Objective To investigate the diagnostic value and the impact on treatment decision of 18F-FDG PET/CT in differentiated thyroid carcinoma (DTC) patients with elevated serum thyroglobulin (Tg) levels and negative radioiodine 131I post-therapy whole body scan (131I-RxWBS).Methods Totally 72 patients with DTC who had elevated serum Tg levels and negative 131I-RxWBS were enrolled,and 18F-FDG PET/CT was performed.The imaging results of 18F-FDG PET/CT were compared with the clinical results of surgical pathology or 6 to 36 months follow up.The diagnostic efficacy of 18F-FDG PET/CT in detection of recurrence and/or metastasis of DTC with elevated Tg levels and negative 131I-RxWBS was evaluated.Results The accuracy,sensitivity,specificity,positive prediction value and negative prediction value of 18F-FDG PET/CT in diagnosis of DTC with elevated Tg levels and negative 131I-RxWBS was 83.33％ (60/72),89.47％ (34/38),76.47％ (26/34),80.95％ (34/42) and 86.67％ (26/30),respectively.18F-FDG PET/CT changed the treatment strategies of 35 patients (35/72,48.61 ％) among 72 patients,while recurrence or metastasis of DTC was not found during clinical follow-up in 23 of these 35 patients (23/35,65.71％) who underwent reoperation,but was detected in the other 12 patients (12/35,34.29％).Conclusion 18F-FDG PET/CT is a valuable method for detection of recurrence and/or metastasis of DTC with elevated Tg levels and negative 131I-RxWBS,also for guiding the follow-up treatment strategy.

Primary hemifacial spasm is a motor disorder of facial muscles related to facial nerve. During the attack, the facial muscles present irregular and involuntary clonus, which can be induced or aggravated by emotional excitement, mental tension and random facial movement, seriously affecting daily work and life. The pathogenesis, diagnosis, differential diagnosis and treatment of the primary hemifacial spasm have been studied extensively in recent years. This article reviews the progress in these aspects.

Objective:To evaluate the efficacy of radiofrequency thermocoagulation with CT-guided transforaminal puncture of intervertebral foramen through the superior margin of costotransverse joint for refractory post-herpetic neuralgia (PHN) in the upper thoracic segment.Methods:Thirty patients with PHN in the upper thoracic segment underwent radiofrequency thermocoagulation with CT-guided intervertebral foramen puncture. The visual analogue scale and self-rating depression scale were used to evaluate the degree of postoperative pain and mental state before and after treatment, and patients were followed by telephone or outpatient visit.Results:No infection occurred after radiofrequency thermocoagulation in all 31 PHN patients. After operation, all patients had hypoesthesia in skin of the original pain area, the pain was significantly relieved, and the mental state improved significantly. The VAS scores were 5.94±0.93, 2.74±0.69, 2.68±0.70 and 2.45±0.51 before and 3 hours, 1 week, 1 month after treatment( t=18.80, t=18.80, t=16.44, all P<0.01). The SDS scores were 58.6±12.2, 47.7±4.4, 48.1±4.8 before and 1 week, 1 month after treatment( t=6.75, t=5.86, all P<0.01). There were 13 patients with moderate or severe depression before treatment, while no patients with moderate or severe depression after treatment; only 5 patients had mild depression one month after surgery. There was no hypoxemia under nasal catheter during the operation. Intraoperative hypertension was found in 19 cases; after treatment with Urapidil (12.5 - 50.0 mg), the blood pressure was not higher by 20% of the basal blood pressure and<180/100 mmHg (1 mmHg=0.133 kPa). No pneumothorax, perioperative cardiovascular and cerebrovascular accidents occurred. Conclusion:Radiofrequency thermocoagulation with CT-guided intervertebral foramen puncture through the superior margin of costotransverse joint can effectively relieve refractory PHN of the upper thoracic segment with safety.