Objective To evaluate CT and ultrasonic imaging as a diagnostic means of acute intestinal obstruction. Methods Acute intestinal obstruction of 30 patients diagnosed by preoperative CT scanning and ultrasonic imaging was retrospectively viewed, compaired with intraoperative and pathologic findings.Results The overall accuracy of CT for detection of obstruction was 86.7% (26/30),CT and ultrasonic imaging was 93.3% (28/30). Conclusion CT with ultrasonic imaging is of great advantages for senile patients especially having malignant tumors and for patients with intestinal intussuception. CT with ultrasonic imaging is found to be reliable for diagnosing ileolithiasis and abdominal abscess and mesentery vein thrombosis, but is less sensitive in cases of bowel torsion.
Objective To clarify relationship between signal heterogeneity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI and prognosis of hepatocellular carcinoma (HCC). Methods From January 2014 to January 2017 in the First Affiliated Hospital of Chongqing Medical University, a total of 77 patients with the pathologically proved HCC underwent Gd-EOB-DTPA-enhanced MRI prior to surgery were included in this study. On the basis of the signal heterogeneity in the hepatobiliary phase, the included patients were designed to homogeneous hypointensity group and heterogeneous hyperintensity group. The disease-free survival time were compared between the 2 groups and it’s influencing factors were analyzed. Results Seventy-seven patients with HCC were included, including 45 cases of homogeneous hypointensity and 32 cases of heterogeneous hyperintensity. There were no significant differences in the age, gender, etiology, liver function, alpha-fetoprotein, differentiated degree, Child-Pugh grade, lesion diameter, lesion border, and number of lesions between the 2 groups (P>0.05). However, the HCC patients with heterogeneous hyperintensity had a later BCLC staging (P=0.001). The disease-free survival time of the patients with homogeneous hypointensity and heterogeneous hyperintensity was (17.0±9.8) months and (12.4±10.4)months, respectively. The Kaplan-Meier survival curve showed that the disease-free survival time in the patients with homogeneous hypointensity was significantly better than that in the patients with heterogeneous hyperintensity (P=0.020). The results of univariate analysis showed that the other confounding factors had no effect on the disease-free survival time of patients with hepatocellular carcinoma (P>0.05) except for the signal of hepatobiliary phase (P<0.05). Furthermore, the hepatobiliary phase signal, BCLC stage, and degree of differentiation, which might be clinically considered as potentially influencing for the prognosis of patients with HCC, were included in the Cox multivariate proportional hazard regression model and found that the heterogeneous hyperintensity was still the risk factor of the disease-free survival rate in patients with HCC (P=0.047). Conclusion Signal heterogeneity on hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is related to prognosis of patients with HCC, heterogeneous hyperintensity may indicate a lower disease-free survival rate.
【Abstract】 Objective Using 16-slice multi-detector row helical CT (16-slice MDCT) to investigate the value of multiplanar reformation technique (MPR) in the diagnosis of bowel obstruction. Methods Thirty patients with surgically (27 cases) or clinically (3 cases) proofed diagnosis of bowel obstruction underwent 16-slice MDCT examination of the entire abdomen. All cases had plain CT scan, while 20 cases had additional contrast-enhanced CT scan at portal venous phase. In addition to the conventional axial images, the original CT raw data were then reconstructed into both coronal and sagittal images using MPR technique. Imaging findings were analyzed on axial, MPR coronal and sagittal images. Results Among the 30 patients with bowel obstruction, there were 8 cases caused by adhesion, 7 by simple intestinal tumor, 5 by intussusception (including caused by instestinal tumor), 4 by abdominal hernia, 2 by volvulus, 1 by ileocecal abscess, 1 by stenosis of mesenteric artery，1 by retroperitoneal cyst, and 1 by carcinoma in pancreatic tail. Six patients developed intestinal ischemia or strangulation. Both axial and MPR images correctly depicted the presence of bowel obstruction. Based on CT axial view （AV）, the site and the underlying etiology of bowel obstruction were determined in 26 (86.7%) and 22 (73.3%) patients respectively, while the combination with MPR coronal and sagittal images improved the diagnostic performance to 29 (96.7%) and 27 (90.0%) patients respectively. Both axial and MPR images correctly revealed the presence of intestinal ischemia or strangulation in 5 （83.3%）patients. Conclusion MPR technique of MDCT is very useful for evaluating the site and etiology of bowel obstruction, as well as the circulation status of involved bowel loop.
Currently, the medical imaging methods based on artificial intelligence are developing rapidly, and the related literature reports are increasing year by year. However, there is no special reporting standard, and the reporting of the results is not standardized. In order to improve the report quality of this kind of research and help readers and evaluators evaluate the quality of this kind of research more scientifically, a checklist for artificial intelligence in medical imaging (CLAIM) was put forward abroad. This paper introduces the content of CLAIM and explains its items.
