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        1 General Diagnosis

        2015-03-22 03:35:26
        東南大學學報(醫(yī)學版) 2015年1期
        關鍵詞:張紅晶晶

        1 General Diagnosis

        201500118F-FDG PET/CT im aging in the diagnosis of polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome.ZHANG Bing(張冰),et al.PET/CT Center,1st Affil Hosp,Sun Yat-sen Univ,Guangzhou 510080.Chin J Nucl Med Imaging 2014;34(5):345-348.

        ObjectiveTo analyze the PET/CT findings in polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes(POEMS)syndrome and explore its clinical value.MethodsEleven patients with POEMS syndrome(7 males,4 females;age range:49-73 years;mean age:(58.5±8.4)years)from October2008 to February 2013 were retrospectively analyzed.All patients underwent18F-FDG PET/CT scan.The image characteristics,including the abnormal18F-FDG uptake and SUVmax of the lesions,were analyzed.ResultsA total of141 sclerotic bone lesions were found in 11 cases,including 5 lesions in parietal bones,8 in scapulas,4 in clavicles,16 in ribs,64 in vertebraes,29 in iliac bones,6 in ischiums,8 in pubic bones and 1 in humerus.Fifty-eight lesions increased FDG uptake with the average SUVmaxof 4.3±1.6.One case waswith hepatomegaly,3 with splenomegaly,2 with hepatosplenomegaly and 5 with lymphadenopathy.Three patients with splenomegaly and 5 with lymphadenopathy were hypermetabolic,and the SUVmax was3.2-4.1 and 2.6-4.9,respectively.One case was with bilateral pleural effusions,3 caseswith seroperitoneum,3 cases with pelvic effusion and 2 cases with both polyserious effusions and subcutaneous dropsy.ConclusionMultisystem lesions,including bone damage,organomegaly,extravascular volume overload,could be detected by18F-FDG PET/CT in patients with POEMS syndrome.

        (Authors)

        2015002 Clinical study of99Tcm-N-DBODC5 as a novelm yocardial per fusion im aging agent for the diagnosis of coronary artery disease.MA Haiyan(馬海彥),etal.Dept NuclMed,1st Affil Hosp,ShanxiMed Univ,Taiyuan 030001.Chin JNucl Med Mol Imaging 2014;34(5):349-353.

        Ob jectiveTo investigate the clinical value of99Tcm-(bis(dimethoxypropylphosphinoethyl)-ethoxyethylamine)-(bis(N-ethoxyethyl)-dithiocarbamato nitride(99Tcm-NDBODC5)for the detection of coronary artery disease(CAD).)Methods From October 2010 to October 2012,46 patients with suspected CAD(31males,15 females;average age:60 years)were recruited.They all underwent stress-rest MPI using both99Tcm-N-DBODC5 and99Tcm-MIBI within 1 week.CAG was carried out within 1 month after MPI and chosen as the gold standard.The diagnostic accordance rate between MPI and CAG was analyzed using Kappa test.The diagnostic efficiency of99Tcm-N-DBODC5 and99Tcm-MIBI MPI was compared byχ2test.ResultsAmong the 46 patients,29 were positive and 17 were negative for CAD by CAG. The sensitivity and specificity in the detection of CAD were 86%(25/29)and 65%(11/17)for99Tcm-MIBI MPI,86%(25/29)and 88%(15/17)for99Tcm-NDBODC5 MPI(χ2=2.62,P>0.05),respectively.A-mong the 138 vessels,48 were positive and 90 were negative on CAG.The vessel-based sensitivity,specificity and accuracy for the detection ofstenosiswere notsignificantly differentbetween99Tcm-N-DBODC5 and99Tcm-MIBI(χ2=3.79,all P>0.05).The accordance between99Tcm-N vDBODC5 MPI and angiography was very good(Kappa=0.73)andmoderate for99Tcm-MIBIMPI(Kappa=0.52).Conclusion99Tcm-N-DBODC5mighthave a potential role as MPIagent for the diagnosis of CAD.

        (Authors)

        2015003 Evaluations of diastolic functionsw ith E/e′obtained by dual-Dopp ler sim u ltaneous recording of flow and tissue Dopp ler velocities in coronary heart disease patients with preserved systolic function.WANG Jingjing(汪晶晶),et al.Dept Cardiol;Chinese PLA General Hosp,Beijing 100853.Natl Med J China 2014;94(35):2740-44.

