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Objective: To explore the value of real-time ultrasound and 99Tcm-pertechnetate scintigraphy for diagnosis of Meckel's diverticulum (MD) in children. Methods: Totally 156 children with clinically diagnosed MD or complications and then treated with surgical operations were enrolled. Real-time ultrasound examination and 99Tcm-pertechnetate scintigraphy were performed before operation. Taking surgical pathological results as gold standards, the diagnostic efficacies of these two methods were compared. Results: MD was diagnosed in 105 children after operation. The sensitivity, specificity and accuracy of ultrasound for MD was 87.62% (92/105), 88.24% (45/51) and 87.82% (137/156), while of 99Tcm-pertechnetate scintigraphy was 71.43% (75/105), 72.55% (37/51) and 71.79% (112/156), respectively. The sensitivity, specificity and accuracy of ultrasound were all higher than those of 99Tcm-pertechnetate scintigraphy in diagnosis of MD. Conclusion: Real-time ultrasound can effectively diagnose MD and complications, which can be used as the preferred auxiliary diagnostic method for clinic.
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Objective To study the radiation level in the surrounding of patients undergoing 99Tcm-MDP SPECT bone imaging and associated influencing factors and provide experimental data for the radiation safety of personnel around the patients.Methods A total of 367 patients undergoing whole-body bone imaging in Cancer Hospital,Chinese Academy of Medical Sciences were investigated to measure the ambient dose equivalent rate around the patients at different time and different distances from the patients,analyze the variations of ambient dose equivalent rate with time and distances,estimate the dose level at different distances around the patients,and evaluate the radiation dose to personnel around the patients.Results The ambient dose equivalent rate around the patient decreased exponentially with time;the effective half-life of 99Tcm in patients' body increased with time.The ambient dose equivalent rate varied by power function with increasing distance within 4 meters from the patient with the mean power value of -1.45.The radiation levels were 238.3 μSv at 0.5 m,99.7 μSv at 1 m,and 61.8 μSv at 1.5 m from the patient undergoing 99Tcm injection to its vanishing in patients' body.At different time points,the radiation doses at 0.5 m off the patient for 10 min were:9.9,3.0,1.9 μSv at 0,3 and 6 h,respectively.Conclusions The ambient dose equivalent rate around the patients undergoing 99Tcm-MDP SPECT bone imaging decrease rapidly with increasing time and distance.The patients can cause a certain degree of exposures to the surrounding personnel,but the exposure level is far lower than the relevant national standards.It is suggested that the patients should not receive other types of diagnosis and treatments spending lot of time and in close contact with medical staff while bone imaging being conducted on the same day.
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Objective To investigate the preoperative localizaion diagnosis and surgical strategies of primary hyperparathyroidism (pHPT).Methods The clinical data of pHPT patients who underwent initial parathyroid surgery at the Peking Union Medical College Hospital from Jan.2009 to Apr.2017 were retrospectively analyzed to explore preoperative localization and surgical options.Results There were a total of 902 surgical cases included in the study with 674 women and 228 men.All had preoperative parathyroid ultrasonography (US) (sensitivity 97.18％,positive predictive value (PPV) 98.40％) and 99Tcm-sestamibi (MIBI) scan (sensitivity 94.24％,PPV 98.00％).The combination of US and MIBI scan had a sensitivity of 92.39％ and PPV of 97.37％.MIBI scan showed negative results in 51 cases.We found that male patients with cystic lesions were more likely related to negative MIBI scan (P＜0.05).Among 89 patients with negative MIBI and/or US,39 received neck CT,17 received positron emission tomography (PET)/CT,and 9 received ultrasound-guided biopsy for further localization.800 patients (88.69％) underwent minimally invasive parathyroid surgery (MIP) with anesthesia of cervical plexus block.656 patients (72.72％) had normal parathyroid hormone (PTH) level on the first post-operative day,140 patients (15.52％) had postoperative hypocalcaemia and 234 patients (25.94％) presented hypocalcaemic symptoms within 3 days after operation,which could be relieved by intravenous calcium or continuous medicine taken by mouth.During the follow-up of the 800 MIP patients,4 had recurrence and one patient was not cured.Conclusions Parathyroid US and MIBI scan are of good value in localizaion diagnosis.Neck CT or PET/CT should be used as supplementary approaches in patients with negative US and/or MIBI scan.MIP with anesthesia of cervical plexus block is simple and feasiable for pHPT cases with accurate localization.
