• 【胸腔镜前脊柱融合手术后肺体积的变化: 三维计算机断层扫描研究。】 复制标题 收藏 收藏
    DOI:10.1097/BRS.0000000000001949 复制DOI
    作者列表:Yu CG,Grant CA,Izatt MT,Labrom RD,Askin GN,Adam CJ,Little JP
    BACKGROUND & AIMS: STUDY DESIGN:Lung volumes and thoracic anatomy were measured from low-dose computed tomography (CT) scans preoperatively and 2 years following thoracoscopic anterior spinal fusion (TASF) for adolescent idiopathic scoliosis (AIS). OBJECTIVE:The aim of this study was to assess changes in lung volume after TASF surgical correction. SUMMARY OF BACKGROUND DATA:AIS patients are known to have decreased pulmonary function as a consequence of their spinal and ribcage deformity. Several studies have evaluated changes in pulmonary function clinically after scoliosis correction surgery showing varied results. To date, there have been no published studies using CT to evaluate lung volume changes following TASF. METHODS:Twenty-three female AIS patients with both pre- and 2 years postoperative low-dose CT scans were selected from an ethically approved, historical databank. Three-dimensional lung volumes were reconstructed to determine anatomical lung volumes. Right and left lung volumes, total lung volume, and right-to-left lung volume ratio were obtained as well as hemithoracic symmetry, to indicate the extent of thorax deformity. Cobb angle, rib hump, levels fused in surgery, and patient height were used for correlation analysis with the lung volume results. RESULTS:Left lung volume, total lung volume, and hemithoracic ratio all increased significantly 2 years after surgery. There was no significant change in right-to-left lung volume ratio (P = 0.36). Statistical regression found significant positive correlation between lung volume changes, reduction in Cobb angle, increase in height, and improvement in hemithoracic symmetry ratio. CONCLUSION:TASF resulted in a statistically significant increase in lung volume following surgery, as well as improvement in the symmetry of the thoracic architecture; however, the postoperative lung volumes remained in the lower 50th percentile relative to females without thoracic deformity. Furthermore, change in lung volume was significantly correlated with changes in Cobb angle, hemithoracic asymmetry, and increased patient height, which are important consequences of thoracic deformity correction surgery. LEVEL OF EVIDENCE:3.
    背景与目标:
  • 【地形相关的地震层析成像揭示了西藏东部的垂直地壳运动。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03578-z 复制DOI
    作者列表:Zhang X,Wang Y,Gao R,Xu T,Bai Z,Tian X,Li Q
    BACKGROUND & AIMS: :Using a topography-dependent tomographic scheme, the seismic velocity structure of the Eastern Tibetan Plateau, including the uplifted Longmenshan (LMS) orogenic belt, is accurately imaged in spite of the extreme topographic relief in the LMS region and thick sedimentary covers in the neighbouring Sichuan Basin. The obtained image shows a high-resolution upper crustal structure on a 500 km-long profile that is perpendicular to the LMS. The image clearly shows that the crystalline basement was uplifted within the LMS orogenic belt, and that the neighbouring Songpan-Ganzi Terrane was covered by a thick flysch belt, with evidence of near-surface thrust faults caused by convergence between Eastern Tibet and the Sichuan Basin. The indication that the lower crust beneath the LMS was folded and pushed upwards and the upper crust was removed by exhumation, supports the concept of a lower crustal channel flow beneath Eastern Tibet. The image also reveals that the destructive Wenchuan earthquake of year 2008 occurred in the upper crust, directly at the structural discontinuity between Eastern Tibet Plateau and the Sichuan Basin.
