核子醫學 by Meimei Lin

核子醫學雜誌

總編輯

彭南靖

副總編輯

陳泰賓 • 陳志成 • 高志浩 • 杜高瑩 • 顏若芳

編輯顧問

傅應凱 • 洪家瑤 • 高潘福 • 劉仁賢 • 沈立漢 • 施維貞 • 薛晴彥 • 丁幹 • 蔡道桂 • 曾凱元 • 王世楨 • 魏孝萍 • 楊敬文 • 姚維仁 • 葉鑫華 • 閻紫宸

執行編輯

陳家杰 • 陳遠光 • 陳毓雯 • 邱南津 • 蔡世傳 • 王昱豐

編輯委員

陳輝墉 • 陳錦薰 • 鄭澄意 • 朱力行 • 朱任公 • 丁慧枝 • 許重輝 • 黃詠暉 • 洪光威 • 鐘相彬 • 高嘉鴻 • 李碧芳 • 李將瑄 • 李永康 • 林明賢 • 林萬鈺 • 林武智 • 劉得建 • 羅建苗 • 沈志傑 • 諶鴻遠 • 沈業有 • 蕭聿謙 • 施並富 • 王安美 • 王信二 • 王佩文 • 吳志順 • 吳良治 • 吳明哲 • 吳彥雯 • 楊邦宏 • 楊光道 • 游冬齡

編輯秘書

黃宗祺

《核子醫學雜誌》

第27卷第1期中華民國103年03月

出版者發行人地址電話傳真 E-mail 網址

中華民國核醫學學會黃文盛 505彰化縣鹿港鎮鹿工路6號彰濱秀傳紀念醫院核子醫學科 886-4-7811233 886-4-7073299 tsnm.tw@gmail.com http://www.snm.org.tw/

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ISSN 2226-9681

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Annuals of Nuclear Medicine and Molecular Imaging Production Editors

Editor-in-Chief Nan-Jing Peng

Deputy Editor-in-Chief

Tai-Been Chen, Jyh-Cheng Chen (Molecular Imaging) Chih-Hao K. Kao (Radiopharmaceuticals) Kao-Ying Tu (Technology) Ruoh-Fang Yen (Cardiology)

Advisory Editorial Board Ting-Kai Fu, Joseph C. Hung (USA), Pan-Fu Kao, Ren-Shyan Liu, Lie-Hang Shen, Wei-Jen Shih (USA), Chyng-Yann Shiue, Gann Ting, Daw-Quey Tsai, Kai-Yuan Tzen, Shyh-Jen Wang, Shiaw-Pyng Wey, David J. Yang, Wei-Jen Yao , Peter Shin-Hwa Yeh (Australia), Tzu-Chen Yen

Chia-Chieh Chen, Yen-Kung Chen, Yu-Wen Chen, Nan-Tsin Chiu, Shih-Chuan Tsai, Yuh-Feng Wang

Editorial Board

Hue-Yong Chen, Jiin-Shiun Chen, Cheng-Yi Cheng, Lee-Shing Chu, Yum-Kung Chu, Hueisch-Jy Ding, Chung-Huei Hsu, Yung-Hui Huang, Guang-Uei Hung, Shiang-Bin Jong, Chia-Hung Kao, Bi-Fang Lee, Chiang-Hsuan Lee, Jong-Kang Lee, Ming-Shyan Lin, Wan-Yu Lin, Wu-Jr Lin, Der-Jenn Liu (USA),

Annuals of Nuclear Medicine and Molecular Imaging

Jem-Mau Lo, Chih-Chieh Shen, Daniel H. Y. Shen, Yeh-You Shen, Yu-Chien Shiau, Bin-Fu Shih, An-Mei Wang, Hsin-Ell Wang, Pei-Wen Wang, Chih-Shun Wu, Liang-Chih Wu, Ming-Che Wu, Yen-Wen Wu, Bang-Hung Yang. Andrew Kuang-Tao Yang, Dong-Ling You

