricular ( LV) EDV, LVESV, LVEF by G?MPI and ultrasonography were compared. Pearson correlation analysis and repeated measures analysis of variance were used. Results Six models were successfully constructed. Six hours after the coronary artery ligation, the G?MPI showed no significant or very few perfusion defects;24, 48, 72 and 96 h after the liga?tion, G?MPI showed sparseness and defects at the anterior septum, anterior and lateral wall of apical seg?ment of apical segment. The peak strain values of SR, SC and Rot at the anterior septal apical segment, the anterior and lateral wall of apical segment decreased at different time points after the ligation. Six hours after the coronary artery ligation, the STI was positive. For healthy swine, the LVEF measured with G?MPI and ultrasonic STI showed good correlation ((68±3)% vs (70±4)%, r=0.84, P<0.05). The LVEF values of G?MPI and ultrasonic STI at 6, 24, 48, 72, 96 h after the ligation were (79±1)%, (80±4)%, (58±2)%, (54±4)%, (57±4)%, and(76±2)%,(76±3)%,(57±3)%,(55±3)%,(68±6)% (r:0.40-0?76, all P<0.05). LVEDV and LVESV measured by the two methods showed variation trends at different time points ( F=64.104, 30?069, 35.186, 54.903, all P<0.01) with good consistency after the ligation. Conclusions Ultrasonic STI could estimate the myocardial injury at an earlier stage and measure the severity of damaged myocardium quantitatively, and the resluts are in good agreement with myocardial perfusion and function by G?MPI.

Multimodality imaging evaluation of the treatment effect and mechanism of bone marrow mesenchy-mal stem cells transplantation in swine with acute myocardial infarction / 中华核医学与分子影像杂志

Objective To evaluate the effect and mechanism of bone morrow MSCs transplantation in swine with AMI by cell biology and molecular imaging methods including PET/CT, SPECT, and MRI. Methods Twenty?four Chinese mini?swine ( ( 25 ± 5 ) kg ) were randomly divided into 2 groups: MSCs group ( n=12) and control group ( n=12) . Myocardial infarction was induced in swine hearts by occlusion of the LAD. Thirty minutes later, the MSCs group received autologous MSCs transplantation through in?tramyocardial injection into the peri?infarcted areas (2×107,2 ml) and the control group was subjected to cell culture medium in the same way. At the 1st and 4th weeks after MSCs transplantation, myocardial glu?cose metabolism, myocardial perfusion and cardiac function were evaluated in the two groups through PET/CT, SPECT and MRI. The minimum FDG mean signal intensity ( MSI ) , summed MSI, SRS, SRS%, LVEF, ESV, stroke volume ( SV) and cardiac output ( CO) were calculated. On the 4th week, HE and Masson′s Trichrome stains were performed. Mann?Whitney u test and non?parametric Wilcoxon test were used. Results (1) As evaluated by PET in the 1st week, the MSI and summed MSI in MSCs group were less than those in control group ( 22. 10 ± 3. 18 vs 35. 70 ± 3. 02, z=-2. 65; 1 013. 50 ± 29. 37 vs 1 084. 00 ± 21?15, z=-1.97;both P0.05). (2) In the 1st week, the perfusion variables had no signifi?cant differences between the two groups ( P>0.05) . There was no significant difference in any perfusion vari?ables between the 1st and 4th weeks in the two groups, respectively (P>0.05). (3) As evaluated by MRI, the cardiac functional parameters had no significant differences between the two groups at the 1st week. In the MSCs groups, LVEF increased significantly ((54.41±2.62)% vs (47.54±2.43)%;z=-2.60, P0.05) . Conclusions Four weeks after MSCs transplantation for AMI, cardiac func?tion and myocardial glucose metabolism improved significantly but without significant myocardial perfusion improvement. Therefore, the cardiac function improvement might be associated with increased myocardial glucose metabolism.

Evaluation of the diagnostic value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the recurrence or postoperative residual lesions of glioma / 实用医学杂志

Objective To evaluate the value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the diagnosis of recurrence and postoperative residual of glioma. Methods Of 30 cases of glioma, 21 cases were residual or recurrent of glioma, while 9 cases were not, confirmed by pathology or follow-up. 99mTc-MIBI SPECT positive tumor imaging and MRI were performed on all patients. Results The sensitivity of 99mTc-MIBI SPECT positive tumor imaging (80.1%)was lower than that of MRI (90.5%) (χ2 = 0.006 4,P = 0.035), while the specificity of 99mTc-MIBI SPECT(88.9%) was much higher than that MRI(77.8%)(χ2= 3.827,P = 0.006). The accuracy in diagnosing residual or recurrent glioma between the two imaging has no significant difference. The sensitivity, specificity and accuracy were 95.2%, 100% and 93.3% when the two imaging methods were combined. Conclusions 99mTc-MIBI SPECT positive tumor imaging has higher specificity in the diagnosis of recurrence and postoperative residual of glioma. The combination of 99mTc-MIBI SPECT positive tumor imaging and MRI has great clinical significance.