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Objective To investigate the efficacy of SPECT/CT in detecting parathyroid lesions in chronic kidney disease (CKD) with secondary hyperparathyroidism (sHPT) patients.Methods Within 2 weeks before parathyroidectomy (PTX),52 patients of CKD with sHPT underwent 99Tcm-sestamibi (99Tcm-MIBI) dual-phase planar and delayed SPECT/CT scintigraphy.Taking surgical pathology as the golden standards,the sensitivity,specificity and accuracy of dual-phase planar,SPECT,CT and SPECT/CT were calculated and compared.Results Totally 172 lesions were detected in surgical operation,including 13 parathyroidomas (PM),26 adenomatoid hyperplasias (AH) and 133 diffuse parathyroid hyperplasias (PH).The sensitivity of 99Tcm-MIBI dual-phase planar,SPECT,CT and SPECT/CT was 55.81％ (96/172),70.35％ (121/172),79.65％ (137/172) and 81.40％ (140/172),respectively,while the specificity was 92.05％(81/88),90.91％ (80/88),76.14％ (67/88),93.18％ (82/88),the accuracy was 68.08％ (177/260),77.31％ (201/260),78.46％ (204/260) and 85.38％ (222/260),respectively.The sensitivity of SPECT/CT was superior to that of SPECT (x9 =17.053,P＜0.001) and 99Tcm-MIBI dual-phase planar (x2 =44.000,P＜0.001).SPECT/CT was superior to CT (x2 =10.316,P =0.001) for specificity,and superior to CT (x2 =13.136,P＜0.001),SPECT (x2 =14.815,P＜0.001) or 99Tcm-MIBI dual-phase planar (x2=39.706,P＜0.001) for accuracy.Conclusion SPECT/CT fusion imaging is better in localization of parathyroid lesions of CKD with sHPT patients than 99Tcm-MIBI dual-phase planar,SPECT or CT imaging alone.
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Objective To study the application of 99Tcm in rabbit cerebral thromboembolic stroke and thrombolysis effect of recombinant tissue plasminogen activator (rt-PA).Methods The 0.5 mL radioactive pertechnetate sodium (specification:5 mCi/2mL and radiation intensity 92.5 MBq/mL) was combined with 30 μL stannous chloride (5 mg/mL),and the 20 μL mixture was joined to whole blood,red blood cells,and plasma for labelling.Then 50 μL CaCl2 (0.5 mol/L) and bovine thrombin (50 IU/mL) were doped in mixture,and rapidly sucked into a polyethylene plastic pipe (PE80).Thrombus was formed for 2 h at 37 ℃ and cut into small pieces of 10 mm.Autologous blood clots combined with 99Tcm from external carotid artery were injected to internal carotid artery of rabbit,the radioactivity (counts per minute,CPM) was measured by gamma counting instrument,and the improvement of rt-PA 4.5 mg/kg (clinical equivalent dose) on this model was observed.Results After thromboembolism,CPM increased approximately by (5.1 ± 1.3) times,which suggested that the model was reliable.The rt-PA 4.5 mg/kg had significant progressive thrombolysis effect.Conclusion 99Tcm tracer technology could be applied to rabbit cerebral stroke model,which is stable and reliable
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Purpose To evaluate the clinical guiding value of 99Tcm-methoxyisobutylisonitrile gated myocardial perfusion imaging (99Tcm-MIBI G-MPI) in diagnosing the coronary microangiopathy in patients with diabetic mellitus.Materials and Methods Sixty patients with clinical confirmed coronary microvascular angina were selected and assigned into two groups,with 26 patients (with diabetes mellitus) in group A and 34 patients in group B (without diabetes mellitus).The region,extent and range of coronary microangiopathy was detected by 99Tcm-MIBI G-MPI,and the difference of myocardial ischemia between the two groups was statistically analyzed.Results The ratio of abnormal myocardial perfusion in group A was significantly higher than that in group B (96.15％ vs.73.53％,x2=5.43,P＜0.05);the total number of abnormal coronary branches in group A was significantly larger than that in group B (82.67％ vs.62.67％,P＜0.05);the total number abnormal perfusion segments in group A was significantly larger than that in group B (P＜0.05),and the abnormal perfusion segments number of anterior wall,septum,apical region and inferior wall in group A was significantly larger than that ingroup B (P＜0.05);the rate of abnormal perfusion at single coronary supplying region in group A was significantly lower than that in group B (P＜0.05).Conclusion 99Tcm-MIBI G-MPI is of great clinical significance for diagnosing coronary microangiopathy and evaluating myocardial ischemia in patients with diabetes mellitus.
