第十七章7肝脾胶体显像课件.ppt

1、 消消 化化 系系 统统山西医科大学第一医院核医学科山西医科大学第一医院核医学科肝脾胶体显像肝脾胶体显像肝血流灌注、血池显像肝血流灌注、血池显像胃肠道出血显像胃肠道出血显像异位胃粘膜显像异位胃粘膜显像M肝胆动态显像肝胆动态显像M胃肠功能测定胃肠功能测定M胃幽门螺杆菌检测胃幽门螺杆菌检测M唾液腺显像唾液腺显像85%85%肝脏肝脏5%骨髓10%10%脾脏脾脏放射性放射性胶体胶体静脉静脉n99Tcm-SC（硫化锝胶体）（硫化锝胶体）颗粒大小为颗粒大小为0.10.5 mn99Tcm-植酸盐植酸盐水溶性无色透明物水溶性无色透明物 静脉注入后与血液中的静脉注入后与血液中的Ca2+鳌合鳌合 形成形成99mT

2、c-植酸钙胶体植酸钙胶体(大小大小0.3 m)n显像剂显像剂 99Tcm-SCn剂量剂量 46mCin显像时间显像时间 2020mn体位体位 ANT、POST、RLA、LLA，LAO、RPOn控制呼吸幅度，减少肝脾活动伪影控制呼吸幅度，减少肝脾活动伪影ANTRLAPOST三角形，右叶放射性三角形，右叶放射性分布较高，右叶下缘分布较高，右叶下缘左叶放射性较低左叶放射性较低左叶外端和右叶间有左叶外端和右叶间有一个放射性减低带一个放射性减低带逗点状、卵圆形或菱逗点状、卵圆形或菱形，中部放射性分布形，中部放射性分布较高，周边较低较高，周边较低 TcTc-植酸钠肝胶体显像植酸钠肝胶体显像横断面冠状面矢状

3、面肝胶体断层显像肝胶体断层显像n位置异常位置异常n大小异常大小异常n形态异常形态异常n放射性分布异常放射性分布异常n不能不能施行施行MRI、CTn阴性对照、定位阴性对照、定位n肝脏肿块，肝腺瘤肝脏肿块，肝腺瘤、FNHn诊断布诊断布卡氏综合卡氏综合征征肝血池诊断肝血管瘤肝血池诊断肝血管瘤111In白细胞诊断感染白细胞诊断感染131I-MIBG嗜铬细胞瘤嗜铬细胞瘤99Tcm-MAA肝动脉灌注肝动脉灌注67Ga肝癌肝癌单克隆抗体作肿瘤定位单克隆抗体作肿瘤定位153Xe局灶性脂肪变性局灶性脂肪变性Tc-植酸钠肝右叶占位性病变Case 1Tc-植酸钠、右叶肝癌Case 2Tc-植酸钠肝右叶多发血管瘤Ca

4、se 3Tc-植酸钠、多囊肝Case 4Case 5 Focal Nodular Hyperplasia nSPECT images of the liver were obtained and correlated with a recent outside CT study.There is focally increased uptake involving the majority of the medial segment of the left hepatic lobe.This region of increased uptake corresponds to the abnor

5、mality identified on the CT study.Case 6 Focal Nodular Hyperplasia nFocal nodular hyperplasia is a benign tumor seen more commonly in women(80-90%of documented cases)than men.The origin is unknown,but a vascular malformation is suspected.The lesion frequently contains a central scar,and is character

6、ized by the presence of Kupffer cells.nFindings:nMildly increased colloid uptake is seen in a large lesion involving the left lobe of the liver.This corresponds to a well circumscribed 7 cm mass at this location on the CT.Note that these are non-attenuation-corrected images,so there should be apparently decreased activity in deeper structures.The lesion is more intense that the immediately adjacent liver.