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Multimodality Imaging of Angiogenesis 血管生成的多模态成像
Pub Date : 2010-12-14 DOI: 10.2174/1876388X01002010166
Ho-Yyoung Lee, J. Jeong
Angiogenesis is an important biological process that is also related to various diseases, such as cancer, cardiovascular and cerebrovascular disease. Currently, the need for angiogenesis imaging is increasing due to the use of anti-angiogenic therapy to treat tumors, and of angiogenesis-inducing therapy to treat vascular diseases. Several techniques can be used to visualize angiogenesis related parameters at the structural, functional, and molecular level, although clinically, most techniques involve structural or functional imaging. However, structural and functional parameters do not completely represent angiogenic activity, because they evaluate angiogenesis indirectly by measuring structural and functional changes. Molecular imaging techniques can be used to evaluate bio-markers directly related to angiogenesis, but have only recently been applied in clinical practice. It is now evident that assessment of angiogenesis at several different levels provides valuable information which could be used to individualize therapy and improve diagnosis.
血管生成是一个重要的生物学过程,与癌症、心脑血管疾病等多种疾病有关。目前,由于使用抗血管生成疗法治疗肿瘤和血管生成诱导疗法治疗血管疾病,对血管生成成像的需求正在增加。几种技术可用于在结构、功能和分子水平上可视化血管生成相关参数,尽管临床上大多数技术涉及结构或功能成像。然而,结构和功能参数并不能完全代表血管生成活性,因为它们通过测量结构和功能变化来间接评估血管生成。分子成像技术可用于评估与血管生成直接相关的生物标志物,但直到最近才应用于临床实践。现在很明显,在几个不同的水平上评估血管生成提供了有价值的信息,可用于个体化治疗和提高诊断。
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引用次数: 2
In Vivo Stem Cell Imaging 体内干细胞成像
Pub Date : 2010-12-14 DOI: 10.2174/1876388X01002010171
Chun-lei Zhao, M. Tian, Hong Zhang
In recent years, the emerging and advances of non-invasive in vivo stem cell imaging has significantly contributed to the real-time tracking of transplanted stem cells as well as monitoring their proliferation, migration and persistence in live animals and ultimately possibly in humans. This review summarized the different in vivo imaging modalities for imaging stem cell, especially for its monitoring viability, death and proliferation; and discussed the strategies of combined multimodality approaches for monitoring of the fate of transplanted stem cell by offering the opportunity to distinguish different biological and biochemical processes.
近年来,非侵入性体内干细胞成像技术的出现和发展,极大地促进了对移植干细胞的实时跟踪,以及监测其在活体动物甚至可能在人体中的增殖、迁移和持久性。本文综述了用于干细胞成像的不同体内成像方式,特别是对其活力、死亡和增殖的监测;并讨论了通过提供区分不同生物和生化过程的机会来监测移植干细胞命运的联合多模态方法的策略。
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引用次数: 11
The Utility of Tc-99m MDP Bone Scintigraphy for the Detection of Articular Involvement in Behçet's Disease Tc-99m MDP骨显像检测beharet病关节受累的应用
Pub Date : 2010-10-21 DOI: 10.2174/1876388X01002010138
A. Amin, H. Darweesh, Heba Attia
Introduction: Behcet's disease (BD) is a chronic relapsing inflammatory disease. 40-70% of BD patients display rheumatic features with a 9% incidence as an initial presentation. However, there are no pathognomonic laboratory tests in BD and the diagnosis depends on the occurrence and grouping of sufficient clinical manifestations to allow the physician to either suspect, or definitely diagnose the condition. Our aim was to assess the utility of Tc-99m methylene diphosphonate (Tc-99m MDP) bone scintigraphy for the detection of articular involvement in BD patients and its impact on disease activity & severity scoring. Methods: 25 BD patients diagnosed according to the international study group criteria for BD diagnosis (ISG) (18 �, 7 �, mean age 32.44±7.78, disease duration 6.98±4.61year) were included and subjected to selected joint x-ray and bone scintigraphy. Results: 25/25 was scintigraphically positive for arthritis (100%, 64%, 44%, 40%, 36%& 20% in wrist, Metacarpophalangeal, proximal interphalangeal (PIPs), distal interphalangeal (DIPs), Knees & ankles respectively). 13/25 were clinically negative while scintigraphically positive for arthritis. 11/25 (44%) and 8/25 (32%) turned from inactive to active BD and from mild to moderate disease severity, based on their positive hand scintigraphy with treatment modification. 4/25 (16%) had recurrent oral ulcers with normal laboratory data and only positive hand scintigraphy; with follow-up they met ISG criteria. Conclusion: skeletal scintigraphy is a simple diagnostic modality with a low radiation burden, when compared to conventional radiology. Hence, when used appropriately in the diagnostic algorithm of BD, bone scintigraphy can be used for detection of early joint involvement, assessment of the extent and activity status with guidance for the selected therapy.
