Objective To observe dopamine transporter (DAT) binding capacity using 99Tcm-TRODAT-1 in drug-naive patients with Tourette's syndrome (TS) on SPECT imaging, and explore possible correlations between 99Tcm-TRODAT-1 uptake ratio and TS patient's age, disease duration, and tic severity.Methods Eighteen drug-naive TS patients, male 14, female 4, as well as 8 age- and gender-matched healthy subjects were recruited. Brain SPECT imaging was performed 2. 5 h after intravenous injection of 11.1 - 14.8 MBq/kg 99Tcm-TRODAT-1. ROI was drawn on the striatum including its sub-regions of caudate and putamen, with cerebellum as the background. Striatum/cerebellum ratio was calculated. Comparisons of the ratios between TS patients and controls were carried out by independent-sample t-test. Pearson correlation analysis was performed between DAT uptake ratios of striatum and patients' age, disease duration, tic severity. Results Compared with the control, higher symmetrically striatum uptake of 99Tcm-TRODAT-1 in TS patients was observed (2.17±0.23 vs 1.87±0.24, t =2.957, P＜0.05). Age (r= -0.320, P＞0.05)and tic severity(r = 0. 345, P ＞ 0.05) scores were not significantly correlated with specific uptake ratios measured in the striatum. But there was significant negative correlation between disease duration and the specific uptake ratios (r = - 0. 483, P ＜ 0. 05). Conclusions 99 Tcm-TRODAT-1 SPECT imaging may play an adjuvant role for initial evaluation of untreated TS.

Objective To compare the effect of right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing on ventricular systolic synchrony using gated blood pool SPECT (GBPS).Methods A total of 50 patients implanted with pacemaker due to high degree or complete atria-ventricular block were enrolled in the study. Twenty-three patients were RVOT paced ( Group A, n = 23) and 27 were RVA paced (Group B, n=27). Twenty-four patients with malignancy, normal echocardiographic findings and no history of cardiac diseases were scheduled for pre-chemotherapy evaluation of cardiac structure and function and were enrolled as control group ( Group C, n = 24). All patients underwent GBPS imaging and the values of phase angle (PS), mean phase of each wall, standard deviation (SD) of mean phase of each wall, lateral-septal motion delay of left ventricle ( LV Sep-Lat Delay), septal-right ventricular (RV) delay of LV ( LV Sep-RV Delay) and LV-RV Delay were acquired. The parameters of ventricular systolic synchrony among the three groups were compared using one-way ANOVA. Results The mean phase of LV lateral wall in Groups A and B were significantly higher than that in Group C: Group A (120.50 ±40.58) ms; Group B (103.23±28.34) ms; Group C (84.63 ±22.38) ms (F=7.72, P ＜0.05). There was no significant difference between Groups A and B ( t = 1.30, P ＞ 0.05 ). The mean phase of RV in Group A was significantly larger than those in Groups B and C: Group A ( 137.05 ± 39.27) ms, Group B ( 100.85 ± 23.79) ms,Group C (59. 13 ±30.52) ms (F=35.55, P＜0.05). PS, SD and LV Sep-Lat Delay in Groups A and B were significantly higher than those in Group C: (85.73 ± 12.00)°vs (89.85 ± 15.61 )°vs (58.95 ±9.87)°, (27.68±10.66) ms vs (26.15 ±13.02) ms vs (15.63 ±8.35) ms, (25.06±34.23) ms vs (2. 62 ± 60. 31 ) ms vs ( - 23.66 ± 31.39) ms, F = 41.54,8.55,6.81, all P ＜ 0.01 ), however, there was no significant difference between Groups A and B ( t = 0. 68, 0.68, 1.30, all P ＞ 0.05 ). LV Sep-RV Delay and LV-RV Delay were significantly different among the three groups ( LV Sep-RV Delay: Group A (57.60 ±56.77) ms, Group B (6.36 ±61.88) ms, Group C ( -41.89 ±35.78) ms; LV-RV Delay:Group A (47.36 ±42.59) ms, Group B ( 3.08 ± 38.81 ) ms Group C ( - 26.50 ± 20.99 ) ms, F = 20. 32,25.38, both P ＜ 0.01 ). Conclusion Both RVA and RVOT pacing increase the segmental phases detected by GBPS, causing inter- and intra- ventricular asynchrony compared with patients without pacemakers.