Preliminary study on effective dose of patients in SPECT/CT fusion imaging / 中华核医学与分子影像杂志

Objective To assess the patient effective dose during SPECT/CT imaging.Methods A total of 157 patients (85 males,72 females;mean age:(60.46±13.44) years,range:24-88 years) who underwent SPECT/CT from April 2013 to September 2014 were retrospectively analyzed.They were divided into 3 groups:99Tcm-MDP bone scan group (n=113),99Tcm-MIBI parathyroid imaging group (n=23) and 99Tcm-MAA pulmonary perfusion imaging group (n=21).The injection dose (MBq) was recorded and the effective dose (mSv) was estimated according to the International Commission on Radiological Protection (ICRP) guideline.The volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) of CT were also recorded and the effective dose (mSv) due to CT was calculated.The effective doses among different groups were statistically compared by Kruskal-Wallis rank sum test and Wilcoxon rank sum test.Results The effective dose from radiopharmaceuticals were (4.02±0.35) mSv for 99Tcm-MDP bone scan,(6.13±0.53) mSv for 99Tcm-MIBI parathyroid imaging and (1.66±0.13) mSv for 99Tcm-MAA pulmonary perfusion imaging (x2=96.853;Z =7.533,7.262 and 5.676;all P＜ 0.05).The effective dose due to CT were (3.84±1.98),(1.04±0.19),(4.05±0.47) mSv respectively (x2 =41.225,P＜0.05),and there were significant differences between 99Tcm-MIBI parathyroid imaging group and 99Tcm-MDP bone scan group,99Tcm-MAA pulmonary perfusion imaging group(Z=6.046 and 5.672,both P＜0.05).The total effective dose during SPECT/CT imaging were (7.86± 1.98),(7.21±0.81) and (5.71±0.45) mSv (x2 =28.988,P＜ 0.05).There were significant differences between 99Tcm-MAA pulmonary perfusion imaging group and 99Tcm-MDP bone scan group,99Tcm-MIBI parathyroid imaging group(Z=4.967 and 4.994,both P＜0.05).Conclusions The increase in effective dose due to spiral CT during SPECT/CT examination should be concerned.Appropriate utilization and optimization of SPECT/CT is needed.

Clinical value of 99Tcm-MIBI scintigraphy in patients with differentiated thyroid carcinoma after surgery and first 131I therapy / 中华核医学与分子影像杂志

Objective To evaluate the clinical value of 99Tcm-MIBI scintigraphy for diagnosis of residual thyroid tissue and metastasis in patients with DTC after their first 131I therapy.Methods From February 2010 to March 2014,192 DTC patients (38 males,154 females,average age (43.2±8.6) years) who received total or near-total thyroidectomy and were pathologically diagnosed as DTC (171 papillary and 21 follicular carcinomas) underwent 99Tcm-MIBI scan (average dosage:740-925 MBq) 6 months after their first 131 I therapy.131 I scans was performed 4 d after oral administration of 131I of therapeutic dose (average dosage:5 550-8 140 MBq).Pre-and post-therapeutic images and the serum Tg level (detected before the imagings) were compared and analyzed.Any abnormal uptake of agent found inside or outside the thyroid was regarded as positive result.Patient-based and lesion-based data analysis were performed by x2 test and two-sample t test.Results A total of 191 patients were finally included,of which 65 positive cases were found.The sensitivity of 99Tcm-MIBI imaging was significantly lower than that of 131I imaging(56.9％ (37/ 65) vs 92.3％ (60/65);x2 =14.7,P＜0.01).Among 43 thyroid remnants and 22 metastatic lesions,99Tcm-MIBI imaging detected 39.5％ (17/43) of thyroid remnants and 90.9％ (20/22) of metastases,and those of 131I imaging were 100％ (43/43) and 77.3％ (17/22) respectively.The sensitivity of 131 I imaging in detecting thyroid remnants was significantly higher than that of 99Tcm-MIBI imaging(x2=24.0,P＜0.01).The sensitivities in detecting metastasis were not significantly different (x2=0.57,P＞0.05).The serum Tg level of positive groups (99Tcm-MIBI positive + 131I positive or 131I negative) were significantly higher than that of 99Tcm-MIBI negative + 131I negative group (t =-20.7 and-6.0,both P＜0.01),and that of 99Tcm-MIBI positive + 131I negative group was higher than that of 131I positive + 99Tcm-MIBI negative group(t=-2.7,P＜0.05).Conclusion 99Tcm-MIBI imaging could detect metastasis of DTC patient after first radioiodine therapy,but the value in detecting thyroid remnants is limited.