Editorial Secretary Tzung-Chi Huang

Volume 27 No. 1 March 2014

Publisher Publisher Address Phone Fax E-mail Website

The Society of Nuclear Medicine, R.O.C. Wen-Sheng Huang No. 6 Lugong Rd. Lukang Zhen, Changhua County 505, Taiwan, R.O.C. 886-4-7811233 886-4-7073299 tsnm.tw@gmail.com http://www.snm.org.tw/

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Editorial Annals of Nuclear Medicine and Molecular Imaging 2014;27:xx-xx

AUTHOR INFO 彭南靖中華民國核醫雜誌總編輯高雄榮民總醫院核醫部主任國立陽明大學核醫科副教授高雄榮總醫訊副總編輯中華民國核醫學會理事

《核子醫學雜誌》的出版作業，在全體會員的支持之下，已堂堂邁入第 27 個年頭了！三年前，南靖於銜命之初，深感自身能力之有限，無法承續先進之發行水準，實誠惶恐，所幸在核醫界前輩指導及理事長的鼎力相助之下，雜誌的編排、出版方能順利進行，在此本人對於參與、協助編修之人員致上十二萬分之謝意。《核子醫學雜誌》是目前國內核醫學對外發表研究成果的重要平台，也是核子醫學界相互交流的園地，這裡是屬於大家的，總編輯對雜誌經營之目標就是要活絡交流，讓大家更喜歡到這裡來看看，更喜歡到這裡來發表研究成果，為此編輯部將雜誌做了些調整：其一，為因應分子影像發展快速之世界潮流，及呼應核子醫學之分子造影技術之特異性及重要性，於本屆第 3 次理監事會決議更改雜誌英文名稱，由原先之 Annals of Nuclear Medicine and Science, ANMS 改為 Annals of Nuclear Medicine and Molecular Imaging, ANMMI，也由於中華民國分子影像醫學會成立較他國為早，搶得創始國先機，應有其專業刊物相輝映；分子影像本為核子醫學之一環，將此名稱加入《核子醫學雜誌》代表本學會貼近核子醫學相關先進之脈動，重視相關技術之發展，有其積極的宣示作用。其二，對於原有的內容方面也做了調整，Editorial 由資深核醫前輩執筆，傳承其經驗用以指引核子醫學及分子影像學的趨勢及方向。除了原有的 Original Article、Case Report 之外，增加了一個 Interesting Images 的收稿項目，呼應了本刊分子影像之主體性；另外同時也開闢了繼續教育的單元，期望雜誌具有教育訓練的功能，並使先進的心得、觀念及知識得以傳承。其三為將原有雜誌的封面、內文的排版方式作了些改變，增加雜誌的質感與符合讀者的閱讀期待。希望藉