        ObjectiveTo evaluate the usefulness of ratio of early diastolic transmitral flow velocity(E)tomitral annular velocity(e′)calculated by simultaneously recording E and e′in coronary heart disease(CHD)patients.M ethodsA total of 77 CHD patients with preserved systolic functions underwent echocardiography.Left ventricular catheterization was performed to measure left ventricular and diastolic pressure(LVEDP).The accuracy of E/e′was compared by recording the dual-Doppler and conven-tional methods for diagnosing diastolic dysfunction and the relationship with N-terminal pro-brain natriuretic peptide(NT-proBNP).The validity of E/e′dualDopplerand combination of E/e′dualDopplerand NT-proBNP in estimating left ventricular diastolic dysfunction,namely LVEDP≥12 mmHg(1 mmHg=0.133 kPa),were estimated.ResultsE/e′dualDopplerwas correlated with left ventricular end diastolic pressure(LVEDP)and logNT-proBNP(r=0.79,r=0.47,respectively,P<0.01).E/ e′conventionalwas correlated with LVEDP and logNT-proBNP(r=0.61,P<0.01,r=0.35,P<0.05,respectively).The area under curve(AUC)of E/e′dualDopplerand E/e′conventionalwas 0.87 and 0.82.The optimal cut-off of E/e′dualDopplerwas 9.2 with a sensitivity of 74%and a specificity of 81%.And the optimal cut-off of plasma NT-proBNPwas 108 ng/Lwith a sensitivity of 69%and a specificity of86%,AUC 0.79.When E/e′dualDoppler≥9.2 and NT-proBNP≥108 ng/L were combined,the sensitivity and specificity for diagnosing diastolic dysfunction were 86%and 69%,AUC 0.89.ConclusionThe accuracy of E/e′dualDoppleris better than E/e′conventionalfor diagnosing left diastolic dysfunction.When E/ e′dualDopplerand NT-proBNP are combined,it improves the evaluation accuracy of left diastolic dysfunction.

        (Authors)

        2015004 Com puted tom ographic features of abdominal compartment syndrome complicated by severe acute pancreatitis.WU Jingtao(吳晶濤),et al.Dept Radiol,Subei People's Hosp,Yangzhou 225001.Natl Med JChina 2014;94(43):3378-81.

        ObjectiveTo explore the computed tomographic(CT)imaging features of abdominal compartment syndrome(ACS)complicated by severe acute pancreatitis(SAP)to improve the diagnosis of disease.M ethodsThirty-six cases of ACS and 61 cases of non-ACS(NACS)complicated by SAPwere studied retrospectively.And the meaningful CT features were studied.ResultsAmong them,the ACS vascular complications of abdominal cavity and gastrointestinal bleedingwere found significantlymore in ACS than in NACS(P<0.05). The ACS intestinal obstruction occurred significantly more often in ACS than in NACS(P<0.05).The ACS inferior vena cava pressure,diaphragm elevation,round belly sign and marked seroperitoneum occurred significantly more often in ACS than in NACS(P<0.05).The score of ACS with Balthazar was higher than that of NACS(P<0.05).For CT signs associated with ACS,four ormore associated with ACSCT characteristics,the diagnostic sensitivity was 96.5%.And the specifcity,positive predictive value and negative predictive value were 100%,100%and 87.5%respectively.And the surgical survival rate was significantly higher than the non-surgical survival(P<0.05).ConclusionA comprehensive analysis of CT features of ACS is important for early diagnosis and guidance of treatment.

        (Authors)

        2015005 Diagnostic value of endobronchial u ltrasound-guided transbronchial needle aspiration in pulmonary sarcoidosis.ZHANG Hong(張紅),et al. Dept Respir&Critical Care Med,Peking Univ 1st Hosp,Beijing 100034.Chin JTuberc Respir Dis 2014;37(10):774-777.

        ObjectiveThe aim of this study was to observe the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in sarcoidosis.MethodsWe retrospectively analyzed the diagnostic efficiency of standard bronchoscopy and EBUS-TBNA in all patients diagnosed as sarcoidosis in Peking U-niversity First Hospital between August2010 and October 2011.The relationship between biopsy puncture numbers and sensitivity was calculated.ResultsThere were 17 sarcoidosis patients among a total of107 patientswho had received EBUS-TBNA.Fourteen patients had a postitive TBNA result and the sensitivity of EBUS-TBNA was 82%.The sensitivity of standard bronchoscopy was53% and when combined with EBUS-TBNA,the sensitivity increased to 88%.The sensitivity of EBUS-TBNA was associated with the size of lymph nodes.Lymph nodeswith a diameter≥2 cm showed a higher positive rate.Four punctures for 1 lymph node showed a concordance rate of 100%with the final results.ConclusionEBUS-TBNA was a safe and effectivemethod in diagnosing pulmonary sarcoidosis.For patients with suspected sarcoidosis EBUS-TBNA should be performed in the largest lymph node with at least 4 punctures.

        (Authors)

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