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Objective: To analyze the application value of radionuclide myocardial perfusion imaging in the localization and diagnosis for stable angina pectoris in clinical practice. Methods: A total of 70 patients who had been diagnosed with stable angina pectoris (SAP) were enrolled, and all patients underwent ATP-loaded ATP-99Tcm-MIBI (99Tcm-MIBI) myocardial perfusion imaging (MPI) and coronary angiography (CAG) were used to compare the accuracy of MPI imaging in localization and diagnosis for SAP. Results:In the 70 cases of patients with two methods of examination: ①In MPI diagnosis, positive patients were 50 cases, and the positive predictive value of SAP, sensitivity, negative predictive value and specificity were, respectively, 92.0%, 90.2%, 75.0% and 78.9%. There were 45 patients were consistently diagnosed as SAP by the two methods and the total compliance rate was 90.0%. ②in 70 patients, 51 cases were diagnosed as SAP by CAG examination, the positive rate was 72.9%; ③in 50 MPI positive patients, 46 patients were consistent with the results of CAG diagnosis, and the positive rate was 92.0%. The difference between the two methods was statistically significant (x2= 5.72, P<0.05). Conclusion: 99Tcm-MIBI myocardial perfusion imaging can be used as a gatekeeper in patients with stable angina pectoris, and has high application value in the location and diagnosis for stable angina pectoris. The diagnosis and treatment links of stable angina pectoris can save costs and provide a reliable evidencet for clinical practice.
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Objective:To study the radiation dose rate around patients underwent renal dynamic imaging of SPECT with 99Tcm-DTPA, so as to provide the basis for ensuring the radiation safety of the surrounding environment and the general public.Methods: 109 patients who underwent renal dynamic imaging were enrolled in this study, and the radiation dose rates of different time and different distance after 99Tcm-DTPA was injected patients were measured. And then, the changes of dose rate following time and distance were analyzed. Results: At the 0.5h, 1h, 2h, 3h, 6h, and 7h after radiopharmaceuticals were injected patients underwent renal dynamic imaging, the radiation dose rates were 0.76-8.86 μSv/h, 0.68-7.27 μSv/h, 0.57-4.52 μSv/h, 0.56-3.90 μSv/h, 0.23-2.07 μSv/h and 0.21-1.05 μSv/h, respectively, between 0.5 m and 4 m away from patients. At 24h after radiopharmaceuticals were injected, all of radiation dose rates at different distances around patients were same with background values.Conclusion: The radiation dose rates around patients underwent renal dynamic imaging will rapidly decrease with the increasing of time and distance. At 24h after radiopharmaceuticals were injected, all of radiation dose rates at different distances away from patients were same with background values.
