Revista Espanola De Medicina Nuclear E Imagen Molecular最新文献

英文中文

Correlación entre los índices estandarizados SUVmáx de la PET/TC con [68Ga]Ga-PSMA-I&T pre-prostatectomía radical y los resultados histopatológicos finales: un análisis en profundidad 前列腺癌根治术前 PET/CT 的 [68Ga]Ga-PSMA-I&T 标准化 SUVmax 比率与最终组织病理学结果之间的相关性：深入分析

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-03-01 DOI: 10.1016/j.remn.2024.01.001

M.G. Arıkan , S. Soyluoğlu , Ü. Korkmaz , E. Taştekin , U. Elboğa , E. Arda

Objective

To evaluate the predictive potential of the maximum standardized uptake value (SUVmax) value of intraprostatic tumors derived from preoperative [⁶⁸Ga]Ga-PSMA-I&T PET/CT (SUVT), and its ratios to SUVmax in the liver (SUVTLR) and parotid gland (SUVTPR) with respect to histopathological findings.

Materials and methods

Data from patients who underwent radical prostatectomy (RP) for prostate cancer (PC) at our clinic between 2017-2020 were assessed. Patients with a secondary malignancy, a history of transurethral prostate resection, prior treatment for PC, or who received salvage RP were excluded. Whole-body images obtained using the same device, as per the guidelines, were reviewed by two nuclear medicine specialists with more than a decade of experience to reach a consensus for each lesion. The relationships between age, PSA, Prostate Volume, clinical T stage, biopsy International Society of Urological Pathology grade (ISUP), D’amico risk group, intraprostatic tumor volume (HPTV) identified in the final histopathological specimen review, HP-ISUP grade, seminal vesicle invasion (SVI), extracapsular invasion (ECI), positive surgical margine (PSM), SUVT, SUVTLR, and SUVTPR were analyzed.

Results

The mean age of the 64 included patients was 64.1±5.3 y-o. A statistically significant correlation was found between SUVT, SUVTLR, SUVTPR values, and histopathologic stage parameters, such as biopsy ISUP, D’amico Risk Classification, HP-ISUP, HPTV (P<.05). PSMATV, SUVT, and SUVTLR were statistically significant predictors of extracapsular invasion, while PSA, PSMATV, and SUVTLR were significant predictors of SVI (P<.05).

Conclusion

The standardized SUVT, SUVTLR, and SUVTPR values could be employed as noninvasive markers to assist in predicting postoperative histopathological findings, particularly ECI, SVI, and PSM.

目的评估术前[68Ga]Ga-PSMA-I&T PET/CT（SUVT）得出的前列腺内肿瘤最大标准化摄取值（SUVmax）值及其与肝脏（SUVTLR）和腮腺（SUVTPR）的SUVmax值之比对组织病理学结果的预测潜力。材料与方法对2017-2020年间在本诊所接受前列腺癌根治术（RP）的患者数据进行了评估。排除了有继发性恶性肿瘤、经尿道前列腺切除术史、曾接受过 PC 治疗或接受过挽救性前列腺癌根治术的患者。根据指南要求，使用同一设备获取的全身图像由两位具有十多年经验的核医学专家进行审查，以就每种病变达成共识。分析了年龄、前列腺特异性抗原（PSA）、前列腺体积、临床T分期、活检国际泌尿病理学会分级（ISUP）、D'amico风险组、最终组织病理学标本审查确定的前列腺内肿瘤体积（HPTV）、HP-ISUP分级、精囊侵犯（SVI）、囊外侵犯（ECI）、手术切缘阳性（PSM）、SUVT、SUVTLR和SUVTPR之间的关系。结果64例患者的平均年龄为（64.1±5.3）岁。SUVT、SUVTLR、SUVTPR值与活检ISUP、D'amico风险分类、HP-ISUP、HPTV等组织病理学分期参数之间存在统计学意义的相关性（P<.05）。结论标准化 SUVT、SUVTLR 和 SUVTPR 值可作为无创标记物，协助预测术后组织病理学结果，尤其是 ECI、SVI 和 PSM。

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引用次数: 0

Papel del radiofarmacéutico clínico en la seguridad del paciente durante los estudios de perfusión miocárdica de esfuerzo con vasodilatadores 使用血管扩张应激剂进行心肌灌注成像时，临床放射药剂师在患者安全方面的作用

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-03-01 DOI: 10.1016/j.remn.2023.11.005

C. Salgado-Garcia , A. Moreno-Ballesteros , P. Guardia-Jimena , E. Sanchez-de-Mora , A.C. Rebollo-Aguirre , A. Ramirez-Navarro , A. Santos-Bueno , A. Jimenez-Heffernan

Aim

To assess the radiopharmacist's role in a multidisciplinary team focused on the contraindications of regadenoson in order to ensure the safe use of pharmacologic vasodilator stress agents in patients undergoing SPECT-MPI.

