ObjectiveTo investigate correlation of bedside index for severity in acute pancreatitis (BISAP) and computed tomography severity index (CTSI) or modified CT severity index (MCTSI) in assessing severe acute pancreatitis (SAP). MethodsThirty-eight patients confirmed SAP from July 2015 to October 2015 in West China Hospital of Sichuan University were prospectively included into this study. Contrast-enhanced multi-detector-row CT scan was performed for all the patients. The abnormal imaging features, such as pancreatic and peri-pancreatic inflammatory changes, involvement of other organs, and local complications, were observed and used to calculate by CTSI score and MCTSI score. The clinical data were also collected to calculate BISAP score and as compared with CTSI score and MCTSI score. ResultsThe results of BISAP score were as follows:3 cases gradeⅠ(8.9%), 20 cases gradeⅡ(52.6%), 15 cases gradeⅢ(39.5%). The results of CTSI score were as follows:6 cases gradeⅠ(15.8%), 22 cases gradeⅡ(57.9%), 10 cases gradeⅢ(26.3%). The results of MCTSI score were as follows:2 cases gradeⅠ(5.3%), 19 cases gradeⅡ(50.0%), 17 cases gradeⅢ(44.7%). The results of interobserver agreement were good (BISAP:Kappa=1, P < 0.01; CTSI:Kappa=0.748, 95% CI 0.00-0.076, P < 0.01; MCTSI:Kappa=0.788, 95% CI 0.00-0.076, P < 0.01). There was a positive correlation between CTSI score (rs=0.385, P=0.001) or MCTSI score (rs=0.326, P=0.004) and BISAP score using the Spearman test. ConclusionThere is a weak correlation between CTSI score or MCTSI score and BISAP score.
Object To evaluate the sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) for the preoperative T staging of gastric cancer. MethodsThe databases such as the PubMed, Cochrane Database Systematic Reviews, EMbase, CNKI, and Wanfang Data were searched on computer from 1993 to 2012.The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data, and assessed the methodology quality.Meta-analysis were performed using the Metadisc 1.40 software, the pathology diagnosis as gold standard.The acquired pooled sensitivity, specificity, and summary receiver operating characteristic curve (SROC) were used to describe the value of MRI in T staging. ResultsEight case-control studies involving 302 patients with gastric cancer were included in the study.The pooled statistical results of Meta-analysis showed that:the pooled sensitivity and specificity of MRI for T1-stage gastric cancer were 85%(55%-98%) and 97%(91%-99%) respectively, and the area under the SROC curve (AUC) was 0.961.The pooled sensitivity and specificity of MRI for T2-stage gastric cancer were 73%(60%-84%) and 93%(89%-96%) respectively, and the AUC was 0.935.The pooled sensitivity and specificity of MRI for T3-stage gastric cancer were 87%(81%-92%) and 82%(74%-88%) respectively, and the AUC was 0.914.The pooled sensitivity and specificity of MRI for T4-stage gastric cancer were 75%(62%-86%) and 97%(94%-99%) respectively, and the AUC was 0.963. ConclusionMRI has the high consistency in preoperative T staging with pathology, and should be recommended as a preferred to increase the accuracy of preoperative staging, and improve the prognosis.
ObjectiveTo evaluate the sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) in characterizing cirrhosis-related nodules. MethodsThe databases such as the Cochrane Library, PubMed, EMbase were searched on computer from 1998 to 2012.The reviewers screened the trials according to strict inclusion and exclusion criteria, extracted the data, and assessed the methodology quality.Meta-analysis was performed using the metadisc 1.40 software.The acquired pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curve were used to describe the diagnostic value.The pooled likelihood ratio was calculated based on the pooled sensitivity and specificity. ResultsSix case-control studies involving 917 patients diagnosed with cirrhosis who were suspected to have hepatic nodules were included and 776 masses were confirmed by the biopsy or postoperative histopathology.The pooled statistical results of meta-analysis showed that the sensitivity and specificity of MRI were 87%(83%-89%) and 79%(73%-84%) respectively, the positive and negative likelihood ratios of MRI were 3.95 and 0.18 respectively, and the area under the SROC curve (AUC) was 0.895 6.The sensitivity and specificity of CT were 69%(65%-73%) and 83%(77%-88%) respectively, the positive and negative likelihood ratios of CT were 3.29 and 0.42 respectively, and the AUC was 0.728 7.The sensitivity, positive likehood ratio, and accuracy of MRI in characterizing cirrhosis-related nodules were higher than those of CT. ConclusionAccording these evidences, the MRI should be the first imaging examination for qualitative diagnosis of cirrhosis-related nodules.