Objective To investigate the mechanism of reverse redistribution (RR) on dipyridamole 201Tl myocardial perfusion studies in the patients with coronary artery spasm. Methods Twenty-six patients with coronary artery spasm and presented as RR on dipyridamole 201Tl myocardial perfusion studies were enlisted as RR group, while other 16 patients with no coronary artery stenosis nor RR were enlisted as control group. Dipyridamole test was repeated during coronary angiography. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) were measured at RR related and non-RR related coronary arteries before and after dipyridamole infusion respectively.All of the data were analyzed by Student's t-test orχ2-test and correlation analysis. Results Coronary artery angiography showed slower blood flow and lower myocardial perfusion in RR related vessels when compared with non-RR related vessels in RR group, but there was no significant difference among the main coronary arteries in control group. The perfusion defects of RR area at rest were positively related to slowerblood velocity at corresponding coronary arteries ( r = 0.79, t = 10.18, P ＜ 0.001 ). In RR related vessels,CTFC were (36 ±6) frames and (26 ±7) frames (t =4.15, P ＜0.01 ), while TMPG were (2.02 ±0.39)grades and (2.92 ± 0.12) grades ( t = 2.25, P ＜ 0.05 ) before and after dipyridamole infusion, respectively.In non-RR related vessels, CTFC were (29 ±7) frames and (25 ±5) frames (t =2.31, P ＜0.05), while TMPG were (2.56 ± 0.31 ) grades and (2.96 ± 0.06) grades ( t = 2.17, P ＜ 0.05 ) before and after dipyridamole infusion, respectively. However, there were no significant changes of CTFC and TMPG before and after dipyridamole infusion in control group ( t = 0.932, 0.867, respectively, both P ＞ 0.05 ). Conclusion RR is related to the decreased blood flow and myocardial perfusion induced by coronary artery spasm at rest,which may be improved by stress test such as intravenous dipyridamole infusion.

Objective To evaluate the accuracy of automated quantification of myocardial perfusion imaging (MPI) using a method based on a Western normal database for the detection of coronary artery disease (CAD) in a group of Chinese patients. Methods Seventy-two Chinese patients who underwent coronary angiography (CAG) and MPI within 3 months were recruited into this study. Eighty selected from 140 Chinese patients with low probability of CAD ( ＜ 5% ) were enrolled into local normal database of 99Tcm-methoxyisobutylisonitrile (MIBI) MPI using Cedars quantitative perfusion SPECT (QPS) database. Two Western MPI normal databases (CSMC MibiMbiAuto and Mibimibi) were used for processing the Chinese CAD patients recruited in this study, and the results were compared with those using local normal database and visual interpretation. T-test and z-test were used for statistical analysis. Results The extent (EXT)measurement obtained from Mibimibi and local database was ( 10.73 ± 14.54)% and ( 14.22 ± 16.51 )%,respectively ( t = 7.87, P ＜ 0.001 ); the severity (SEV) was 1.07 ± 0.93 and 1.34 ± 1.20, respectively ( t =7.45, P＜0.001). The area under curve(AUC) by using EXT measurement for local database (0.85 ±0.05) was larger than that for CSMC MibiMbiAuto ( AUC = 0.72 ± 0.06, z = 2.50, P ＜ 0.01 ) and Mibimibi ( AUC = 0.77 ± 0.06, z = 2.47, P = 0.014). The AUC of local database showed no significant difference from that of visual interpretation (AUC=0.83 ±0.05, z=0.05, P＞0.05). Conclusion Quantification of MPI of our Chinese patients using Western normal database would decrease the accuracy for the detection of CAD.