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Objective@#To analyze the clinical value of SPECT/CT in diagnosis of skull base bone invasion and clinical decision-making for nasopharyngeal carcinoma (NPC), and to compare their diagnostic value with SPECT/CT, CT, MRI, and MRI combined with SPECT (MRI-SPECT) for skull base bone invasion.@*Methods@#Before treatment, among 348 newly diagnosed NPC patients, CT scan was performed in 186 patients (group A) and the remaining 162 patients received MRI scan (group B). Clinical doctors then made clinical management decisions according to the CT or MRI results. After that, all patients underwent 99Tcm-MDP SPECT/CT examination for nasopharyngeal local tomography, and the results were provided to the clinical doctors to make clinical management decisions again. The changes between the two clinical management decisions were scored according to diagnosis, range of lesion, staging, treatment regimens, and auxiliary examination. The diagnostic value of CT scan, MRI scan, SPECT/CT and MRI-SPECT for skull base bone invasion was then evaluated and compared.@*Results@#In terms of changes in scores of clinical management decisions, the score of group A was 1.387 and group B was 0.951, showing a significant difference between the two groups by Wilcoxon test (Z=6.570, P<0.001). By χ2 test, there were correlations between CT and SPECT/CT (χ2 =98.495, P<0.001), and between MRI and SPECT/CT (χ2 =32.662, P<0.001). The consistency of CT and SPECT/CT (Kappa=0.713) was greater than MRI and SPECT (Kappa=0.449). The sensitivity of CT, MRI, SPECT/CT and MRI-SPECT was 67.1%, 84.5%, 90.8% and 100%, the specificity was 73.3%, 92.3%, 85.6% and 84.6%, and the area under the ROC curve was 0.702, 0.884, 0.882 and 0.923, respectively.@*Conclusions@#SPECT/CT has important impact on clinical management decision for NPC. In the judgement of skull base invasion, the diagnostic value of SPECT/CT is significantly higher than CT and approximately equal to MRI. SPECT/CT should be one of the routine examination methods of nasopharyngeal carcinoma. In addition, in view of its greater diagnostic value, MRI combined with SPECT should be the focus of future imaging studies.
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Objective To assess the diagnostic accuracy of solitary pulmonary nodules while selecting different backgrounds in 99 Tcm‐MIBI SPECT/CT examination .Methods Totally 38 suspected solitary pulmonary nodules (SPN) were analyzed retrospectively .The lesions were divided into malignant group and benign group according to the pathological findings . We selected two different backgrounds , contralateral lung field ( DL ) and the contralateral soft tissue (NST) .The maximum counts and the mean counts of lesion to non‐lesion ratio (L/N) were calculated to evaluate diagnostic efficacy using ROC curve . The relationship between lesion size , pathological grading and L/N ratio was analyzed by Spearman correlation analysis . Results With DL and NST as the backgrounds ,the maximum counts and the mean counts of L/N between benign and malignant groups both differed significantly (all P0 .05) .The size and pathological grading of SPN did not affect 99 Tcm‐MIBI accumulation in the SPN (all P>0 .05) .Conclusion DL and NST both can be used as the background in diagnosis of pulmonary nodules on 99 Tcm‐MIBI SPECT/CT examination .The mean counts of the contralateral tissue used as the background can provide a stable result and a high diagnostic accuracy to assess the SPN .
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OBJECTIVE: To study the bone-targeting potential and dynamic changing process in vivo of a new type of anti-osteoporosis bisphosphonate drug under research (SC). METHODS: The distribution in rabbits and bone-targeting of SC was observed by isotope tracer technique. 99Tcm-SC was injected into the rabbits, then the SPECT images were collected and analyzed in 12 h. RESULTS: The labeling rate of 99Tcm-SC could be maintained above 90% within 12 h, which proved the good stability of 99Tcm-SC in vitro. The rabbit bone imaging showed that the targeting of SC to bone was equivalent to MDP, a bone imaging agent. CONCLUSION: This study provides valuable data for the non-clinical and clinical studies of SC. SC has a good potential for being developed into a new generation of anti-osteoporosis drug.