白塞病(BD)是一种慢性复发性炎症性疾病。40-70%的BD患者首发表现为风湿病特征,发病率为9%。然而,BD没有病理学实验室检查,诊断依赖于足够的临床表现的发生和分组,以使医生怀疑或明确诊断该病症。我们的目的是评估Tc-99m亚甲基二膦酸盐(Tc-99m MDP)骨显像检测BD患者关节受损伤的效用及其对疾病活动性和严重程度评分的影响。方法:入选符合国际研究小组BD诊断标准(ISG)的患者25例(18岁,7岁,平均年龄32.44±7.78岁,病程6.98±4.61年),择期行关节x线及骨显像检查。结果:25/25的关节显像阳性(腕部、掌指关节、近端指间(pip)、远端指间(dip)、膝关节和踝关节分别为100%、64%、44%、40%、36%和20%)。13/25临床阴性,而关节炎的显像阳性。11/25(44%)和8/25(32%)的患者在接受治疗后,从非活动性BD变为活动性BD,从轻度疾病严重程度变为中度疾病严重程度。4/25(16%)有复发性口腔溃疡,实验室数据正常,仅手显像阳性;通过随访,他们符合ISG标准。结论:与传统放射学相比,骨骼闪烁成像是一种简单的诊断方式,辐射负担低。因此,当在BD的诊断算法中适当使用时,骨显像可以用于早期发现关节受累,评估程度和活动状态,并指导选择治疗方法。
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引用次数: 0
Editorial-Lung Imaging in the Acute Respiratory Distress Syndrome 编辑-急性呼吸窘迫综合征的肺部影像学
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010071
C. Guérin
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引用次数: 0
Lung Imaging in Acute Lung Injury and Acute Respiratory DistressSyndrome with PET PET在急性肺损伤和急性呼吸窘迫综合征中的肺显像
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010099
J. Richard, C. Pouzot, C. Guérin
PET imaging is an attractive technique to study patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) because of its non-invasiveness, its potential to obtain quantitative measurements on a regional basis, and its ability to give functional (not simply morphologic) information about the lungs. The purpose of this manuscript is to focus on the application of PET imaging in ALI/ARDS, to review PET measurements of potential interest in this context and to address their limitations, and finally to summarize the contribution of previous studies in ALI/ARDS patients in the understanding of the physiopathology of this syndrome.
PET成像是研究急性肺损伤(ALI)和急性呼吸窘迫综合征(ARDS)患者的一种有吸引力的技术,因为它的无创性,它可以在区域基础上获得定量测量,并且它能够提供肺的功能(而不仅仅是形态学)信息。本文的目的是关注PET成像在ALI/ARDS中的应用,回顾PET测量在这一背景下的潜在兴趣,并解决其局限性,最后总结以往在ALI/ARDS患者中研究的贡献,以了解该综合征的生理病理。
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引用次数: 0
Electrical Impedance Tomography in Acute Respiratory Distress Syndrome 急性呼吸窘迫综合征的电阻抗断层扫描
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010110
I. Frerichs, S. Pulletz, G. Elke, G. Zick, N. Weiler
Electrical impedance tomography (EIT) is an emerging new imaging modality not yet routinely used in a clinical setting. The generation of EIT scans is based on the non-invasive measurement of electrical properties of tissues which does not require the use of radiation. Thoracic EIT examinations have been shown to track changes in regional lung volumes at scan rates of up to 40-50 scans/s. Experimental and clinical studies indicate the potential of EIT in monitoring regional lung ventilation and aeration at the bedside. Mechanically ventilated patients with acute lung injury and acute respiratory distress syndrome (ARDS) might benefit from possible continuous monitoring of their regional lung function by EIT which could be used to optimise the ventilator settings and minimise the ventilator-induced lung injury. This review explains the measuring principle of EIT and the analysis of regional EIT signals which allow the assessment of regional lung ventilation, aeration and potentially also lung perfusion. Protective lung ventilation using low tidal volumes and adequate positive end-expiratory pressures, recruitment manoeuvres, surfactant administration, prone posture, restricted fluid administration, assisted ventilation allowing spontaneous breathing, partial liquid ventilation, administration of pulmonary vasoactive, anti-inflammatory and antioxidant agents are used or considered in the management of ARDS patients. EIT is capable of monitoring the pulmonary effects of many of these therapeutic procedures. This is documented by examples from experimental and clinical EIT studies and by references to relevant EIT literature. The perspectives and limitations of EIT monitoring are also addressed.