Objective To evaluate serum soluble intercellular adhesion molecule-1 (sICAM-1) before and after lung transplantation for diagnosing acute rejection. Methods Biotin-streptavidin time resolved fluoroimmunoassay (BSA-TRFIA) was used to detect the concentration of serum sICAM-1 before and after lung transplantation in 26 patients. All patients were divided into stable lung transplantation group (n =16), acute rejection group (n =4) and infected group (n =6). The serum level of sICAM-1 in those groups was compared with that of the control group ( n = 30 ) by the non-parametric rank sum test ( KruskalWallis H test). Results No significant difference was found for serum sICAM-1 among the three groups and the control group before operation: (357.07 ± 220.01 ), ( 396. 18 ± 136.25 ), (468.95 ± 85.48 ) μg/L vs(348.63 ±69. 12) μg/L, H=6. 0436, P ＞0.05. However, when rejection and infection happened after operation, the serum sICAM-1 increased in the acute rejection group (455.53 ± 126.51 μg/L) and decreased in the infection group (146.43 ± 327.11 μg/L), and the level in the stable transplantation group was (274.23 ± 157.53 ) μg/L (H = 21. 8994, P ＜ 0.01 ). Conclusion Serum sICAM-1 level might be a potential marker to differentiate acute rejection from infection after lung transplantation.

Objective To investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in the localization of ectopic adrenocorticotrophic hormone ( ACTH)-secreting tumors. Methods Seven patients with ectopic ACTH syndrome (confirmed by clinical symptom, biochemical data or bilateral simultaneous inferior petrosal sinus sampling) were included, 4 males and 3 females with age ranged 27-63 years old.All patients were examined with head MR, chest and abdomen CT, abdomen ultrasonography, and whole body 18F-FDG PET/CT. Location, size, and the maximum standardized uptake value (SUVmax) of the tumor were measured. Results 18 F-FDG PET/CT detected three ectopic ACTH-secreting tumors with the sizes 1. 1 cm×1.0 cm (SUVmax =9.4), 1.5 cm×1.1cm (SUVmax =6.4), and 1.6 cm ×1.5 cm (SUVmax =12.0). The pathological findings of the three tumors were thymoma, lung carcinoid, and mediastinal carcinoid respectively. Conclusion 18 F-FDG PET/CT may help the localization of ecto pic ACTH-secreting tumors .

Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.

Objective To investigate the cerebral blood flow (CBF) perfusion patterns and related factors in hyperthyroidism patients.Methods Twenty-five patients with hyperthyroidism and twenty-two healthy controls matched for age,sex,education were enrolled.~(99)Tc~m-ethylene cysteinate dimer (ECD) SPECT CBF perfusion imaging was performed at rest.Statistical parametric mapping 5.0 software (SPM5) was used and a statistical threshold of P＜0.05 (corrected) was applied for signifying changes of regional CBF (rCBF).The semiquantitative values of rCBF were extracted automatically by brain search 1.1 software and were correlated with concentrations of serum thyroid hormones(FT_3,FT_4),thyroid autoimmune antibodies:sensitive thyroid stimulating hormone(sTSH),thyroid peroxidase antibody (TPOAb) and TSH receptor antibody (TRAb) by Pearson analysis,with disease duration by Spearman analysis.Results rCBF was decreased significantly in limbic system and frontal lobe,including parahippocampal gyrus,uncus (posterior entorhinal cortex,posterior parolfactory cortex,parahippocampal cortex,anterior cingulate,right inferior temporal gyrus),left hypothalamus and caudate nucleus (P＜0.05,corrected).rCBF in left lingual gyrus,posterior cingulated was negatively correlated with concentration of FT_3(r=-0.468,-0.417,both P＜0.05).rCBF in left lingual gyrus,bilateral inferior temporal gyrus,right superior parietal lobe was negatively correlated with concentration of FT_4(r=-0.4M,-0.418,-0.415,-0.459,all P＜0.05),while that in left mammillary body and putamen was positively correlated with concentration of FT_4(r=0.419,0.412,both P＜0.05).rCBF in left insula was negatively correlated with concentration of sTSH,and right auditory associated cortex was positively correlated with concentration of sTSH(r=-0.504,0.429,both P＜0.05).rCBF in left middle temporal gyrus,left angular gyrus was positively correlated with concentration of TRAb while that in right thalamus,right hypothalamus,left anterior nucleus,left ventralis nucleus was negatively correlated with concentration of TRAb(r=0.750,0.862,-0.691,-0.835,-0.713,-0.759,all P＜0.05).rCBF in right anterior cingulate,right cuneus,right rectus gyrus,right superior marginal gyrus was positively correlated with concentration of TPOAb(r=0.696,0.581,0.779,0.683,all P＜0.05).rCBF in postcentral gyrus,temporal gyrus,left superior marginal gyrus and auditory associated cortex was positively correlated with disease duration(r=0.502,0.457,0.524,0.440,all P＜0.05).Conclusion Hypoperfusions in limbic system and fontal lobe were found in hyperthyroidism Patients,which might be associated with thyroid function and disesse duration.