    背景与目标: : 采用地形相关的层析方案,尽管LMS地区地形起伏极端,邻近的四川盆地沉积覆盖层较厚,但仍准确成像了包括隆升龙门山 (LMS) 造山带在内的青藏高原东部地震速度结构。所获得的图像显示了垂直于LMS的500   km长轮廓上的高分辨率上地壳结构。图像清楚地表明,LMS造山带内的结晶基底隆起,邻近的松潘-甘孜地体被厚的飞石带覆盖,有西藏东部和四川盆地之间的会聚引起的近地表逆冲断层的证据。LMS下方的下地壳被折叠并向上推动,而上地壳被挖掘出的迹象支持了西藏东部下方的下地壳通道流的概念。该图像还揭示了2008年汶川破坏性地震发生在上地壳上,直接发生在青藏高原东部和四川盆地之间的结构不连续处。
  • 【正电子发射断层扫描在肺癌分期中的作用。】 复制标题 收藏 收藏
    DOI:10.1016/s0169-5002(97)00638-7 复制DOI
    作者列表:Schiepers C
    BACKGROUND & AIMS: Early detection and staging of lung cancer is important in initiating rapid treatment and improving prognosis. Computed tomography (CT) and magnetic resonance (MR) imaging have a high resolution and are able to reveal structural abnormalities, but still have problems differentiating benign from malignant lesions. Lesion size is used as a distinguishing parameter but definite diagnosis still relies on invasive procedures. Positron emission tomography (PET) is based on imaging of biochemical processes in vivo. PET is unique by disclosing metabolic differences between benign and malignant disease, e.g. glucose utilization. Here, the role of PET in diagnosis and (re)-staging of lung cancer as well as monitoring of therapy response will be reviewed.

    背景与目标: 肺癌的早期发现和分期对于开始快速治疗和改善预后至关重要。计算机断层扫描 (CT) 和磁共振 (MR) 成像具有高分辨率,能够揭示结构异常,但在区分良性和恶性病变方面仍然存在问题。病变大小用作区分参数,但明确的诊断仍依赖于侵入性操作。正电子发射断层扫描 (PET) 基于体内生化过程的成像。PET通过揭示良性和恶性疾病 (例如葡萄糖利用) 之间的代谢差异而独特。在这里,将回顾PET在肺癌的诊断和 (再) 分期以及监测治疗反应中的作用。
  • 【正电子发射断层扫描/计算机断层扫描: 评估原发性和转移性肝恶性肿瘤对常规成像方式的挑战。】 复制标题 收藏 收藏
    DOI:10.3748/wjg.v13.i20.2775 复制DOI
    作者列表:Sun L,Wu H,Guan YS
    BACKGROUND & AIMS: :Computer tomography (CT) and magnetic resonance imaging (MRI), as conventional imaging modalities, are the preferred methodology for tumor, nodal and systemic metastasis (TNM) staging. However, all the noninvasive techniques in current use are not sufficiently able to identify primary tumors and even unable to define the extent of metastatic spread. In addition, relying exclusively on macromorphological characteristics to make a conclusion runs the risk of misdiagnosis due mainly to the intrinsic limitations of the imaging modalities themselves. Solely based on the macromorphological characteristics of cancer, one cannot give an appropriate assessment of the biological characteristics of tumors. Currently, positron emission tomography/computer tomography (PET/CT) are more and more widely available and their application with (18)F-fluorodeoxyglucose ((18)F-FDG) in oncology has become one of the standard imaging modalities in diagnosing and staging of tumors, and monitoring the therapeutic efficacy in hepatic malignancies. Recently, investigators have measured glucose utilization in liver tumors using (18)F-FDG, PET and PET/CT in order to establish diagnosis of tumors, assess their biologic characteristics and predict therapeutic effects on hepatic malignancies. PET/CT with (18)F-FDG as a radiotracer may further enhance the hepatic malignancy diagnostic algorithm by accurate diagnosis, staging, restaging and evaluating its biological characteristics, which can benefit the patients suffering from hepatic metastases, hepatocellular carcinoma and cholangiocarcinoma.