144 Annals of Nuclear Medicine and Molecular Imaging 2014; 27:xx-xx

由上述種種的改變，讓大家知道編輯部對於刊

境，但是稿件以 Case Report、Interesting Images

物經營的用心，進一步吸引大家更多的關注與

居多，Original Article 較少，Original Article 的英

支持。

文稿就更少了；之所以將全英語發行列為階段性

感謝本屆雜誌編輯委員們的協助，遴選之

目標之一，是國際化的考量，但目前優良期刊審

初，再三斟酌委員專長領域、區域性及其個人

核的門檻還是以 Original Article 為審查重點，

時間因素，雖結果難免有遺珠之憾，但在有限

這是雜誌推動過程中所面臨的最大困難。繼續

的名額中所呈現的個個都是一時之選，在分配

教育現階段是以陳執行編輯遠光、高編輯顧問

的任務編組下都能發揮專才。副總編輯包括審

潘福的大作「FDG PET/CT 在癌症的運用」為

視論文統計的陳泰賓教授，生物分子影像學的

主體，依據每期主題之不同再邀請編輯委員作

陳志成教授，迴旋加速器及正子製藥方面的高

補充，感謝他們的慷慨解囊，豐富了雜誌的內

志浩主任，核醫醫技專長的杜高瑩主任以及核

容。由於來稿件數量並不足以營造出退稿的環

醫心臟學學會的委員會主席顏若芳醫師，如此

境，執行編輯及審稿者也都能體會這個難處，

安排是期待在核子醫學各個領域都能有引導與

對於部分稿件給予輔導及修改，對於本刊投稿

推動的效果。編輯顧問由資深核醫學界人士擔

人而言這是很大的幫助，但對於雜誌的發展而

任，透過專文論述或直接建言的方式帶領大家探索核醫潮流的脈動及發展方向。執行編輯則擴大編制為 6 人，且分別在北、中、南不同的區域來編制，所考量的是審稿作業的流暢及因應未來大量湧入的稿件，依據編輯部特別制定的「核子醫學雜誌稿件審查作業」標準作業文件，執行編輯能夠依據兩位審稿者的意見，決定修改或接受刊登稿件，為求審稿的公平原則，編輯部會分發與投稿者不同區域的執行編輯來執行審稿作業，避免不必要的審查壓力。編輯委員則都是核子醫學界的精英，任職於台灣各個領域中，無論是學術或臨床方面都是最直接的貢獻者。為了讓《核子醫學雜誌》更好，發行更順利，接任之初我們也制訂工作目標，區分為近期、中期、長期應該達成的工作，逐項實施、落實；它們分別是近程：稿源充足，順利出刊，網路投稿。中程：提高退稿率，國科會評定為優良期刊，全

言並不是件好事，所幸收稿狀況漸入佳境，希望在不久的將來，選、退稿作業都能趨於正常。如果有一天《核子醫學雜誌》能夠列名 SCI、PubMed 上線，那我等核醫人應該都欣然恭逢其盛、於有榮焉，並能雨露均霑；或許這是一個愚公移山的念頭，現實環境是：比起其他專科醫學會，核醫學學會並沒有很雄厚的資本來應付將雜誌推向國際化學術領域所需之龐大經費，雖然參與編輯的人士都有著莫大的服務熱忱，都運用有限的資源去探求所有的可能，朝向我們所制定的目標前進；今年，在黃理事長文盛兄的推動之下，本期雜誌開始與華藝出版社共同出版，我們也進入了專業編輯出版的階段，在這個合作架構之下，本雜誌擁有了自己專屬的線上投、審稿系統，如此一來投稿及審稿的作業將更加便利，在編輯的領域中其實有很多工作我們還沒有做好，希望此項合作案進行後，透過專業的編輯團隊幫助之下，我們能在現有根基上更上一層樓、更接近我們的理想，期待在本屆編輯委員的

英語發行。遠程：上 PubMed，以 SCI 為終極目標。

努力之下，這個偉大的夢想會在幾年後就能將這

經過 3 年的努力，本雜誌尚未面臨無法出刊之窘

塊最後的拼圖補上。

Annals of Nuclear Medicine and Molecular Imaging Volume 27 Number 1 March 2014

Contents Editorial Special Articles The Longitudinal Trend in the Utilization of Nuclear Medicine for Theranostics in Taiwan Mao-Chin Hung, Jeng-Jong Hwang, Shu-Sin Liu, Chih-Hao Kao

Discussion of Improvement Method for Residual F-18 FDG for the Injection Cap: Push/Pause Techniques

1 14

Yen-Lin Kuo, Chiu-Chu Lin, Hua-Mei Hsu, Hue-Yong Chen

Original Articles SAFIRE Improves CT Image quality in PET/CT Scans: An ACR CT Phantom Test Fa-Shun Tsai, Su-Chen Wang, Hsuan-Hung Chou, Tai-Lin Jiang, Lin-Chun Ou

