1 General Diagnosis

1 General Diagnosis

201500118F-FDG PET/CT im aging in the diagnosis of polyneuropathy，organomegaly，endocrinopathy，M-protein，and skin changes（POEMS）syndrome.ZHANG Bing（张冰），et al.PET/CT Center，1st Affil Hosp，Sun Yat-sen Univ，Guangzhou 510080.Chin J Nucl Med Imaging 2014；34（5）：345-348.

ObjectiveTo analyze the PET/CT findings in polyneuropathy，organomegaly，endocrinopathy，M-protein，and skin changes（POEMS）syndrome and explore its clinical value.MethodsEleven patients with POEMS syndrome（7 males，4 females；age range：49-73 years；mean age：（58.5±8.4）years）from October2008 to February 2013 were retrospectively analyzed.All patients underwent18F-FDG PET/CT scan.The image characteristics，including the abnormal18F-FDG uptake and SUVmax of the lesions，were analyzed.ResultsA total of141 sclerotic bone lesions were found in 11 cases，including 5 lesions in parietal bones，8 in scapulas，4 in clavicles，16 in ribs，64 in vertebraes，29 in iliac bones，6 in ischiums，8 in pubic bones and 1 in humerus.Fifty-eight lesions increased FDG uptake with the average SUVmaxof 4.3±1.6.One case waswith hepatomegaly，3 with splenomegaly，2 with hepatosplenomegaly and 5 with lymphadenopathy.Three patients with splenomegaly and 5 with lymphadenopathy were hypermetabolic，and the SUVmax was3.2-4.1 and 2.6-4.9，respectively.One case was with bilateral pleural effusions，3 caseswith seroperitoneum，3 cases with pelvic effusion and 2 cases with both polyserious effusions and subcutaneous dropsy.ConclusionMultisystem lesions，including bone damage，organomegaly，extravascular volume overload，could be detected by18F-FDG PET/CT in patients with POEMS syndrome.

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2015002 Clinical study of99Tcm-N-DBODC5 as a novelm yocardial per fusion im aging agent for the diagnosis of coronary artery disease.MA Haiyan（马海彦），etal.Dept NuclMed，1st Affil Hosp，ShanxiMed Univ，Taiyuan 030001.Chin JNucl Med Mol Imaging 2014；34（5）：349-353.

Ob jectiveTo investigate the clinical value of99Tcm-（bis（dimethoxypropylphosphinoethyl）-ethoxyethylamine）-（bis（N-ethoxyethyl）-dithiocarbamato nitride（99Tcm-NDBODC5）for the detection of coronary artery disease（CAD）.）Methods From October 2010 to October 2012，46 patients with suspected CAD（31males，15 females；average age：60 years）were recruited.They all underwent stress-rest MPI using both99Tcm-N-DBODC5 and99Tcm-MIBI within 1 week.CAG was carried out within 1 month after MPI and chosen as the gold standard.The diagnostic accordance rate between MPI and CAG was analyzed using Kappa test.The diagnostic efficiency of99Tcm-N-DBODC5 and99Tcm-MIBI MPI was compared byχ2test.ResultsAmong the 46 patients，29 were positive and 17 were negative for CAD by CAG. The sensitivity and specificity in the detection of CAD were 86%（25/29）and 65%（11/17）for99Tcm-MIBI MPI，86%（25/29）and 88%（15/17）for99Tcm-NDBODC5 MPI（χ2=2.62，P＞0.05），respectively.A-mong the 138 vessels，48 were positive and 90 were negative on CAG.The vessel-based sensitivity，specificity and accuracy for the detection ofstenosiswere notsignificantly differentbetween99Tcm-N-DBODC5 and99Tcm-MIBI（χ2=3.79，all P＞0.05）.The accordance between99Tcm-N vDBODC5 MPI and angiography was very good（Kappa=0.73）andmoderate for99Tcm-MIBIMPI（Kappa=0.52）.Conclusion99Tcm-N-DBODC5mighthave a potential role as MPIagent for the diagnosis of CAD.

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2015003 Evaluations of diastolic functionsw ith E/e′obtained by dual-Dopp ler sim u ltaneous recording of flow and tissue Dopp ler velocities in coronary heart disease patients with preserved systolic function.WANG Jingjing（汪晶晶），et al.Dept Cardiol；Chinese PLA General Hosp，Beijing 100853.Natl Med J China 2014；94（35）：2740-44.