Systolic synchrony of ischemic myocardium assessed by stress-rest 99Tcm-MIBI gated SPECT myocardial perfusion imaging / 中华核医学与分子影像杂志

Objective To investigate the left ventricular synchrony under different ischemic statuses using phase analysis of 99Tem-MIBI gated SPECT MPI (GSMPI).Methods The data of 129 patients (65 males,64 females,age:48-88 (68.6±10.2) years) who underwent 2-d stress-rest GSMPI were retrospectively analyzed.Perfusion images were scored by a 5-grade criteria (0-4) based on 17 coronary artery segments.Patients were divided into normal perfusion group (G1) and abnormal perfusion group (G2) according to the summed stress scores.G2 was divided into reversible perfusion defect subgroup (G2a) and irreversible perfusion defect subgroup (G2b) by the summed difference scores.The difference of PSD and PHB between groups and the difference between stress and rest GSMPI within each subgroup were compared using two-sample t test and paired t test,respectively.Results The numbers of patients in G1,G2,G2a and G2b were 66,63,39 and 24,respectively.The PSD (18.3±7.8) and PHB (68.6±30.9) of G2 were significantly higher than those (14.3±6.6 and 50.2±20.0) of G1 (t =-3.110,-3.989,both P＜0.05).The PSD and PHB of G2b were higher than those of G2a,but the difference was not statistically significant (t:-1.554 to-0.408,all P＞0.05),and the differences of PSD and PHB between rest and stress MPI within each subgroup were not significantly different (t:-0.961 to-0.114,all P＞0.05).The PSD (20.4±8.1 and 20.8±6.4) and PHB (77.8±53.5 and 78.4±26.7) of rest and stress GSMPI in patients with LVEF ≤60％were significantly higher than those in patients with LVEF＞60％(15.0±6.8 and 15.3±7.0,53.5±23.0 and 55.9±24.5;t:3.642 to 4.567,all P＜0.05).Conclusions 99Tcm-MIBI GSMPI phase analysis can show damage effect of abnormal myocardial perfusion on left ventricular synchrony,which influencing global left ventricular function,and it can show different left ventricular synchrony due to different degrees of myocardial ischemia.There is nearly same value of stress GSMPI and rest GSMPI in assessment of left ventricular synchrony.

Cirugía paratiroidea radioguiada: experiencia inicial / Initial experience in radio-guided parathyroid surgery

Introducción: la gammagrafía con 99mTc-MIBI permite la localización preoperatoria no invasiva y facilita el acceso mínimamente invasivo en pacientes con hiperparatiroidismo primario (HPTP). Objetivos: describir los resultados iniciales de la gammagrafía paratiroidea con 99mTc-MIBI en pacientes con HPTP. Métodos: entre mayo de 2007 y febrero de 2010 fueron operados 10 pacientes por HPTP. Se excluyó una paciente con un síndrome de neoplasia endocrina múltiple. La edad media fue 46,3 años (32-70 años). Predominó el sexo femenino (6). Los síntomas principales fueron dolores óseos, debilidad, cefalea y cólico nefrítico. Un paciente presentaba tumores pardos múltiples. La enfermedad asociada más frecuente fue la hipertensión arterial. Los pacientes fueron seguidos entre 25 y 58 meses (promedio 45,3 meses). Resultados: uno de dos enfermos reintervenidos por HPTP persistente presentó hipoparatiroidismo posoperatorio (ambos tenían enfermedad tiroidea multinodular). De un total de 12 glándulas enfermas, 11 eran inferiores (9 izquierdas y 2 derechas) y una superior izquierda. La sensibilidad para la gammagrafía fue del 83 por ciento y la especificidad del 100 por ciento y, para la ecografía, estos valores fueron del 34,6 por ciento y del 96 por ciento, respectivamente. No hubo complicaciones ni muertes. Con un seguimiento promedio de 45,3 meses (25-58 meses), todos los pacientes se encontraban eucalcémicos. Conclusiones: La sensibilidad de la gammagrafía preoperatoria con 99mTc-MIBI permite obtener resultados satisfactorios en pacientes con HPTP tratados mediante técnicas de mínima invasión. Los pacientes con enfermedad nodular tiroidea deben ser evaluados cuidadosamente por el riesgo de falsos positivos(AU)

Introduction: 99mTc-MIBI scanning allows the non-invasive preoperative location and facilitates the minimally invasive access to patients with primary hyperparathyroidism. Objectives: to describe the initial results of 99mTc-MIBI parathyroid scanning in patients suffering primary hyperparathyroidism. Methods: from May 2007 through February 2010, ten patients with hyperparathyroidism were operated on. A female patient with multiple endocrine neoplasia syndrome was excluded from the study. The mean age was 46.3 years (32-70 years). Females predominated (6). The main symptoms were bone aches, weakness, headache and nephric colic. One patient presented with multiple brown tumors. The most common associated disease was blood hypertension. These patients were followed-up for 25 to 28 months (average 45.3 months). Results: one of the two patients undergoing resurgery for persistent hyperparathyroidism presented with hypoparathyroidsm posoperatively (both suffered multinodular thyroid disease). Of a total of 12 sick glands, 11 were lower glands (9 left and 2 right) and one upper left gland. The scanning sensitivity was 83percent and the specificity was 100 percent whereas the echography values were 34.6 percent and 96 percent, respectively. Neither complications nor deaths were observed. With the average follow-up of 45.3 months (25-28 months), all the patients were eucalcemic. Conclusions: preoperative 99mTc-MIBI scanning sensitivity allows achieving satisfactory results in patients with hyperparathyroidism and treated with minimally invasive techniques. The patients with nodular thyroid disease should be carefully evaluated due to positive false risk(AU)