Methods

We ambispectively studied its safe use in 1905 patients (54.1% female, mean age: 66.6 ± 11.7 years, range: 20-95 years). Sex, age, medical history, medications, drug allergies, and contraindications for stress testing were registered together with recommendations for the nuclear physician in charge.

Results

Detected contraindications and corresponding recommendations were as follows: risk factors for QTc interval prolongation 7.5% — measurement of QTc interval previously to test and monitor ECG; prior stroke or TIA 4.2% — consider carotid stenosis assessment; salicylates/sulfonamides allergy 3.1% — use ^99mTc-sestamibi; epilepsy or risk factors for seizures 2.4% — use of adenosine or reconsider test indication; systemic corticosteroid therapy for severe COPD 1.3% — reassessment of patient's condition; acute exacerbation of COPD 0.8% — defer test until acute episode is over; severe asthma 0.4% — do not perform test; methylxanthine ingestion 0.3% — avoid consumption previously; other 6.1% — evaluation of other contraindications. No contraindications were detected in 73.6% of patients. The test was cancelled due to absolute contraindications in 2.9% of the requests.

Conclusions

Working in a systematic way, the radiopharmacist was able to detect a high number of issues related to regadenoson, with one out of four patients presenting some clinical contraindication. The recommendations given by the radiopharmacist were well accepted by the nuclear physicians who changed their approach contributing to increase the safety of patients referred for MPI.

方法我们对 1905 名患者（54.1% 为女性，平均年龄：66.6 ± 11.7 岁，范围：20-95 岁）的安全使用情况进行了前瞻性研究。我们登记了性别、年龄、病史、用药情况、药物过敏史和压力测试禁忌症，并向负责核医学的医生提出了建议。结果发现的禁忌症和相应的建议如下：QTc 间期延长的危险因素 7.5% - 在测试和监测心电图之前测量 QTc 间期；既往中风或 TIA 4.2% - 考虑颈动脉狭窄评估；水杨酸盐/磺胺类药物过敏 3.1% - 使用 99mTc-sestamibi ；癫痫或癫痫发作的危险因素 2.4% - 使用腺苷或重新考虑检查适应症；严重慢性阻塞性肺病的全身皮质类固醇治疗 1.3% - 重新评估患者病情；慢性阻塞性肺病急性加重 0.8%--推迟测试，直到急性发作结束；严重哮喘 0.4%--不进行测试；摄入甲基黄嘌呤 0.3%--之前避免摄入；其他 6.1%--评估其他禁忌症。73.6%的患者未发现禁忌症。结论通过系统化的工作，放射药剂师能够发现大量与雷加替诺生相关的问题，每四名患者中就有一名存在一些临床禁忌症。放射药剂师提出的建议得到了核医师的广泛认可，他们改变了自己的工作方法，为提高转诊接受 MPI 患者的安全性做出了贡献。

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引用次数: 0

Hallazgo casual mediante 18F-FDG PET/TC de una metástasis tiroidea causada por adenocarcinoma de recto 通过 18F-FDG PET/CT 偶然发现直肠腺癌引起的甲状腺转移瘤

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-03-01 DOI: 10.1016/j.remn.2023.10.001

M. Mangas Losada, I. García Megías, X. Boulvard Chollet, L. Romero Robles, P. Garrastachu Zumarán, R. Ramírez Lasanta

引用次数: 0

Utilidad de la gammagrafía ósea de tres fases en la valoración de la agresividad de las lesiones extraóseas. Dos patrones gammagráficos diferentes 三相骨闪烁成像在评估骨外病变侵袭性方面的作用。两种不同的扫描模式

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-03-01 DOI: 10.1016/j.remn.2023.11.004

P. Zaragoza-Ballester, M.J. Tabuenca

引用次数: 0

Detección de neoplasia oculta en un paciente con dermatomiositis mediante la PET/TC con [18F]AlF-NOTA-FAPI-04 y con [18F]FDG 通过 PET/CT 使用[18F]AlF-NOTA-FAPI-04 和[18F]FDG 检测皮肌炎患者的隐匿性肿瘤

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-03-01 DOI: 10.1016/j.remn.2023.11.002

Z. Ye , Y. Yao , J. Yin , Y. Kou , M. Zhao , Z. Cheng

引用次数: 0

Equipo multidisciplinar de cirugía radioguiada: Alternativa de cambio al paradigma actual 多学科放射引导手术团队：改变现有模式的替代方案

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-03-01 DOI: 10.1016/j.remn.2023.12.001

J. Ribera-Perianes , M. Vega , X. Cases Moreno , J. Cordón , J. Cortés Gracia , P. Paredes , N. Sánchez-Izquierdo , A. Perissinotti , D. Fuster Pelfort , S. Vidal-Sicart

Introduction

Given the constant increase in the healthcare demand for examinations related to radio-guided surgery (RGS), our hospital adopted new professional profiles in the RGS team, in order to partially reduce the time spent by nuclear medicine physicians on this task.