ObjectiveTo evaluate the usefulness of ratio of early diastolic transmitral flow velocity（E）tomitral annular velocity（e′）calculated by simultaneously recording E and e′in coronary heart disease（CHD）patients.M ethodsA total of 77 CHD patients with preserved systolic functions underwent echocardiography.Left ventricular catheterization was performed to measure left ventricular and diastolic pressure（LVEDP）.The accuracy of E/e′was compared by recording the dual-Doppler and conven-tional methods for diagnosing diastolic dysfunction and the relationship with N-terminal pro-brain natriuretic peptide（NT-proBNP）.The validity of E/e′dualDopplerand combination of E/e′dualDopplerand NT-proBNP in estimating left ventricular diastolic dysfunction，namely LVEDP≥12 mmHg（1 mmHg=0.133 kPa），were estimated.ResultsE/e′dualDopplerwas correlated with left ventricular end diastolic pressure（LVEDP）and logNT-proBNP（r=0.79，r=0.47，respectively，P＜0.01）.E/ e′conventionalwas correlated with LVEDP and logNT-proBNP（r=0.61，P＜0.01，r=0.35，P＜0.05，respectively）.The area under curve（AUC）of E/e′dualDopplerand E/e′conventionalwas 0.87 and 0.82.The optimal cut-off of E/e′dualDopplerwas 9.2 with a sensitivity of 74%and a specificity of 81%.And the optimal cut-off of plasma NT-proBNPwas 108 ng/Lwith a sensitivity of 69%and a specificity of86%，AUC 0.79.When E/e′dualDoppler≥9.2 and NT-proBNP≥108 ng/L were combined，the sensitivity and specificity for diagnosing diastolic dysfunction were 86%and 69%，AUC 0.89.ConclusionThe accuracy of E/e′dualDoppleris better than E/e′conventionalfor diagnosing left diastolic dysfunction.When E/ e′dualDopplerand NT-proBNP are combined，it improves the evaluation accuracy of left diastolic dysfunction.

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2015004 Com puted tom ographic features of abdominal compartment syndrome complicated by severe acute pancreatitis.WU Jingtao（吴晶涛），et al.Dept Radiol，Subei People's Hosp，Yangzhou 225001.Natl Med JChina 2014；94（43）：3378-81.

ObjectiveTo explore the computed tomographic（CT）imaging features of abdominal compartment syndrome（ACS）complicated by severe acute pancreatitis（SAP）to improve the diagnosis of disease.M ethodsThirty-six cases of ACS and 61 cases of non-ACS（NACS）complicated by SAPwere studied retrospectively.And the meaningful CT features were studied.ResultsAmong them，the ACS vascular complications of abdominal cavity and gastrointestinal bleedingwere found significantlymore in ACS than in NACS（P＜0.05）. The ACS intestinal obstruction occurred significantly more often in ACS than in NACS（P＜0.05）.The ACS inferior vena cava pressure，diaphragm elevation，round belly sign and marked seroperitoneum occurred significantly more often in ACS than in NACS（P＜0.05）.The score of ACS with Balthazar was higher than that of NACS（P＜0.05）.For CT signs associated with ACS，four ormore associated with ACSCT characteristics，the diagnostic sensitivity was 96.5%.And the specifcity，positive predictive value and negative predictive value were 100%，100%and 87.5%respectively.And the surgical survival rate was significantly higher than the non-surgical survival（P＜0.05）.ConclusionA comprehensive analysis of CT features of ACS is important for early diagnosis and guidance of treatment.

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2015005 Diagnostic value of endobronchial u ltrasound-guided transbronchial needle aspiration in pulmonary sarcoidosis.ZHANG Hong（张红），et al. Dept Respir&Critical Care Med，Peking Univ 1st Hosp，Beijing 100034.Chin JTuberc Respir Dis 2014；37（10）：774-777.

ObjectiveThe aim of this study was to observe the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA）in sarcoidosis.MethodsWe retrospectively analyzed the diagnostic efficiency of standard bronchoscopy and EBUS-TBNA in all patients diagnosed as sarcoidosis in Peking U-niversity First Hospital between August2010 and October 2011.The relationship between biopsy puncture numbers and sensitivity was calculated.ResultsThere were 17 sarcoidosis patients among a total of107 patientswho had received EBUS-TBNA.Fourteen patients had a postitive TBNA result and the sensitivity of EBUS-TBNA was 82%.The sensitivity of standard bronchoscopy was53% and when combined with EBUS-TBNA，the sensitivity increased to 88%.The sensitivity of EBUS-TBNA was associated with the size of lymph nodes.Lymph nodeswith a diameter≥2 cm showed a higher positive rate.Four punctures for 1 lymph node showed a concordance rate of 100%with the final results.ConclusionEBUS-TBNA was a safe and effectivemethod in diagnosing pulmonary sarcoidosis.For patients with suspected sarcoidosis EBUS-TBNA should be performed in the largest lymph node with at least 4 punctures.

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