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Objective To summarize the clinical characters,diagnosis and surgical treatment of primary hyperparathyoidism (PHPT).Methods The diagnosis,treatment and efficacy of 35 cases of PHPT were retrospectively reviewed.Results PHPT presented a variety of clinical manifestations,and occoured to different age groups without significant gender differences.All the 35 cases had elevated blood calcium and PTH.All patients underwent preoperative ultrasonography and 99Tcm-MIB imaging,and the positive rates were 68.6％ and 97.1％ respectively.34 patients received surgical treatment,among whom 30 cases had parathyroid adenoma,1 case had parathyroid hyperplasia and 3 cases had parathyroid carcinoma.Through operation,31 cases were cured,2 cases improved,and 1 case of parathyroid carcinoma suffered from lung metastasls.Conclusions PHPT can be diagnosed according to co-elevated serum calcium and PTH.Ultrasonography combined with 99Tcm-MIB imaging should be recommend for preoperative localization.The main cause of PHPT is solitary parathyroid adenoma.PTPT can be cured by surgery.Minimally invasive parathyroidectomy with accurate location is an efficient surgical strategy,and the prognosis is favorable.
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Objective To evaluate the value of technetium-99m methoxy isobutyl isonitrile (99Tcm-MIBI)tomography and integrated CT in preoperative localization diagnosis of secondary hyperparathyroidism (SHPT).Methods 28 patients with SHPT were selected.15 minutes and 90 minutes (delayed images)after intravenous administration of 99Tcm-MIBI 370 MBq,static anterior planar images of the neck and chest were obtained.99Tcm-MIBI tomography and integrated CT scan were acquired after the delayed imaging.The imaging findings were compared to the pathological results.Results The detection rate of SHPT lesions by 99Tcm-MIBI dua-phase imaging and 99Tcm-MIBI tomography and registration with integrated CT scan was 53.3％ and 70.7％ respectively.The difference had statistical significance(X2 =5.903,P＜0.05).The fusion imaging with integrated CT can provide detailed anatomy data and more information for surgical doctors.Conclusion 99Tcm-MIBI tomography and registration with integrated CT scan can improve the detection rate of SHPT compared with 99Tcm-MIBI dua-phase imaging,provide more detailed anatomy data,and has high clinical value in preoperative localization and diagnosis of SHPT.
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Objective To prepare 99Tcm-B2-S22-AFA (99Tcm-TP1623)and investigate its biodistribution and kinetic imaging in healthy animals.Methods TP-1623 was synthesized and labeled indirectly by 99Tcm using stannous chloride as the reductive agent.The labeling rate was determined with chromatography using Whatman 3MM filter paper and by calculating the specific activity.The biodistribution of 99Tcm-TP1623 was tested at 1,5,10,30,60,120 min after intravenous injection into mice.According to the SPECT images and the time response of the radioactivity in the region of interest (ROI),the dynamic distribution of 99Tcm-TP1623 was assayed.Results The radiolabeling rate of 99Tcm-TP1623 was (96.4-± 0.1) ％ and the specific activity was (24.35 ± 0.06) TBq/mmol.After being conserved at room temperature for 4 h,the radiochemical purity of 99Tcm-TP1623 was (95.03 ± 0.97) ％.The oil-water distribution coefficient was-(2.51 ± 0.15).The bio-distribution test showed that the radioactivity in mice blood disappeared very fast over time by a quick excretion through renal.Meanwhile,the radioactivities in the heart,lung,liver,muscle and bone of mice decreased gradually along time and after 60 min they approached to the lowest levels.The radioactivity in brain always kept at a low level,but the radioactivity in intestinal increased slowly.For rabbits,the SPECT images showed that the radioactivity in blood disappeared quickly and the radioactivities were eliminated through kidneys.Meanwhile there were excretion images in gallbladder and intestinal,but no obvious nuclide accumulation in thyroids and stomach,and low radioactivity in brain as well.Conclusions 99Tcm-TP1623 is easy to prepare and has a high radiolabeling efficiency and good stability in vivo and in vitro,and it has excellent dynamic characteristics in normal animals.