Aim

To analyze the process of incorporating the profiles of Superior Diagnostic Imaging Technician (TSID) and Sentinel Node Referent Nurse (ERGC), evaluating their deployment in the procedures linked to the technique.

Material and methods

Analysis of RGS activity during the period 2018-2022, focusing on pre-surgical and surgical procedures related to breast cancer (BC) and malignant melanoma (MM), as they are those pathologies on which the transfer of care competencies was concentrated. Chronological evolution of the competencies assumed by the different profiles during their integration into the RGS team.

Results

RGS's healthcare activity during the analyzed period experienced an increase of 109%. BC and MM were the pathologies that accounted for by far the greatest demand for care. The transfer of competencies in these two pathologies occurred in a progressive and staggered manner, with 74% (460/622) of the administration phase being carried out by the ERGC and 64% (333/519) of the surgeries by the TSID in 2022.

Conclusions

The creation of a multidisciplinary RGS team that includes different professional profiles (NM, ERGC and TSID) is an effective strategy to respond to the increase in the complexity and number of all procedures related to RGS.

导言鉴于放射引导手术（RGS）相关检查的医疗需求不断增加，我院在 RGS 团队中采用了新的专业人员配置，以部分减少核医学医生在这项任务上花费的时间。材料和方法分析 2018-2022 年期间的放射引导手术活动，重点关注与乳腺癌（BC）和恶性黑色素瘤（MM）相关的术前和手术程序，因为这两种病症是护理能力转移的重点。结果在分析期间，RGS 的医疗活动增加了 109%。迄今为止，BC 和 MM 是医疗需求量最大的病症。2022 年，74%（460/622）的管理阶段由 ERGC 负责，64%（333/519）的手术由 TSID 负责。结论建立一个包含不同专业人员（NM、ERGC 和 TSID）的多学科 RGS 团队是应对 RGS 相关手术的复杂性和数量增加的有效策略。

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引用次数: 0

Tumor desmoplásico de células redondas pequeñas con afectación ovárica en PET/TC con [18F]FDG 用[18F]FDG 进行 PET/CT 检查发现卵巢受累的脱鳞小圆形细胞瘤

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-01-01 DOI: 10.1016/j.remn.2023.08.006

Z. Zheng, P. Hu, Y. He, H. Shi

引用次数: 0

Valor pronóstico de los parámetros hematológicos y los parámetros metabólicos de la PET/TC con [18F]FDG en el cáncer de cabeza y cuello 头颈癌[18F]FDG PET/CT 血液学和代谢参数的预后价值

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-01-01 DOI: 10.1016/j.remn.2023.09.002

A. Baena García , J.R. Infante de la Torre , R. Barco Carbonero , A. Martínez Esteve , V. Vera Barragan , J. Serrano Vicente , P. Jiménez Granero , A. Utrera Costero

Aim

To determine the usefulness of neutrophil/lymphocyte (N/L) and platelet/lymphocyte (P/L) ratios as well as quantitative [¹⁸F]FDG PET/CT parameters as prognostic factors for overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) in patients with head and neck squamous cell carcinoma (HyN).

Material and methods

Sixty-six patients (56 men) diagnosed with HyN carcinoma were retrospectively assessed over an 8-year interval. Maximum SUV (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) parameters were determined from the PET/CT study at diagnosis. After treatment with chemoradiotherapy, patient survival was assessed. The Cox regression model and the Kaplan-Meier method were used to analyse prognostic factors and survival curves.

Results

Median follow-up was 50.4 months, with 39 recurrences-progressions and 39 deaths. In the univariate analysis, metabolic parameters, except SUVmax, were predictive factors for all three survivals and the two blood parameters were predictive for OS and EFS. TLG was the only predictive factor in the multivariate analysis. The three survival curves were significantly different for the metabolic parameters and the OS curve for the N/L ratio. Correlations were seen between N/L ratio, MTV and TLG. No correlations were demonstrated between P/L ratio and metabolic parameters.