    背景与目标: : 计算机断层扫描 (CT) 和磁共振成像 (MRI) 作为常规成像方式,是肿瘤,淋巴结和全身转移 (TNM) 分期的首选方法。然而,目前使用的所有非侵入性技术都不足以识别原发性肿瘤,甚至无法确定转移扩散的程度。此外,仅依靠宏观形态特征得出结论存在误诊的风险,这主要是由于成像方式本身的内在局限性。仅根据癌症的宏观形态特征,就无法对肿瘤的生物学特征进行适当的评估。目前,正电子发射断层扫描/计算机断层扫描 (PET/CT) 越来越广泛,它们与 (18)F-氟脱氧葡萄糖 (18) f-fdg) 在肿瘤学中的应用已成为诊断和分期的标准成像方式之一。肿瘤,并监测肝恶性肿瘤的治疗效果。最近,研究人员使用 (18) f-fdg,PET和PET/CT测量了肝脏肿瘤中的葡萄糖利用率,以建立肿瘤的诊断,评估其生物学特征并预测对肝脏恶性肿瘤的治疗效果。以 (18) f-fdg为放射性示踪剂的PET/CT可通过准确的诊断、分期、复查和评价其生物学特性,进一步提高肝恶性肿瘤的诊断算法,使肝转移瘤、肝细胞癌和胆管癌患者受益。
  • 【使用光学相干断层扫描,视网膜厚度分析和地形血管造影对年龄相关性黄斑变性中色素上皮脱离的三维成像。】 复制标题 收藏 收藏
    DOI:10.1007/s00417-006-0418-z 复制DOI
    作者列表:Ahlers C,Michels S,Beckendorf A,Birngruber R,Schmidt-Erfurth U
    BACKGROUND & AIMS: INTRODUCTION:New diagnostic tools such as the retinal thickness analyzer (RTA), optical coherence tomography (OCT), and topographic angiography (TAG) were introduced into clinical ophthalmology during the last years giving the examiner new insights into anatomical and functional aspects of macular disease. In this study, advantages and disadvantages of the new imaging methods have been evaluated in patients with serous (sPED) and fibrovascular pigment epithelial detachments (fPED) secondary to age-related macular degeneration (AMD). METHODS:TAG, using fluorescein angiography (FA), provides a three-dimensional profile of the fluorescein pattern based on the analysis of a set of 32 confocal images over a depth of 4 mm. RTA and OCT provide cross-sectional images of the neurosensory retina and the retinal pigment epithelium-choriocapillary complex as well as retinal thickness data encoded in a false color map. We compared and evaluated these modalities in 15 patients with fPED and 15 patients with sPED secondary to AMD. RESULTS:In patients with classic fPED, TAG detected neovascular structures and delineated their configuration. In sPEDs, pooling of extravascular fluid was detected in a dome-shaped configuration. OCT provided detailed information on the neurosensory retina's structures but failed to detect the neovascular membrane in fPED. Mapping the retinal thickness, RTA and OCT both failed to detect the PED and showed typical algorithm error-based patterns. CONCLUSION:TAG OCT and RTA are useful imaging modalities in the evaluation of AMD cases. TAG visualizes the vascular configuration, dynamic perfusion, and leakage changes. OCT and RTA are able to complementarily document intra-, subretinal, and sub-RPE fluid accumulation secondary to CNV. However, OCT seems to be more efficient in imaging AMD-related pathologies than RTA, as this modality is often compromised by intra- or subretinal structural abnormalities. Nevertheless, all modalities may provide further valuable insight into AMD pathogenesis, enhance diagnostic quality, and improve the assessment of therapeutic effects.