Objective To study the correlation of ~(18)F-fluorodeoxyglucose (FDG) PET/CT with pathological changes of the VX2 rabbit tumors after treatment of Ar-He knife,and to explore the evolution of the Ar-He knife curative effect for VX2 rabbit tumors.Methods Thirty-six Japanese white rabbits had successfully been implanted with VX2 tumors in thighs.Four weeks later,the rabbits with VX2 tumors were imaged with FDG PET/CT before they were treated with Ar-He cryoablation.The rabbits were evenly and randomly divided into 6 groups (6 rabbits in each group) and imaged with FDG PET/CT respectively on the first day,third day,seventh day,fourteenth day,thirtieth day and sixtieth day after cryoablation.The rabbits in each group were sacriftced after post-treatment FDG PET/CT imaging for pathology and immunohistochemistry studies.The standardized uptake value (SUV) of tumor regions were calculated and compared with pathology and immunohistochemistry findings in the cryoablative area in each group.Paired-samples t-test and bivariate correlation analysis were evaluated by statistical software SPSS 16.0.Results After ArHe cryoablation,pathological changes of "necrosis-inflammatory response→organization" were found.On CT imaging,the tumors enlarged during 3-14 d after treatment and then shrank gradually.On FDG PET imaging,the maximum SUV (SUV_(max)) dropped dramatically on the first day after the operation(from 2.54±1.12 to 0.67±0.12),and increased slightly on the third day (1.71±0.82),and then continually dropped to 0.51±0.32 (60 d afterthe operation).The differences of SUV_(max) between pre-and after cryoablationin each stage were significant,respectively (t=5.471,8.716,11.388,5.713,7.144 and 7.213,all P＜0.05).The size and SUV_(max) of the targeting area did not correlate with each other(r=0.259,P=0.675).The change of the MVD closely correlated with SUV_(max)(r=0.865,P=0.032).Conclusion FDG PET/CT can reveal the pathological change of tumor tissue after Ar-He cryoablation therapy and therefore may be a potential tool for evaluating the curative effect of this treatment modality.

Objective Thymic epithelial tumors(TET) consist of thymoma and thymic carcinoma. The purpose of this study was to investigate the diagnostic value of 18 F-fluorodeoxyglucose (FDG) coinci-dence SPECT imaging in TET. Methods 18 F-FDG coincidence SPECT images of 37 TET patients ( male 16, female 21, age range 24-82 years; mean age 55 years) were retrospectively analyzed according to the simplified WHO histological classification: high survival thymoma (types A, AB and B1 ), median survival thymoma (types B2 and B3 ), and low survival thymoma (thymic carcinoma). Qualitative visual interpreta-tion was based on foci of18F-FDG uptake'higher than that of normal mediastinum. Turnour/lung radioactivity ratio (TLR) was calculated from the counts of region of interest (ROI) drawn around the mass and over a comparable area of normal lung tissue in TET patients. The distribution of18F-FDG uptake was compared with the enhanced CT findings. TLR was also correlated with the Ki67-1abeling index. Statistical comparison for TLR in different groups were performed with variance analysis. Results Thirty-four TET were positive and 3 negative ( A, A, AB) by 18 F-FDG coincidence SPECT images. The differences among the 3 sub-groups were statistically significant (F=9.99,P<0.05). The TLR of these 3 subgroups was variable: 1.42±0.27, 2.13±0.74, 3.00±1.19, respectively. A close correlation (r=0.613, P=0.002) of the TLR with the Ki67 labeling index (n= 22) was found. In addition, 18 F-FDG coincidence SPECT detected two metastases ( anterior chest wall and right supraclavicular fossa lymph node) that were not identified on enhanced CT. Conclusions 18 F-FDG coincidence SPECT is useful in differentiating subgroups of thymic epithelial tumors and in identifying more invasive thymic lesions.18 F-FDG may be a novel tracer that ena-bles in vivo evaluation of cellular proliferation in human TET.