电阻抗断层扫描(EIT)是一种新兴的新成像方式,尚未在临床环境中常规使用。EIT扫描的产生是基于对组织电特性的非侵入性测量,不需要使用辐射。在高达40-50次扫描/秒的扫描速率下,胸部EIT检查已被证明可以追踪局部肺容量的变化。实验和临床研究表明,EIT在监测床边区域肺通气和通气方面具有潜力。机械通气的急性肺损伤和急性呼吸窘迫综合征(ARDS)患者可能受益于EIT对其局部肺功能的连续监测,该监测可用于优化呼吸机设置并最大限度地减少呼吸机引起的肺损伤。本文阐述了EIT的测量原理和区域EIT信号的分析,该信号可用于评估区域肺通气、通气和肺灌注。在ARDS患者的管理中,使用或考虑使用低潮气量和适当的呼气末正压、复吸操作、表面活性剂施用、俯卧姿势、限制性液体施用、允许自主呼吸的辅助通气、部分液体通气、肺血管活性、抗炎和抗氧化剂的施用。EIT能够监测许多这些治疗程序的肺部影响。这是通过实验和临床EIT研究的例子以及相关EIT文献的参考来证明的。本文还讨论了EIT监测的前景和局限性。
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引用次数: 53
Functional MRI of the Lung 肺功能MRI
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010125
Y. Berthezène
Imaging of the pulmonary parenchyma represents a unique challenge for MRI. Limited signal is caused by low proton density, susceptibility artefacts, and physiological motion (cardiac pulsation, respiration). Improvements in MRI techniques have extended the potential for investigations of pulmonary parenchymal disease with the evaluation of lung perfusion. More recently inhalation of non proton-MRI nuclei such as hyperpolarized gases (3He or 129Xe) can provide functional ventilation images.
肺实质成像对MRI来说是一个独特的挑战。有限的信号是由低质子密度、敏感性伪影和生理运动(心脏搏动、呼吸)引起的。MRI技术的改进扩大了肺实质疾病的潜在调查与肺灌注的评估。最近吸入非质子核磁共振,如超极化气体(3He或129Xe)可以提供功能通气图像。
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引用次数: 0
Real Time Lung Imaging for the Detection of Lung Injury and Alveolar Fluid Movement During Mechanical Ventilation 实时肺成像检测机械通气过程中肺损伤和肺泡液运动
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010079
N. Prost, J. Ricard, G. Saumon, D. Dreyfuss
Experimental ventilator-induced lung injury (VILI) is characterized by alterations in alveolar epithelial and microvascular permeability that favors the systemic dissemination of lung borne cytokines or bacteria. Animal models of VILI have been shown relevant to patient care and outcome and help explaining why most patients with the acute respiratory distress syndrome do not die from respiratory failure but from multiple organ dysfunction. Recent experimental studies also showed that adverse ventilator patterns may propel airway secretions and bacteria to previously healthy lung regions. Noninvasive imaging techniques were used for years to study the net rate of protein flow across the pulmonary microvascular endothelium and the alveolar epithelium in vivo, during normal breathing and lung inflation. More recently, the two-way protein fluxes across the alveolo-capillary barrier and the intra-pulmonary dispersion of alveolar edema have been monitored during mechanical ventilation. These experiments have provided new insights on the mechanisms of experimental VILI that may be of clinical value. This review will describe the evolution of these techniques and their main physiological and pharmacological applications in the era of VILI.