    背景与目标:
  • 【人工耳蜗植入后电极阵列的标量定位: 使用64层多探测器计算机断层扫描的临床经验。】 复制标题 收藏 收藏
    DOI:10.1097/MAO.0b013e3180686e26 复制DOI
    作者列表:Lane JI,Witte RJ,Driscoll CL,Shallop JK,Beatty CW,Primak AN
    BACKGROUND & AIMS: OBJECTIVE:To use the improved resolution available with 64-slice multidetector computed tomography (MDCT) in vivo to localize the cochlear implant electrode array within the basal turn. STUDY DESIGN:Sixty-four-slice MDCT examinations of the temporal bones were retrospectively reviewed in 17 patients. Twenty-three implants were evaluated. SETTING:Tertiary referral facility. PATIENTS:All patients with previous cochlear implantation evaluated at our center between January 2004 and March 2006 were offered a computed tomographic examination as part of the study. In addition, preoperative computed tomographic examinations in patients being evaluated for a second bilateral device were included. INTERVENTION:Sixty-four-slice MDCT examination of the temporal bones. MAIN OUTCOME MEASURE:Localization of the electrode array within the basal turn from multiplanar reconstructions of the cochlea. RESULTS:Twenty-three implants were imaged in 17 patients. We were able to localize the electrode array within the scala tympani within the basal turn in 10 implants. In 3 implants, the electrode array was localized to the scala vestibuli. Migration of the electrode array from scala tympani to scala vestibuli was observed in three implants. Of the 7 implants in which localization of the electrode array was indeterminate, all had disease entities that obscured the definition of the normal cochlear anatomy. CONCLUSIONS:Sixty-four-slice MDCT with multiplanar reconstructions of the postoperative cochlea after cochlear implantation allows for accurate localization of the electrode array within the basal turn where normal cochlear anatomy is not obscured by the underlying disease process. Correlating the position of the electrode in the basal turn with surgical technique and implant design could be helpful in improving outcomes.
    背景与目标:
  • 【差分x射线相衬计算机断层扫描的代数迭代重建技术。】 复制标题 收藏 收藏
    DOI:10.1016/j.zemedi.2012.11.002 复制DOI
    作者列表:Fu J,Schleede S,Tan R,Chen L,Bech M,Achterhold K,Gifford M,Loewen R,Ruth R,Pfeiffer F
    BACKGROUND & AIMS: :Iterative reconstruction has a wide spectrum of proven advantages in the field of conventional X-ray absorption-based computed tomography (CT). In this paper, we report on an algebraic iterative reconstruction technique for grating-based differential phase-contrast CT (DPC-CT). Due to the differential nature of DPC-CT projections, a differential operator and a smoothing operator are added to the iterative reconstruction, compared to the one commonly used for absorption-based CT data. This work comprises a numerical study of the algorithm and its experimental verification using a dataset measured at a two-grating interferometer setup. Since the algorithm is easy to implement and allows for the extension to various regularization possibilities, we expect a significant impact of the method for improving future medical and industrial DPC-CT applications.
    背景与目标: : 在传统的基于x射线吸收的计算机断层扫描 (CT) 领域中,迭代重建具有广泛的已证明的优势。在本文中,我们报告了基于光栅的差分相衬CT (dpc-ct) 的代数迭代重建技术。由于dpc-ct投影的微分性质,与通常用于基于吸收的CT数据相比,在迭代重建中添加了微分算子和平滑算子。这项工作包括对算法的数值研究及其使用在两光栅干涉仪设置下测量的数据集的实验验证。由于该算法易于实现,并且可以扩展到各种正则化可能性,因此我们希望该方法对改善未来的医疗和工业dpc-ct应用产生重大影响。
  • 【实时超声与计算机断层扫描的图像融合: 影响局灶性肝病灶配准误差和运动的因素。】 复制标题 收藏 收藏
    DOI:10.1016/j.ultrasmedbio.2017.01.027 复制DOI
    作者列表:Lee MW,Park HJ,Kang TW,Ryu J,Bang WC,Lee B,Lee ES,Choi BI
    BACKGROUND & AIMS: :Factors affecting the registration error (RE) and motion of focal hepatic lesions (FHLs) in image fusion of real-time ultrasonography (US) with computed tomography (CT) images were prospectively assessed by focusing on respiratory movement and FHL location. Real-time US and pre-acquired CT images at end-inspiration were fused with FHLs for 103 patients. Three-dimensional US data containing FHLs were obtained during end-inspiratory/expiratory phases. Multivariate analysis revealed that diaphragm motion (p < 0.001), chronic liver disease (p = 0.02) and the absolute difference in distance between the FHL and the central portal vein (CPV) during respiration (p = 0.03) were the independent factors that revealed the maximum effect on RE. In contrast, diaphragm motion (p < 0.001) and distance between the FHL and CPV at inspiration (p = 0.036) revealed the maximum effect on FHL motion. In conclusion, RE and FHL motion are affected by the degree of respiratory movement and the location of the FHL. Therefore, image fusion with CT images should be used with caution if the degree of respiratory motion is significant or if the FHL is located at the periphery of the liver.