A Study of Modified Approach of Synthesizing 3’-Deoxy-3’-F18 Fluorothymidine Yun-Hsuan Hsu, Yi-Jia Huang, Bo-Ren Su, Hsiao-Wei Liao, Hsiu-Ling Lin, Wei-Ming Chang, Tai-Been Chen, Hueisch-Jy Ding, Huei-Yong Chen

The Study of Influences on Imaging Processing by Using Gamma Camera to Measure Thyroid Uptake of Iodine-131

19 28

Chung-Shun Wu, Nan-Jing Peng, Tai-Been Chen

Case Reports Peritoneal Dialysis-Related Peritonitis Complicated with Ischemic Bowel Disease Manifested on Ga-67 Scan

Yu-Ting Lai, Rong-Hsin Yang, Yum-Kung Chu

Dual Phase Change of F-18 FDG Uptake in Oncocytic Schneiderian Papilloma on PET Imaging: A Case Report

Cheng-Han Hou, Daniel HY Shen, Li-Fan Lin, Hong-Wei Gao, Yi-Chih Hsu, Cheng-Yi Cheng

Interesting Image Interval Change of Fibrous Dysplasia Found during Cancer Staging Bo-Kai Huang, Wen-Bao Teng, Da-Yu Dong, Shu-Mei Huang

Continuing Education Application of FDG PET/CT in Lung Cancer Yen-Kung Chen, Pan-Fu Kao

Technical Innovations and Notes Annals of Nuclear Medicine and Molecular Imaging 2014;27:xx-xx

Peritoneal Dialysis-Related Peritonitis Complicated with Ischemic Bowel Disease Manifested on Ga-67 Scan Yu-Ting Lai1, Rong-Hsin Yang1,2, Yum-Kung Chu1,2 1 2

Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan

ABSTRACT KEY WORDS Ga-67 scan, peritoneal dialysis, peritonitis, ischemic bowel disease

ARTICLE INFO Article history Received (mm dd, yyyy) Accepted (mm dd, yyyy)

Continuous ambulatory peritoneal dialysis (CAPD) is a widely accepted treatment for end-stage renal disease. Peritonitis is a common complication in patients with peritoneal dialysis. The diagnosis and effective treatment of peritonitis depends on clinical signs, dialysate evaluation, and the identification of microorganisms. Ischemic bowel disease (IBD) is a usual complication of hemodialysis and rare in patients on CAPD. Herein, we present the first case of CAPD-related peritonitis complicated with IBD demonstrable on Ga67 scan. Scintigraphy is more visually straightforward to the problems, although there is no solid evidence of Ga67 uptake in the ischemic bowel.

Corresponding author Yum-Kung Chu M.D., Department of Nuclear Medicine, Taipei Veterans General Hospital No. 201, Shipai Rd. Sec. 2, Beitou District, Taipei 112, Taiwan, R.O.C. Tel: 886-2-28757301 Fax: 886-2-28715849 E-mail: ykchu@vghtpe.gov.tw

1. Introduction Peritonitis is the most common infection in CAPD. It typically presents with fever and abdominal pain, and some patients also complain of diarrhea and nausea. The diagnostic criteria for peritonitis are two of the three following criteria: abdominal pain, cloudy effluent (WBC > 100/mL with > 50% PMN), or identification of an organism on gram stain or culture [1]. Ischemic bowel disease (IBD) is a form of intestinal ischemia which could manifest as a spectrum from transient ischemia to transmural gangrene of the intestinal wall, depending on the degree of vascular occlusion, segment involved and the pre-existing condition of the patient [2]. In patients on CAPD, imaging with isotope-labeled leukocytes or Gallium-67 could delineate the presence of peritonitis, tunnel infection,

144 Annals of Nuclear Medicine and Molecular Imaging 2014; 27:xx-xx catheter infection or even ischemic bowel with a high specificity and sensitivity and more visually straightforward to the problems.

