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ObjectiveTo study the application of positron emission tomography (PET) in detection of myocardial metabolism in pig ventricular fibrillation and asphyxiation cardiac arrest models after resuscitation. MethodsThirty-two healthyminiature pigs were randomized into aventricular fibrillation cardiac arrest (VFCA) group (n=16) and an asphyxiation cardiac arrest (ACA)group (n=16). Cardiac arrest (CA) was induced byprogrammed electric stimulationorendotracheal tube clamping followed by cardiopulmonary resuscitation (CPR) anddefibrillation. At four hours and 24 h afterspontaneous circulation was achieved, myocardial metabolism was assessed by PET.18F-FDG myocardial uptake in PET was analyzed and the maximum standardized uptake value (SUVmax) was measured. ResultsSpontaneous circulation was 100% and 62.5% in VFCA group and ACA group, respectively.PET demonstrated that the myocardial metabolism injuries was more severe and widespread after ACA than after VFCA. The SUVmax was higher in VFCA group than in ACA group (P<0.01).In VFCA group,SUVmaxat 24h after spontaneous circulation increased to the level of baseline. ConclusionACA causes more severe cardiac metabolism injuries than VFCA. Myocardial dysfunction is associated with less successful resuscitation. Myocardial stunning does occur with VFCA but not with ACA.
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正电子发射断层成像术在肥厚型心肌病中的应用:发现微血管功能异常所致的心肌低灌注
肥厚型心肌病是常见的遗传性心脏疾病,其在人群中患病率约为2/1000,以表型表达和临床表现差异极大为特点--从完全无症状到猝死、疾病进展和心力衰竭相关并发症等~([1-3]).微血管水平的心肌缺血与疾病表达和临床后果密切相关,是一些致命性并发症,如室性心律失常、猝死、左心室重构和收缩功能障碍的直接原因~([9-16]).
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Tongxinluo has been widely used in China for the treatment of acute stroke and for neu-roprotection. However, there are few positron emission tomography (PET) studies on the neuroprotective effect ofTongxinluo on cerebral ischemia/reperfusion in small animals. In the present study,Tongxinluosuperfine powder suspension or its vehicle was administered intragastrically to rats for 5 successive days before middle cerebral artery occlusion.18F-lfuo-rodeoxyglucose (FDG) small animal PET imaging showed that at 1 and 2 weeks after cerebral ischemia/reperfusion, glucose metabolism in the ischemic area was greater in rats that had receivedTongxinluo than in those that had received the vehicle. Nissl staining showed that 2 weeks after cerebral ischemia/reperfusion, there was less neuronal loss in the prefrontal cortex in Tongxinluo-treated rats than in controls. In addition,Tongxinluo-treated animals showed better neurologic function and lower cerebral infarct volume than rats that received the vehicle. These findings suggest thatTongxinluo exhibits neuroprotective effects in cerebral ischemia/reper-fusion injury and demonstrates that18F-FDG small animal PET imaging is a useful tool with which to study the molecular pharmacology of traditional Chinese medicine.
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Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the ce-rebel um, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography and single photon emission CT. However, these methods are expensive and radioactive. Thus, the present study quantified the changes of infarction core and remote regions after unilateral middle cerebral artery occlusion using apparent diffusion coefficient values. Diffu-sion-weighted imaging showed that the area of infarction core gradual y increased to involve the cerebral cortex with increasing infarction time. Diffusion weighted imaging signals were initial y in-creased and then stabilized by 24 hours. With increasing infarction time, the apparent diffusion coefficient value in the infarction core and remote bilateral cerebel um both gradual y decreased, and then slightly increased 3-24 hours after infarction. Apparent diffusion coefficient values at mote regions (cerebel um) varied along with the change of supratentorial infarction core, suggesting that the phenomenon of diaschisis existed at the remote regions. Thus, apparent diffusion coeffi-cient values and diffusion weighted imaging can be used to detect early diaschisis.
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脱氧葡萄糖-正电子发射断层显像在鼻咽癌诊断和放疗后肿瘤残留或复发判定中的价值
鼻咽癌放疗后残留或复发的早期诊断和鉴别诊断是正确再治疗的前提.CT是鼻咽癌诊断和随诊的主要手段,但由于放疗后会出现纤维化或不对称性的改变,CT仍有一定假阳性率.复发病灶常在黏膜下生长,致使CT易漏诊.脱氧葡萄糖-正电子发射断层显像(F-18-fluoro-2-deoxyglucose positron emission tomography,18FDG-PET)用于鼻咽癌诊断的经验不多,本文评价在鼻咽癌诊断和放疗后复发或残留的临床价值.
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Is the customer always right?
Every Friday morning we have grand rounds at our small hospital.Usually,this means watching a videotape of grand rounds that happened at a university hospital,but sometimes we have live speakers.This particular Friday,Dr.Seagall from the Palo Alto VA was talking about positron emission tomography(PET)scans.