    背景与目标: : 通过关注呼吸运动和FHL位置,前瞻性评估了实时超声 (US) 与计算机断层扫描 (CT) 图像融合中影响局灶性肝病灶 (FHLs) 的配准误差 (RE) 和运动的因素。将103例患者的实时US和吸气末采集的CT图像与FHLs融合。在吸气/呼气末阶段获得了包含FHLs的三维US数据。多因素分析显示,膈肌运动 (p < 0.001) 、慢性肝病 (p = 0.02) 和呼吸过程中FHL与门静脉中央 (CPV) 距离的绝对差异 (p = 0.03) 是显示对RE影响最大的独立因素。相反,隔膜运动 (p < 0.001) 和吸气时FHL和CPV之间的距离 (p = 0.036) 揭示了对FHL运动的最大影响。总之,RE和FHL运动受呼吸运动程度和FHL位置的影响。因此,如果呼吸运动程度明显或FHL位于肝脏外围,则应谨慎使用与CT图像的图像融合。
  • 【急诊观察持续时间对轻度钝头外伤儿童计算机断层扫描使用的影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.annemergmed.2013.06.020 复制DOI
    作者列表:Schonfeld D,Fitz BM,Nigrovic LE
    BACKGROUND & AIMS: STUDY OBJECTIVE:We determine the effect of the duration of emergency department (ED) observation on computed tomography (CT) rate for children with minor blunt head trauma. METHODS:We performed a prospective cohort study of children with blunt head trauma and a Glasgow Coma Scale score greater than 14. We defined time from injury as the time from head injury to initial physician (emergency attending physician or fellow) assessment. For children who were observed in the ED before CT decisionmaking, we defined ED observation time as time from initial physician assessment to the decision whether to obtain a CT. After adjusting for time from injury, patient age, sex, physician type, and study month, we measured the effect of ED observation time on CT rate in each of the 3 Pediatric Emergency Care Applied Research Network Traumatic Brain Injury risk groups. RESULTS:Of the 1,605 eligible patients, we enrolled 1,381 (86%). Of the enrolled patients, 676 (49%) were observed in the ED and 272 (20%) had a CT performed. After adjustment, every hour of ED observation time was associated with a decrease in CT rate for children in all 3 traumatic brain injury risk groups: high risk (adjusted odds ratio [OR] 0.11; 95% confidence interval [CI] 0.05 to 0.24), intermediate risk (adjusted OR 0.28; 95% CI 0.21 to 0.36), and low risk (adjusted OR 0.47; 95% CI 0.31 to 0.73). All 8 children with a significant traumatic brain injury had an immediate CT. CONCLUSION:For children with minor blunt head trauma, ED observation time was associated with a time-dependent reduction in cranial CT rate, with no delay in the diagnosis of a significant traumatic brain injury.