2. Case Presentation A 77-year-old woman with a history of end stage renal disease and initiated hemodialysis since 2002. In year 2005, the renal replacement therapy was switched to CAPD because recurrent episodes of thrombosis at the vascular access. On the night before coming to the emergency department, she experienced nausea, vomiting and diarrhea. Fever and abdominal pain was also noted later on. At admission, her vital signs were checked as following, heart rate: 109 beats/min, respiratory rate: 23 times/min, body temperature: 38.4째C. The total white blood cell count was 15,400 /cu mm. The dialysate analysis revealed an increase of white blood cell count (250/cu mm) mostly neutrophils (98%) and implied an ongoing peritonitis. Empirical antibiotic therapy was initiated by intraperitoneal cephradine and gentamycin, plus systemic pipracillin and tazobactam. Her blood pressure was declined for the first two days (SBP: around 70 to 80 mmHg) and returned stable after fluid resuscitation and use of vasopressors. Intermittent low grade fever persisted, however. Because of vague abdominal pain, this patient underwent abdominal CT scan which disclosed edematous change with poor contrast enhancement

Figure 1. Contrast-enhanced abdomen CT eContrastenhanced Contrast-enhanced Contrast-enhanced abdominal transverse CT scan edematous change of bowel loop with poor contrast enhancement of the jejunal wall (white arrows), no emboli can be identified at mesentery arteries. Subtle ischemic change of the bowel loop is considered.

of jejunal wall (Figure 1, arrow heads) and subtle ischemic change of the bowel loop was considered. The third day of admission, group D Enterococcus was yielded in her blood culture as well as the dialysate effluent. Gallium-67 inflammation scan therefore was arranged to assess underlying infection consequently, revealing diffused uptake in the peritoneal cavity and increased radioactivity in the bowel loop (Figure 2), compatible with peritonitis and assumed ischemic bowel change of the jejunum. No active focus was noted otherwise. Antibiotic regimen was tailored to systemic vancomycin. Gradually her condition settled and fever subsided after sustained antibiotic therapy for the following two weeks.

3. Discussion Peritonitis is a common complication in patient who is carrying out peritoneal dialysis and remained the leading morbidity associated with this techniques [3,4]. Several sources have been well acknowledged to result in bacterial peritonitis in patients undergoing PD, including: touch contamination, catheter-related infection, transvisceral migration due to intraabdominal pathology, hematogenous pathogen, and rarely vaginal leak. The most common symptoms and signs for peritonitis are: cloudy effluent (84%), abdominal pain (79% ~ 88%), and fever (29% ~ 53%) [5]. Ischemic bowel disease (IBD) affects almost always the small bowel and colon [6]. IBD could be classified into occlusive and non-occlusive, while

Figure 2. Gallium-67 inflammation scan demonstrates generalized increased radioactivity in the lower peritoneal cavity, suggesting peritonitis (black arrow). Persistent tracer uptake in the bowel loop observed three days later (hollow arrows), corresponding to the site of bowel ischemia assumed on CT scan.

Ischemic bowel disease manifested on Ga-67 scan 145

non-occlusive is mainly resulted from declined blood flow [7]. It appears clear that patient with ESRD tend to have multiple pre-existing conditions lead to non-occlusive IBD such as diabetes neuropathy or angiopathy, organic heart disease and dyslipidemia [8]. The blood pressure is to be more stable on CAPD than those under hemodialysis (HD) since intravascular volume is not withdrawn in a short period of time. Nevertheless, there do some conditions when patients in CAPD may develop severe hypotension, including: use of hypertonic dialysate or diuretics to remove excessive fluid from circulating volume, or sustained very low sodium intake [9,10]. Marquez-Julio, et al [10] suggested that low aldosterone level resulted in reduced colonic absorption of sodium, which could bring about hypovolemia if aldosterone is removed in dialysate [2,10]. The clinical presentation of IBD could range from chronic, mild symptoms to catastrophic consequence, depending on the severity of the ischemia. In the clinical scenario and severity of our case, we propose that the ischemic change is nonocclusive and resultant from hypoperfusion, rather than occlusion secondary to vascular emboli. Some common symptoms of IBD, namely abdominal pain, diarrhea or fever, would be easily confused with CAPD-associated peritonitis, or even coexist, assuming in our case. Some articles have shown that nuclear medicine imaging modality could pose an efficient way in diagnosing infectious complication of patient with CAPD, including Indium-111 labeled leukocytes [11,12], Tc-99m HMPAO-labeled leukocytes [13,14], and Gallium-67 scan [15]. Those observations obtained high sensitivity (83%) and specificity (75%) in catheter related complications, and 100% sensitivity in peritonitis. Despite nuclear medicine image provides a prospect in diagnosing infectious complication in CAPD. There do some limitation at its application being proposed, which sometime would cause ambiguous interpretation. Concomitant antibiotic therapy may cause false negatives [16]. It is also noted have false positive result in presence of malignancy and patients undergo chemotherapy or radiotherapy because it highlight renal enhancement [17]. The above finding may be the result of that chemo/radio-therapy decreased serum binding capacity to Gallium-67 [15].