ObjectiveTo investigate correlation of bedside index for severity in acute pancreatitis(BISAP) and computed tomography severity index(CTSI), modified computed tomography severity index(MCTSI), or extra-pancreatic inflammation on CT(EPIC) score, respectively, in assessing severity of acute pancreatitis. MethodsForty-five patients confirmed SAP from July 2015 to November 2015 in West China Hospital of Sichuan University were prospectively included into this study. Contrast-enhanced multi-detector-row CT scan was performed for all the patients. The abnormal imaging features, such as pancreatic and peri-pancreatic inflammatory changes, involvement of other organs and local complications, were observed and used to calculate three CT severity indexes(CTSI, MCTSI, and EPIC). The clinical data were also colle-cted to calculate BISAP and as compared with CT severity indexes. Correlation between the CT indexes points and BISAP score was estimated using the Spearman test. Interobserver agreement for CTSI, MCTSI or EPIC was calculated using the Kappa statistic. ResultsThe results of BISAP score were as follows: 4 cases gradeⅠ, 22 cases gradeⅡ, 19 cases gradeⅢ. The results of CTSI score were as follows: 6 cases gradeⅠ, 22 cases gradeⅡ, 17 cases gradeⅢ. The results of MCTSI score were as follows: 1 case gradeⅠ, 13 cases gradeⅡ, 31 cases gradeⅢ. The results of EPIC score were as follows: 6 cases gradeⅠ, 11 cases gradeⅡ, 28 cases gradeⅢ. The score of BISAP, CTSI, MCIST, or EPIC was 2.41±0.82, 6.02±1.96, 7.91± 2.11, and 5.57±1.52, respectively. Interobserver agreements for CTSI, MCTSI, and EPIC were good(CTSI: Kappa=0.748, 95% CI 0.000-0.076, P < 0.01; MCTSI: Kappa=0.788, 95% CI 0.000-0.076, P < 0.01; EPIC: Kappa=0.768, 95% CI 0.000-0.076, P < 0.01). Spearman statistic showed there was a positive correlation between CTSI score(rs=0.439, P=0.003), MCTSI score(rs=0.640, P=0.000), or EPIC(rs=0.503, P=0.001) and BISAP score. ConclusionThere is a positive correlation between MCTSI or EPIC and BISAP score, and MCTSI is more strongly correlated with BISAP as compared with EPIC.
ObjectiveTo evaluate the value of 120 kV portal venous phase images combined with iodine maps created from dual-source dual-energy CT (DECT) for the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. MethodsThis prospective study enrolled 17 patients who underwent abdominal dual-source DECT within 72 hours from the onset of acute pancreatitis. All patients had received treatment in West China Hospital from May 2014 to August 2014. Comparison of the diagnostic value of 120 kV portal venous phase images alone and 120 kV portal venous phase images combined with iodine maps created from dual-source DECT was performed. ResultsSix of the 17 patients were found the presence of pancreatic necrosis (4 patients without obvious necrosis in the early stage developed to pancreatic necrosis, and 2 patients with the presence of necrosis in the early stage improved). The sensitivity, specificity, and accuracy of 120 kV portal venous phase images for the diagnosis of pancreatic necrosis were 50.0% (3/6), 100% (11/11), and 82.4% (14/17), respectively, and it had a good diagnostic value (AUC=0.856, P=0.018). The sensitivity, specificity, and accuracy of 120 kV portal venous phase images combined with iodine maps created from dual-source DECT for predicting pancreatic necrosis were 100% (6/6), 90.9% (10/11), and 94.1% (16/17), respectively, and this method had good value too (AUC=0.977, P=0.002), which higher than that of 120 kV portal venous phase images (P=0.002). ConclusionsThe 120 kV portal venous phase images combined with iodine maps created from dual-source DECT is helpful to improve subjective judgment in the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. It also contributes to the display of hypo-perfusion area of the pancreatic parenchyma, and has higher diagnostic value.