Conclusion

The use of haematological and metabolic markers would allow to identify patients with a high risk of recurrences and poor survival and to individualise treatment by applying more aggressive therapies.

目的确定中性粒细胞/淋巴细胞（N/L）和血小板/淋巴细胞（P/L）比率以及定量[18F]FDG PET/CT参数作为头颈部鳞状细胞癌（HyN）患者总生存期（OS）、癌症特异性生存期（CSS）和无进展生存期（PFS）的预后因素是否有用。最大 SUV（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）参数由诊断时的 PET/CT 研究确定。化疗放疗后，对患者的生存率进行了评估。结果中位随访时间为50.4个月，复发进展39例，死亡39例。在单变量分析中，除 SUVmax 外，代谢参数是所有三个生存期的预测因素，两个血液参数是 OS 和 EFS 的预测因素。在多变量分析中，TLG是唯一的预测因素。代谢参数的三条生存曲线和 N/L 比值的 OS 曲线有明显差异。N/L比率、MTV和TLG之间存在相关性。结论使用血液学和代谢标记物可以识别复发风险高和生存率低的患者，并通过采用更积极的疗法进行个体化治疗。

{"title":"Valor pronóstico de los parámetros hematológicos y los parámetros metabólicos de la PET/TC con [18F]FDG en el cáncer de cabeza y cuello","authors":"A. Baena García , J.R. Infante de la Torre , R. Barco Carbonero , A. Martínez Esteve , V. Vera Barragan , J. Serrano Vicente , P. Jiménez Granero , A. Utrera Costero","doi":"10.1016/j.remn.2023.09.002","DOIUrl":"10.1016/j.remn.2023.09.002","url":null,"abstract":"<div><h3>Aim</h3><p>To determine the usefulness of neutrophil/lymphocyte (N/L) and platelet/lymphocyte (P/L) ratios as well as quantitative [<sup>18</sup>F]FDG PET/CT parameters as prognostic factors for overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) in patients with head and neck squamous cell carcinoma (HyN).</p></div><div><h3>Material and methods</h3><p>Sixty-six patients (56 men) diagnosed with HyN carcinoma were retrospectively assessed over an 8-year interval. Maximum SUV (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) parameters were determined from the PET/CT study at diagnosis. After treatment with chemoradiotherapy, patient survival was assessed. The Cox regression model and the Kaplan-Meier method were used to analyse prognostic factors and survival curves.</p></div><div><h3>Results</h3><p>Median follow-up was 50.4months, with 39 recurrences-progressions and 39 deaths. In the univariate analysis, metabolic parameters, except SUVmax, were predictive factors for all three survivals and the two blood parameters were predictive for OS and EFS. TLG was the only predictive factor in the multivariate analysis. The three survival curves were significantly different for the metabolic parameters and the OS curve for the N/L ratio. Correlations were seen between N/L ratio, MTV and TLG. No correlations were demonstrated between P/L ratio and metabolic parameters.</p></div><div><h3>Conclusion</h3><p>The use of haematological and metabolic markers would allow to identify patients with a high risk of recurrences and poor survival and to individualise treatment by applying more aggressive therapies.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135809614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Áreas de respeto graso que simulan metástasis hepáticas en PET/TC con 18F-FDG 18F-FDG PET/CT 上模拟肝转移的脂肪尊区

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-01-01 DOI: 10.1016/j.remn.2023.09.005

P. Oliván-Sasot , C. la Parra-Casado , A.C. Orozco-Molano , L. Camacho-Berne , T. Peris-Conejero , A. Tembl-Ferrairo

引用次数: 0

Análisis visual y semicuantitativo del 6-[18F]FDOPA PET/TC en pacientes con tumores cerebrales ante la sospecha de recurrencia tumoral versus radionecrosis 对疑似肿瘤复发与放射性坏死的脑肿瘤患者进行 6-[18F]FDOPA PET/CT 的可视化和半定量分析

IF 1.2 4区医学 Q3 Medicine

Revista Espanola De Medicina Nuclear E Imagen Molecular

Pub Date : 2024-01-01 DOI: 10.1016/j.remn.2023.08.004

M. Suárez-Piñera , L. Rodriguez-Bel , M. Alemany , A. Pons-Escoda , M. Pudis , A. Coello , G. Reynes , N. Vidal , M. Cortes-Romera , M. Macia

Introduction

Amino acid PET is a tool recommended by the main neuroimaging societies in the differential diagnosis between radionecrosis (RNC) and tumour recurrence (TR) in brain tumours, but its use in our country is still limited. The aim of this work is to present our experience with 6-[¹⁸F]FDOPA PET/CT (FDOPA) in brain tumours (primary and M1), comparing these results with other published results.