4. Conclusion It is documented that CAPD related peritonitis is a common infectious complication in patient u n d e rg o i n g P D . H o w e v e r, i t i s a l s o w e l l acknowledged that the vulnerable cardiovascular system and pre-existing multiple risk factors in ESRD may pose a high risk in developing ischemic bowel disease. The clinical symptoms of the two are similar, but treatment approaches are different. Inflammation scan including Gallium-67 and labeled leukocytes are useful methods to evaluate ongoing infection process especially while clinical symptoms/signs are absent or atypical.

Reference 1. Tr a n a e u s A , H e i m b 端 rg e r O , L i n d h o l m B . Peritonitis in continuous ambulatory peritoneal dialysis (CAPD): diagnostic findings, therapeutic outcome and complications. Perit Dial Int 1989;9:179-190. 2. Liu HL, Huang JJ, Lan RR, Wang MC, Sung JM, Hsieh RY. Ischemic bowel disease in patients on continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 1999;14:2032-2034. 3. Voinescu CG, Khanna R. Peritonitis in peritoneal dialysis. Int J Artif Organs 2002;25:249-260. 4. Va rg e m e z i s V, T h o d i s E . P r e v e n t i o n a n d management of peritonitis and exit-site infection in patients on continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 2001;16:106108. 5. Oliveira LG, Luengo J, Caramori JC, Montelli AC, Cunha M de L, Barretti P. Peritonitis in recent years: clinical findings and predictors of treatment response of 170 episodes at a single Brazilian center. Int Urol Nephrol 2012;44:15291537. 6. Wa t t - B o o l s e n S . N o n o c c l u s i v e i n t e s t i n a l infarction. Acta Chir Scand 1977;143:365-369. 7. Lowrie EG, Lazarus IM, Hampers CL, Merrill JP. Editoral: Cardiovascular disease in hemodialysis patients. N Engl J Med 1974;290:737-738. 8. Boley SJ, Brandt LJ, Veith FJ. Ischemic disorders of the intestines. Curr Probl Surg 1978;15:1-85. 9. Shetty A, Afthentopoulos IE, Oreopoulos DG. Hypotension on continuous ambulatory peritoneal dialysis. Clin Nephrol 1996;45:390-397.

146 Annals of Nuclear Medicine and Molecular Imaging 2014; 27:xx-xx 10. Marquez-Julio A, Dombros N, Osmond D, et al. Hypotension in patients on continuous ambulatory peritoneal dialysis. In: Legrain M, ed. Continuous Ambulatory Peritoneal Dialysis. Proceedings of International Symposium, Paris. Amsterdam: Excerpta Medica;1980:263-267. 11. Kipper SL, Steiner RW, Witztum KF, et al. In111-leukocyte scintigraphy for detection of infection associated with peritoneal dialysis catheters. Radiology 1984;151:491-494. 12. B e c k e r W, G ö t z R , H e i d b r e d e r E , e t a l . I n d i u m - 111 w h i t e b l o o d c e l l s c a n i n t h e diagnosis of infectious complications in patients undergoing regular dialysis treatment. Contrib Nephrol 1987;56:191-195. 13. Ruiz Solís S, García Vicente A, Rodado Marina S, et al. Diagnosis of the infectious complications of continuous ambulatory peritoneal dialysis by