实验性呼吸机诱导的肺损伤(VILI)的特征是肺泡上皮和微血管通透性的改变,有利于肺源性细胞因子或细菌的全身传播。VILI的动物模型已被证明与患者护理和预后相关,并有助于解释为什么大多数急性呼吸窘迫综合征患者不是死于呼吸衰竭,而是死于多器官功能障碍。最近的实验研究也表明,不利的呼吸机模式可能会推动气道分泌物和细菌到以前健康的肺区域。多年来,无创成像技术被用于研究正常呼吸和肺膨胀期间体内肺微血管内皮和肺泡上皮的蛋白流动净速率。最近,在机械通气期间监测了通过肺泡-毛细血管屏障的双向蛋白通量和肺泡水肿的肺内弥散。这些实验为实验性VILI的机制提供了新的见解,可能具有临床价值。本文将介绍这些技术的发展及其在VILI时代的主要生理和药理应用。
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引用次数: 0
What is and how to Manage the Acute Respiratory Distress Syndrome 什么是急性呼吸窘迫综合征,如何处理
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010072
C. Guérin, J. Richard
Acute respiratory distress syndrome (ARDS) is an acute hypoxemic respiratory failure with lung oedema of non cardiac origin. Its primary treatment is mechanical ventilation. ARDS is under the spotlights with influenza A pandemic flu. An operating definition has been set out by an experts-consensus conference in order to include patients in clinical trials. However, this definition lacks diagnostic accuracy when compared with lung pathology. The conventional mechanical ventilation has two main objectives: firstly, preservation of arterial blood oxygenation, and secondly, protection of the lung from excessive volume or pressure at the end of inspiration. It has been demonstrated that high tidal volume can increase mortality as compared to low tidal volume. The setting of positive end-expiratory pressure (PEEP) is still not solved. Three large randomized controlled trials failed to demonstrate any benefit between a high and a low level of PEEP. A fascinating strategy of mechanical ventilation is lung recruitment, which is defined as an increase in aerated lung mass by reducing non-aerated or poorly aerated lung mass. Recruiting the lung is useful because it can improve oxygenation and limit ventilator-induced lung injury. Lung recruitment depends not only on the ventilatory settings but also on lung and patient. Several adjunct treatments can be used, as prone position or various pharmacological interventions (inhaled nitric oxide). There are several non conventional methods to deliver mechanical ventilation, such as non invasive mechanical ventilation, liquid ventilation, none of them being recommended to date. Finally, the use of extracorporeal lung support is gaining further interest.
急性呼吸窘迫综合征(ARDS)是一种急性低氧性呼吸衰竭伴非心源性肺水肿。其主要治疗方法是机械通气。急性呼吸窘迫综合征与甲型流感一起受到关注。为了将患者纳入临床试验,专家共识会议制定了一个操作定义。然而,与肺病理相比,这一定义缺乏诊断准确性。传统的机械通气有两个主要目的:一是保持动脉血氧合,二是保护肺在吸气结束时不受过大的容量或压力的影响。已经证明,与低潮量相比,高潮量会增加死亡率。呼气末正压(PEEP)的设定仍未解决。三个大型随机对照试验未能证明高PEEP和低PEEP之间有任何益处。机械通气的一个引人入胜的策略是肺补充,它被定义为通过减少非通气或通气不良的肺质量来增加通气肺质量。补充肺是有用的,因为它可以改善氧合和限制呼吸机引起的肺损伤。肺补充不仅取决于通气设置,而且取决于肺和患者。可以使用几种辅助治疗,如俯卧位或各种药物干预(吸入一氧化氮)。目前有几种非传统的机械通气方式,如无创机械通气、液体通气等,但均未被推荐使用。最后,体外肺支持的使用得到了进一步的关注。
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引用次数: 2
Where the Future Goes: What do we Need to Know in the ARDS and how Lung Imaging Can Deal with this? 未来走向:在ARDS中我们需要知道什么以及肺部成像如何处理这一点?
Pub Date : 2010-10-12 DOI: 10.2174/1876388X01002010133
J. Richard, C. Pouzot, C. Guérin
Acute respiratory distress syndrome (ARDS) remains a clinical challenge for intensivists, despite extensive experimental and clinical research over the past thirty years. Meanwhile, lung imaging techniques have emerged as invaluable non-invasive tools and have considerably modified and improved management of many lung pathologies. The purpose of this review is to list major unanswered questions in ARDS and to speculate on how lung imaging may provide answers in the near future.
急性呼吸窘迫综合征(ARDS)仍然是一个临床挑战重症医师,尽管广泛的实验和临床研究在过去的三十年。同时,肺成像技术已成为宝贵的非侵入性工具,并大大改进和改善了许多肺部病变的管理。本综述的目的是列出ARDS中未解决的主要问题,并推测在不久的将来肺部影像学如何提供答案。
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引用次数: 0
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The open nuclear medicine journal
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