    背景与目标:
  • 【锥形束计算机断层扫描在正畸牙齿移动继发感觉神经感觉异常诊断中的应用: 临床报告。】 复制标题 收藏 收藏
    DOI:10.1016/j.ajodo.2012.05.024 复制DOI
    作者列表:Chana RS,Wiltshire WA,Cholakis A,Levine G
    BACKGROUND & AIMS: :In this article, we report an incident of transient neuropathy secondary to tooth movement involving the inferior alveolar nerve. This clinical report reflects the need to thoroughly examine potentially high-risk patients for neuropathy using advanced diagnostic tools such as cone-beam computed tomography when diagnosing and planning treatment.
    背景与目标: : 在本文中,我们报告了继发于下牙槽神经的牙齿运动的短暂性神经病事件。本临床报告反映了在诊断和计划治疗时,需要使用先进的诊断工具 (例如锥形束计算机断层扫描) 彻底检查潜在的高危神经病患者。
  • 【单光子发射计算机断层扫描成像在检测前列腺癌腰椎转移中的有用性。】 复制标题 收藏 收藏
    DOI:10.1111/j.1442-2042.2008.02028.x 复制DOI
    作者列表:Nozaki T,Yasuda K,Akashi T,Fuse H
    BACKGROUND & AIMS: OBJECTIVE:To determine whether single photon emission computed tomography (SPECT) is useful in the detection of prostate cancer bone metastases in the lumbar vertebrae. METHODS:Thirty-nine patients (12 with benign prostatic hyperplasia, 27 with prostate cancer) were considered and submitted to bone SPECT. All of them had increased uptake in lumbar vertebrae on bone scintigraphy. In those with prostate cancer, definitive diagnosis of bone metastases was established by magnetic resonance imaging (MRI). SPECT axial images were classified into five accumulation patterns: mosaic, large hot, diffuse, peripheral, and articular (or pediculate). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bone SPECT were calculated. RESULTS:Overall, 116 vertebral lesions (49 metastatic, 67 degenerative) were studied. Mosaic, large hot and diffuse patterns were more frequently associated with metastatic lesions (84.2%, 70.3%, and 63.1% of the cases, respectively). On the other hand, peripheral and articular (or pediculate) patterns were mostly ascribed to degenerative lesions (100% and 87.5% of the cases, respectively). Sensitivity, specificity, PPV and NPV of bone SPECT were 95.9% (47/49), 73.1% (49/67), 72.3% (47/65), and 96.1% (49/51), respectively. CONCLUSIONS:Bone SPECT provides better accuracy than bone scintigraphy in differential diagnosis of lumbar vertebral lesions from prostate cancer.
    背景与目标:
  • 【计算机断层结肠成像筛查大肠癌,结肠外癌和主动脉瘤: 具有成本效益分析的模型模拟。】 复制标题 收藏 收藏
    DOI:10.1001/archinte.168.7.696 复制DOI
    作者列表:Hassan C,Pickhardt PJ,Laghi A,Kim DH,Zullo A,Iafrate F,Di Giulio L,Morini S
    BACKGROUND & AIMS: BACKGROUND:In addition to detecting colorectal neoplasia, abdominal computed tomography (CT) with colonography technique (CTC) can also detect unsuspected extracolonic cancers and abdominal aortic aneurysms (AAA).The efficacy and cost-effectiveness of this combined abdominal CT screening strategy are unknown. METHODS:A computerized Markov model was constructed to simulate the occurrence of colorectal neoplasia, extracolonic malignant neoplasm, and AAA in a hypothetical cohort of 100,000 subjects from the United States who were 50 years of age. Simulated screening with CTC, using a 6-mm polyp size threshold for reporting, was compared with a competing model of optical colonoscopy (OC), both without and with abdominal ultrasonography for AAA detection (OC-US strategy). RESULTS:In the simulated population, CTC was the dominant screening strategy, gaining an additional 1458 and 462 life-years compared with the OC and OC-US strategies and being less costly, with a savings of $266 and $449 per person, respectively. The additional gains for CTC were largely due to a decrease in AAA-related deaths, whereas the modeled benefit from extracolonic cancer downstaging was a relatively minor factor. At sensitivity analysis, OC-US became more cost-effective only when the CTC sensitivity for large polyps dropped to 61% or when broad variations of costs were simulated, such as an increase in CTC cost from $814 to $1300 or a decrease in OC cost from $1100 to $500. With the OC-US approach, suboptimal compliance had a strong negative influence on efficacy and cost-effectiveness. The estimated mortality from CT-induced cancer was less than estimated colonoscopy-related mortality (8 vs 22 deaths), both of which were minor compared with the positive benefit from screening. CONCLUSION:When detection of extracolonic findings such as AAA and extracolonic cancer are considered in addition to colorectal neoplasia in our model simulation, CT colonography is a dominant screening strategy (ie, more clinically effective and more cost-effective) over both colonoscopy and colonoscopy with 1-time ultrasonography.