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Objective To evaluate the value of technetium-99m methoxy isobutyl isonitrile(99Tcm-MIBI) tomography and integrated CT scan in preoperative localization diagnosis of primary hyperparathyroidism (PHPT). Methods 31 patients with PHPT were selected .15 minutes and 90 minutes ( delayed images ) after intravenous administration of 99 Tcm-MIBI 370 MBq, static anterior planar images of the neck and chest were obtained .99 Tcm-MIBI tomography and integrated CT scan were acquired after the delayed images .All patients received neck ultra-sound scan before surgery .The imaging findings were compared to the pathological results .Results The detec-tion rate of hyperparathyroidism lesions of 99 Tcm-MIBI dual-phase imaging and 99 Tcm-MIBI tomography and regis-tration with integrated CT scan was 87.1%and 93.5%respectively, without statistical significance (P>0.05). However , they were both higher than ultrasound scan which had a detection rate of 64.5%.The differences had statistical significance (χ2 =4.039 and 7.884 respectively , P<0.05 ) .The detection rate of parathyroid hyper-plasia of 99 Tcm-MIBI tomography and registration with integrated CT was both 80.0%, higher than that of the ul-trasound test(40.0%)and 99Tcm-MIBI dual-phase imaging(40.0%).The fusion imaging with integrated CT scan provided detailed anatomy data and more information for surgical doctors .Conclusions 99 Tcm-MIBI tomography and registration with integrated CT scan can improve the detection rate of PHPT compared with 99 Tcm-MIBI dual-phase imaging , provide detailed anatomy data , and has high clinical value in preoperative localization diagnosis of PHPT.
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Objective To increase the understanding in protein-losing enteropathy (PLE).Methods Sixty-one PLE patients were enrolled in the study and the clinical characteristics, complicated disease, diagnosis and treatment were analyzed. Results The age of the patients was 16-77 (40±15)years, and the gender ratio was 35:26 (female: male). The main clinical manifestations were bilateral lower limb edema in 51 cases, ascites in 41 cases, bilateral pleural effusion in 23 cases, pericardial effusion in 13cases, abdominal pain in 16 cases and diarrhea in 33 cases. The prominent abnormality in laboratory examinations was hypoalbuminemia. The underlying diseases include systemic lupus erythematosus (SLE) in 28 cases, intestinal lymphangiectasia in 12 cases, hepatic cirrhosis in 5 cases, heart diseases in 5 cases,Crohn's disease in 3 cases, membranous nephropathy in 2 cases, Budd-Chiari syndrome in 1 case. Four cases happened after abdominal operation and 1 case after radiation therapy of gastric cardia cancer. Thirtyseven cases were diagnosed by 99Tcm-labelled human serum albumin scintigraphy and 24 cases were diagnosed clinically. Treatment was focused on underlying diseases. The clinical manifestations in 21 cases of SLE improved after SLE was controlled. In 2 cases of intestinal lymphangiectasia and one with Crohn's disease, the clinical manifestations improved after surgery. The other patients had no improvement.Conclusions PLE was not uncommon in clinical practice. Its predominant characteristics were severe hypoalbuminemia, edema and dropsy of serous cavity. PLE can complicate other diseases such as SLE,intestinal lymphangiectasia. Treatment should be focused on primary disease.
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Objective To evaluate the value of positive 99Tcm-MIBI tumor imaging for thyroid cancer diagnosis. Methods Fifty four suspected thyroid cancer patients underwent 99Tcm-O4 and 99Tcm-MIBI combined imaging procedure. The imaging data were confirmed by pathological findings. Results All the 54 cases had single throid nodules, and 25 of which were pathologically malignant. Fifty two cases of nodules were detected by the 99Tcm O4 thyroid static imaging, including 2 hot nodules,4 warm nodules, 10 cool nodules and 36 cold nodules;2 cases were negative by the imaging. Of the 25 malignant thyroid nodules, 16 nodules were visible by 99Tcm-MIBI uptake and were cold nodules;29 exhibited benign thyroid nodules,of which 15 could be seen by 99Tcm-MIBI uptake,including 1 warm nodules,2 cool nodules and 12 cold nodules. The sensitivity, specificity of the combined imaging of 99Tcm O4 and 99Tcm-MIBI were 64. 00% ( 16/25 ) and 48. 28% (14/29). No significant difference was found for the positivity between benign nodules and malignancy nodules by 99Tcm-MIBI tumor imaging ( χ2 = 0. 83, P ＞ 0. 05 ). Conclusion 99Tcm-MIBI tumor imaging is not specific for the diagnosis of thyroid malignancy.