99mTc-HMPAO labelled leukocytes. Rev Esp Med Nucl 2004;23:403-413. 14. Vicente AMG, Solís SR, Castrejón AS, et al. Scintigraphic diagnosis of infectious complications in renal failure patients undergoing hemodialysis, continuous ambulatory peritoneal dialysis or renal transplant. Braz Arch Biol Technol 2005;48:97108. 15. Fletcher JW, Herbig FK, Donati RM. 67Ga citrate distribution following whole-body irradiation or chemotherapy. Radiology 1975;117:709-712. 16. Hilson AJW, Maisey MN. Gallium-67 scanning in pyrexia of unknown origin. Br Med J 1979;2:1330-1331. 17. Garcia JE, Van Nostrand D, Howard WH 3rd, Kyle RW. The spectrum of gallium-67 renal activity in patients with no evidence of renal disease. J Nucl Med 1984;25:575-580.

Case Report Annals of Nuclear Medicine and Molecular Imaging 2014;27:xx-xx

鎵 -67 掃描揭露腹膜透析腹膜炎併發缺血性腸道疾病賴俞廷 1 楊容欣 1,2 朱任公 1,2 1

臺北榮民總醫院核子醫學部

國立陽明大學醫學院

摘要腹膜透析 CAPD 是腎病末期被廣泛接受的治療，腹膜炎是這族群的常見併發症；缺血性腸道疾病是血液透析病患一種常見的併發症，但是罕見於 CAPD 的患者。本文報告腹膜透析治療併發細菌性腹膜炎的案例，電腦斷層和鎵 -67 掃描亦發現有腸道缺血之變化。雖然目前還沒有證明缺血性病灶攝取鎵 -67；本病例說明鎵 -67 掃描除可診斷腹腔內感染症之外，在核醫影像中也更為直接揭露出潛在的問題。關鍵字 : 鎵 -67 掃描、腹膜透析、腹膜炎、缺血性腸道疾病

牙周病整體治療病例報告及文獻回顧

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372 Annals of Nuclear Medicine and Molecular Imaging 2014

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References Names of the journal are abbreviated according to Index Medicus. Name(s) of the author(s) not more than six are factually listed. Otherwise the first three are listed and followed by “et al.”

Examples: (1) Feely J, Wilkinson GR, Wood AJJ. Reduction of liver blood flow and propanol metabolism by cimetidine. N Engl J Med 1981;304:691695. (2) Yu MD, Chen WL, Jiau SF, et al. Comparison of radioimmunoassay and fluorescence polarization immunoassay data related to determination of cyclosporine concentrations of heart transplant patients. Ann Nucl Med Sci 1992;5:143-147. (3) Kaplan NM. Coronary heart disease risk factors and anti-hypertensive drug selection. J Cardiovasc Pharmacol 1982;4(Suppl 2):186365. (4) Anonymous. Neurovirulence of enterovirus 70 [Editorial]. Lancet 1982;1:373-374.

李寧芝林怡君洪善齡等

(5) Tada A, Hisada K, Suzuki T, et al. Volume measurement of intracranial hematoma by computed tomography. Neurol Surg (Tokyo) 1981;9:251-256. [In Japanese; English abstract]. (6) Araki G. Prognosis in thalamic hemorrhage. Jpn J Stroke 1981;3:120-122. [In Japanese]. (7) Begent RHJ, Jewkes RF. Radiolabelled antibodies for imaging of gastrointestinal tumours. In: Robinson PJA, ed. Nuclear Gastroenterology. 1st ed. Edinburgh: Churchill Livingston; 1986:145-156.

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