    背景与目标:
  • 【使用 [18F] galacto-rgd的正电子发射断层扫描可识别人中整联蛋白 α (v) β3表达的水平。】 复制标题 收藏 收藏
    DOI:10.1158/1078-0432.CCR-06-0266 复制DOI
    作者列表:Beer AJ,Haubner R,Sarbia M,Goebel M,Luderschmidt S,Grosu AL,Schnell O,Niemeyer M,Kessler H,Wester HJ,Weber WA,Schwaiger M
    BACKGROUND & AIMS: PURPOSE:The integrin alpha(v)beta3 plays a key role in angiogenesis and tumor cell metastasis and is therefore an important target for new therapeutic and diagnostic strategies. We have developed [18F]Galacto-RGD, a highly alpha(v)beta3-selective tracer for positron emission tomography (PET). Here, we show, in man, that the intensity of [18F]Galacto-RGD uptake correlates with alpha(v)beta3 expression. EXPERIMENTAL DESIGN:Nineteen patients with solid tumors (musculoskeletal system, n = 10; melanoma, n = 4; head and neck cancer, n = 2; glioblastoma, n = 2; and breast cancer, n = 1) were examined with PET using [18F]Galacto-RGD before surgical removal of the tumor lesions. Snap-frozen specimens (n = 26) were collected from representative areas with low and intense standardized uptake values (SUV) of [18F]Galacto-RGD. Immunohistochemistry was done using the alpha(v)beta3-specific antibody LM609. Intensity of staining (graded on a four-point scale) and the microvessel density of alpha(v)beta3-positive vessels were determined and correlated with SUV and tumor/blood ratios (T/B). RESULTS:Two tumors showed no tracer uptake (mean SUV, 0.5 +/- 0.1). All other tumors showed tracer accumulation with SUVs ranging from 1.2 to 10.0 (mean, 3.8 +/- 2.3; T/B, 3.4 +/- 2.2; tumor/muscle ratio, 7.7 +/- 5.4). The correlation of SUV and T/B with the intensity of immunohistochemical staining (Spearman's r = 0.92; P < 0.0001) as well as with the microvessel density (Spearman's r = 0.84; P < 0.0001) were significant. Immunohistochemistry confirmed lack of alpha(v)beta3 expression in normal tissue (benign lymph nodes, muscle) and in the two tumors without tracer uptake. CONCLUSIONS:Molecular imaging of alpha(v)beta3 expression with [18F]Galacto-RGD in humans correlates with alpha(v)beta3 expression as determined by immunohistochemistry. PET with [18F]Galacto-RGD might therefore be used as a new marker of angiogenesis and for individualized planning of therapeutic strategies with alpha(v)beta3-targeted drugs.