ObjectiveTo evaluate the feasibility of susceptibility weighted imaging (SWI) in determining pathologic grade of hepatocellular carcinoma (HCC) in rat model. MethodsRat models were established first and SWI was performed before killing rats to be examined pathologically. The Edmondson-Steiner grading was used as gold reference for histological grade of HCC. The characters of intratumoral susceptibility signal intensity (ITSS) between lowand high-grade HCCs were compared. The diagnostic value of ITSS in differentiating lowfrom high-grade HCCs was evaluated. ResultsForty eight rat models of HCC were successfully established. Thirty two HCCs (18 low-grade HCCs and 14 highgrade HCCs) were included finally. The incidence of ITSS between two groups was not significant (P=0.113). Characters including component of ITSS (P=0.002) and ratio of ITSS in HCC (P < 0.001) were compared between lowand high-grade HCCs, which were both statistically significant. When score of ratio of ITSS in HCC was assessed as 2 scores, the sensitivity and specificity of ITSS in differentiating lowfrom high-grade HCCs were 85.7% (95% CI:74.9%-96.5%) and 94.4% (95% CI:83.6%-100%) respectively, and the area under roc curve (AUC) was 0.917. ConclusionSWI can evaluate characters of ITSS in HCC and can be an alternative method in grading HCC.
ObjectiveTo investigate the hotspots from researches on imaging of pancreatic neuroendocrine tumor in recent five years. MethodsThe bibliographies from research literatures on imaging of pancreatic neuroendocrine tumor from 2010 to 2015 in PubMed database were downloaded. The Bicomb 2.0 bibliographies analysis software was used to count high-frequency of Mesh major topics (MJMEs). SPSS 22.0 statistical software was applied for clustering analysis with MJMEs, then to get the topic hotspots. ResultsA total of 357 literatures were screened out during the years of 2010-2015. The MJMEs which frequency > 13 were 28. Taken the 28 MJMEs into clustering analysis, then three research hotspots were clustered. ConclusionResearches on imaging of the pancreatic neuroendocrine tumor in recent five years are mainly in terms of imaging techniques, a comparative study of pathology and endoscopic ultrasonography-fine needle aspiration, imaging and disease treatment.
ObjectiveTo summarize the application of dual-energy CT scanning technology in the liver. MethodsTo search the relevant literatures at home and abroad, then the application of dual-energy CT scanning technology in focal liver lesions, diffuse liver lesions were analyzed and summarized. ResultsDual-energy CT scanning technology can improve detection rate of the focal liver lesions, liver cancer recurrence lesions after local treatment and help to differentiate focal liver lesions, to stage the malignant lesions, and it also can be more accurate quantification of liver iron, fat content, indirect measurement of hepatic blood flow dynamics change situation. ConclusionDual-energy CT scanning technology can improve the diagnostic value of CT scanning technology in liver disease.
Objective To summarize the development of process and clinical practice for radiomics. Methods Relevant literatures about the development of process and clinical practice of radiomics were collected to make a review. Results Radiomics, which resulting from big data, had been used in diagnosis, assessment of prognosis, and predictionof therapy response for neoplasm. Conclusion Radiomics is an important part of precision medical imaging in the eraof big data.
ObjectiveTo evaluate the CT findings and causes of thrombosis formation after transjugular intrahepatic portosystemic shunt (TIPS). MethodsOne hundred forty-two patients with cirrhosis after TIPS were included. The imaging features of thrombus in the stent after TIPS were recorded and causes of thrombosis formation were analyzed. The presence, location and amount of thrombus, the location of ends of TIPS stent were analyzed. ResultsThe incidence of thrombosis formation after TIPS was 19.0% (27/142). The thrombus could locate around the upper end (7.4%), lower end (18.6%) of the stent and inside the stent (74.0%), there was significant differences in the incidence of stent thrombosis in different locations (P < 0.05). The thrombus might presented as little mural thrombus (12/27, 44.4%), marked thrombus (3/27, 11.1%) and thrombotic occlusion (12/27, 44.4%), there was a significant difference in the incidence of stent thrombosis with different thrombus volume (P < 0.05). There were stent outlet vascular stenosis in most patients with stent thrombosis (88.9%). ConclusionsStent thrombosis after TIPS is common. Dual source computed tomography angiography could evaluate the thrombotic features. Stent outlet vascular stenosis might be associated with thrombosis formation after TIPS.