Material and methods

Retrospective study of 62 patients with suspected tumour recurrence (TR): 42 brain metastases (M1) and 20 primary, who underwent FDOPA. Images were analysed visually and semi-quantitatively, obtaining SUV_max and SUV_maxlesion/SUV_maxstriatum (L/S) and SUV_maxlesion/SUV_maxcortex (L/C) ratios. The diagnostic validity of PET was analysed and the best performing cut-off points were calculated. PET results were compared with clinical-radiological follow-up and/or histopathology.

Results

TR was identified in 49% of M1 and 76% of brain primaries. The best performing FDOPA interpretation was visual and semi-quantitative, with a sensitivity and specificity in primaries of 94% and 80% and in M1s of 96% and 72% respectively. The cut-off points with the best diagnostic performance were L/C1.44 in M1 and L/C1.55 in primaries. There are discrepant results with other published results.

Conclusion

FDOPA PET/CT is a useful tool in the differential diagnosis between recurrence and RNC in brain tumours. It is needed a standardization to contribute to homogenise FDOPA results a inter-centre level.

导言：氨基酸 PET 是主要神经影像学协会推荐用于鉴别诊断脑肿瘤放射性坏死（RNC）和肿瘤复发（TR）的一种工具，但在我国的应用仍然有限。本研究旨在介绍我们在脑肿瘤（原发和 M1）中使用 6-[18F]FDOPA PET/CT (FDOPA) 的经验，并将这些结果与其他已发表的结果进行比较。对图像进行视觉和半定量分析，获得 SUVmax 和 SUVmaxlesion/SUVmaxstriatum (L/S) 以及 SUVmaxlesion/SUVmaxcortex (L/C) 比率。对 PET 的诊断有效性进行了分析，并计算出了效果最佳的截断点。PET结果与临床放射学随访和/或组织病理学结果进行了比较。效果最好的 FDOPA 解释是视觉和半定量解释，对原发灶的敏感性和特异性分别为 94% 和 80%，对 M1 的敏感性和特异性分别为 96% 和 72%。诊断效果最好的临界点是 M1 的 L/C1.44，以及初诊的 L/C1.55。结论FDOPA PET/CT 是鉴别诊断脑肿瘤复发和 RNC 的有用工具。需要进行标准化，以促进中心间FDOPA结果的同质化。

{"title":"Análisis visual y semicuantitativo del 6-[18F]FDOPA PET/TC en pacientes con tumores cerebrales ante la sospecha de recurrencia tumoral versus radionecrosis","authors":"M. Suárez-Piñera , L. Rodriguez-Bel , M. Alemany , A. Pons-Escoda , M. Pudis , A. Coello , G. Reynes , N. Vidal , M. Cortes-Romera , M. Macia","doi":"10.1016/j.remn.2023.08.004","DOIUrl":"10.1016/j.remn.2023.08.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Amino acid PET is a tool recommended by the main neuroimaging societies in the differential diagnosis between radionecrosis (RNC) and tumour recurrence (TR) in brain tumours, but its use in our country is still limited. The aim of this work is to present our experience with 6-[<sup>18</sup>F]FDOPA PET/CT (FDOPA) in brain tumours (primary and M1), comparing these results with other published results.</p></div><div><h3>Material and methods</h3><p>Retrospective study of 62 patients with suspected tumour recurrence (TR): 42 brain metastases (M1) and 20 primary, who underwent FDOPA. Images were analysed visually and semi-quantitatively, obtaining SUV<sub>max</sub> and SUV<sub>max</sub>lesion/SUV<sub>max</sub>striatum (L/S) and SUV<sub>max</sub>lesion/SUV<sub>max</sub>cortex (L/C) ratios. The diagnostic validity of PET was analysed and the best performing cut-off points were calculated. PET results were compared with clinical-radiological follow-up and/or histopathology.</p></div><div><h3>Results</h3><p>TR was identified in 49% of M1 and 76% of brain primaries. The best performing FDOPA interpretation was visual and semi-quantitative, with a sensitivity and specificity in primaries of 94% and 80% and in M1s of 96% and 72% respectively. The cut-off points with the best diagnostic performance were L/C1.44 in M1 and L/C1.55 in primaries. There are discrepant results with other published results.</p></div><div><h3>Conclusion</h3><p>FDOPA PET/CT is a useful tool in the differential diagnosis between recurrence and RNC in brain tumours. It is needed a standardization to contribute to homogenise FDOPA results a inter-centre level.</p></div>","PeriodicalId":48986,"journal":{"name":"Revista Espanola De Medicina Nuclear E Imagen Molecular","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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