    背景与目标:
  • 【特发性脊柱侧凸双杆前脊柱融合术后螺钉位置: 计算机断层扫描的评估。】 复制标题 收藏 收藏
    DOI:10.1097/01.brs.0000224178.04578.03 复制DOI
    作者列表:Huitema GC,van Rhijn LW,van Ooij A
    BACKGROUND & AIMS: STUDY DESIGN:A retrospective evaluation of screw position after double-rod anterior spinal fusion in idiopathic scoliosis using computerized tomography (CT). OBJECTIVE:To evaluate screw position and complications related to screw position after double-rod anterior instrumentation in idiopathic scoliosis. SUMMARY OF BACKGROUND DATA:Anterior instrumentation and fusion in idiopathic scoliosis is gaining widespread use. However, no studies have been published regarding the accuracy of screw placement and screw-related complications in double-rod and double-screw anterior spinal fusion and instrumentation in idiopathic thoracolumbar scoliosis surgery. METHODS:CT examinations were performed after surgery in 17 patients with idiopathic scoliosis. At each instrumented level, the position of the screw and the plate relative to the spinal canal, relative to the neural foramen, and relative to the aorta was measured. Complications related to screw position were registered. RESULTS:A total of 189 screws in 17 patients were evaluated. Malposition occurred in 23% (16 patients) of the total number of screws. Three screws (2 patients) were partially in the spinal canal (1%). This resulted in pain in the right leg in 2 patients. However, electromyography showed no abnormalities. At three levels (3 patients), there was contact between the instrumentation and the aorta. However, no vascular complications occurred. A total of 113 screws (10 patients) were placed under fluoroscopic control and 76 screws (7 patients) were placed without use of fluoroscopy. Less screw malposition was observed in the group in which fluoroscopic control was used (19% vs. 30%, not significant). CONCLUSIONS:Screw placement in double-rod anterior spinal fusion in idiopathic scoliosis seems to be technically demanding, and the use of fluoroscopic control results in less frequent malposition. The risk of neurologic and vascular complications is low.
    背景与目标:
  • 【光学相干断层扫描在预测前视觉通路脑膜瘤治疗后视觉结果中的应用。】 复制标题 收藏 收藏
    DOI:10.1136/bjophthalmol-2013-303449 复制DOI
    作者列表:Loo JL,Tian J,Miller NR,Subramanian PS
    BACKGROUND & AIMS: PURPOSE:To determine the prognostic value of pretreatment optical coherence tomography (OCT) measurement of the peripapillary retinal nerve fibre layer (PRNFL) in final visual outcomes of patients with anterior visual pathway meningioma and optic neuropathy. METHODS:Retrospective case series from a tertiary care academic referral centre. Fourteen eyes (12 patients) in which pretreatment and post-treatment OCT, visual field and comprehensive neuro-ophthalmic exam data were available were evaluated for visual acuity, colour vision and visual field change after neurosurgical and/or radiation oncologic treatment. RESULTS:Twelve patients and 14 eyes were analysed. Patients had tumours centred at the tuberculum sella (3), planum sphenoidale (3), anterior clinoid (2), optic nerve sheath (2), sphenoid wing (2) and olfactory groove (1). Nine eyes had normal PRNFL thickness (mean 95.5 μm± 11.0), whereas five eyes had thin PRNFL (mean 66.0 μm ± 14.2). The mean duration of follow-up was 9.7 months. There was no significant difference in age, duration of symptoms or duration of follow-up between both groups (p=0.22). After treatment, the normal PRNFL group experienced significant improvement in the visual acuity (p=0.03), colour vision (p=0.016), perimetric mean deviation (p=0.019) and foveal threshold (p=0.016) but not pattern SD (p=0.074) compared with the group with thin PRNFL. On multivariate analysis, duration of symptoms, but neither age nor follow-up duration, predicted final visual outcome. CONCLUSIONS:Patients with compressive optic neuropathy due to anterior pathway meningiomas are more likely to improve post-treatment if they have a normal pretreatment PRNFL and shorter duration of symptoms.
    背景与目标:

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