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Objective To investigate the clinical value of 99Tcm-MIBI SPECT-CT image fusion technology for diagnosing breast tumor and detecting axiiiary lymph node metastasis. Methods 99Tcm-MiBI breast and axillary lymph node planar and SPECT-CT imaging in 80 female breast tumor patients were done. All patients had pathological examination results after surgery as control. Results SPECT-CT fusion images sensitivity for breast cancer diagnosis, specificity and accuracy rates were 88.2 % (45/51), 93.1% (26/29) and 90 % (71/80). Planar imaging sensitivity, specificity and accuracy rate were 82.4 % (42/51), 79.3 %(23/29) and 81.3 %(65/80). SPECT-CT fusion images were higher than planar imaging (P <0.05). SPECT-CT fusion images sensitivity, specificity and accuracy for detecting axillary lymph node metastasis were 81.8 %(18/22), 89.7 % (26/29) and 86.3 % (44/51). Planar imaging sensitivity, specificity and accuracy were 77.2 % (17/22), 86.2 % (25/29) and 82.4 %(42/51). There was no significant difference between them (P0.05). Conclusion SPECT-CT image fusion technology in the diagnosis of breast cancer is better than planar imaging. SPECT-CT image fusion in detecting axillary lymph node metastasis of breast cancer is similar to planar imaging.
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Objective To study serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) and its correlation with accumulation degree of 99Tcm-MDP on bone and arthritis and to study the role of sICAM-1 in the diagnosis of patients with early RA. Methods Serum levels of sICAM-1 were measured by immunoenzymetic assay (ELISA). 99mTc-MDP scintigraphy was carried out for the same patients. The significant test between serum levels of sICAM-1 of three groups was performed with analysis of variance; Correlations between serum levels of sICAM-1 and index of semiquatitive 99Tcm-MDP were obtained using sperman's ranks correlation method. Results Compared with control group,serum levels of sICAM-1 were significantly higher in standard group (group A) (P<0.01) and non-standard group (group B) (P<0.05). No significant difference was found between group A and B(P>0.05). Serum levels of sICAM-1 were positively correlated with 99Tcm-MDP scintigraphy. Most patients of non-standard group and standard group showed visible medium-high uptake of 99Tcm-MDP. While control group had not obviously uptake of 99Tcm-MDP. Conclusion Serum levels of sICAM-1, semiquatitive 99Tcm-MDP scintigraphy, accumulation degree of radiopharmuceuutial on bone and arthritis are helpful for diagnosis of early rheumatoid arthritis and judge-ment of the clinical status and improvement of the prognosis.
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The imaging appearances of 99Tcm-HL91, a new hypoxic imaging agent, in ischemic myocardium were studied and the value of 99 Tcm-HL91 in the evaluation of regional ischemic viable myocardium was explored. Acute myocardial ischemia models were made by coronary artery legations in 18 rats and randomly divided into 2 groups: 99Tcm-HL91 group and 99Tcm-MIBI group. Evan blue infusion during ischemia and TTC staining after operation were used to delineate the area of ischemic and viable myocardium. The isolated heart was sliced in the short axis and then autoradiography was performed. The electron microscopic examination was also done for the myocardial samples. 99Tcm-HL91 and 99Tcm-MIBI uptake activities (counts/g) were measured in the area of ischemic myocardium (T) and normal myocardium (NT) separately. The uptake ratios of 99Tcm-HL91 and that of 99Tcm-MIBI in ischemic myocardium were calculated as T/NT. It was found that the normal myocardium was blue and ischemic or infarct myocardium was negative with Evans blue in all experiment rats. Both the normal and ischemic myocardium was in red color with TTC staining.In the 99Tcm-HL91 group the ischemic myocardium showed much higher uptake over normal myocardium, that was demonstrated both in the autoradiography and quantitative analysis. The ischemic/normal activity ratios were 1.634±0.354. It was suggested that 99Tcm-HL91 might accumulate in ischemic and viable myocardium, which is helpful in the evaluation of hypoxic but viable myocardium and potentially used as a imaging agent to assess myocardial viability.