ObjectiveTo investigate the value of magnetic resonance (MR) imaging in the assessment of bile duct complications after cholecystectomy. MethodsFifty patients of having bile duct complications after cholecystectomy underwent MR imaging and had some positive manifestations. The indication for cholecystectomy was symptometic cholelithiasis in all cases. MR imaging was performed with a 1.5T clinical imager including all of the sequences of: ①T1 weighted imaging (T1WI) was performed in transverse and coronal plane before and after gadolinium-enhanced. ②T2 weighted imaging (T2WI) was performed in transverse plane. ③A true fast imaging with steadystate precession sequence (True fisp) was performed in coronal plane. ④MR cholangiopancreatography was also obtained. ResultsThe bile duct complications after cholecystectomy including: 22 cases of cholelithiasis, 15 cases of chronic cholangitis with or without bile duct abscess. Bile duct strictures or abruption at the confluence of hepatic and common bile duct in 6 and 3 cases respectively. Tumors of bile duct or pancreas in 9 cases. The other complications after cholecystectomy including bile leak with choleperitonitis and/or biloma and acute pancreatitis.ConclusionMR imaging was a valuable method for the assessment of bile duct complications after cholecystectomy. MR imaging could assess the etiology of bile duct complications. If there were bile duct obstruction, MR imaging could assess the location and the severe of obstruction. For bile duct or pancreatic tumors, MR imaging could assess the areas of tumor infiltration and resection and was helpful to select treatment methods. Before lapatoscopic cholecystectomy, the overall and careful imaging assessment for bile duct and gallbladder and its adjacent hepatic tissue and pancreas so to avoid missing the relative tumors.
To better use the phase information to compensate the influence of blood flow, the phase unwrapping problem in susceptibility weighted imaging (SWI) is studied in this paper. In order to improve the accuracy of unwrapping, this paper proposes a magnitude image-guided phase unwrapping algorithm of SWI. The basic idea is as follows: (1) reduce the influence of noise by improving the rotational invariant non-local principal component analysis method (PRI-NL-PCA); (2) extract the corresponding solid region in the phase image to avoid the influence of the background noise on the phase unwrapping method; (3) use the phase compensation method to constrain the phase image reconstructed by the K-space. Finally, the reliability of the unwrapping method is evaluated by using four kinds of statistics as quantification index: the number, mean (M), variance (Var), and positive percentage (Pos) and negative percentage (Neg) of phasic error points. By comparing the simulated data with 226 sets of true head SWI data, the results show that the proposed algorithm has high accuracy compared with the classical branch cut method and the least squares method.
Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS), and analysis the correspondence to conventional images. Methods It was a retrospective case series study. Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled. There were 12 females and 1 male, aged from 22 to 57 years, mean age was 34.5 years. All the eyes underwent fundus color photography, optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF). Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes. The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA. All the eyes were followed up every 1 to 2 weeks, with an average of 16.7 weeks. The characteristic images of SW-FAF and corresponding OCT were studied during follow up. Results MEWDS presented with numerous multiple hyper-autofluorescent spots, sized from 50-500 μm, with a vague boundary in ultra-wide field SW-FAF. These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern. The lesions extended to the mid-peripheral retina as well and became more scattered. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA. It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well. But the number of the spot showed in FAF is much more than that in FFA, and slightly less than that in ICGA. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. After the recovery, the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely. Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph, FFA and ICGA in late-phase. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.
This study aims to explore the potential of polyaspartic acid grafted dopamine copolymer (PAsp-g-DA) chelated Fe3+ for magnetic resonance imaging (MRI) visual photothermal therapy. Polyaspartic acid grafted copolymer of covalently grafted dopamine and polyethylene glycol (PAsp-g-DA/PEG) was obtained by the ammonolysis reaction of poly succinimide (PSI), and then chelated with Fe3+ in aqueous solution. The relaxivity in vitro, magnetic resonance imaging enhancement in vivo and photothermal conversion effect at 808 nm were investigated. The results showed that polymeric iron coordination had good near-infrared absorption and photothermal conversion properties, good magnetic resonance enhancement effect, and good longitudinal relaxation efficiency under different magnetic field intensities. In summary, this study provides a new magnetic resonance visual photothermal therapeutic agent and a new research idea for the research in related fields.
ObjectiveTo explore the feasibility of homemade domestic breast palpation imaging (BPI) instead of clinical breast palpation examination (CBE) for screening breast masses. MethodsThe patients who received breast ultrasonography (BUS), BPI examinations and CBE in the Sichuan Cancer Hospital from March 2022 to September 2022 were retrospectively collected. The result of BUS examination was used as the criteria to compare the efficiency and difference between the BPI examination and CBE in detecting breast masses. The effects of the patients’ body mass index, breast volume, tumor location, benign and malignant tumor, and maximum tumor diameter on the accuracy of breast tumor detection by BPI system were further analyzed. ResultsA total of 102 patients were included in this study. Among the 90 patients with breast mass detected by BUS, 76 cases were detected by BPI and 51 cases were detected by CBE. In the 12 patients without tumor mass detected by BUS, only 11 cases patients without tumor mass were detected by BPI and CBE. The sensitivity and accuracy of breast tumor mass screening by the BPI were higher than those by the CBE (84.4% vs. 56.7%, 85.2% vs. 60.7%, respectively), and the specificity was similar (91.6%, both). The area under the receiver operating characteristic curve (95% confidence interval, 95%CI) of BPI and CBE for screening breast masses were 0.903 (0.791, 0.970) and 0.799 (0.747, 0.851), respectively. The former was higher than the latter (Z=2.494, P=0.013). The consistencies were moderate (Kappa=0.518, P<0.001), general (Kappa=0.204, P=0.002), moderate (Kappa=0.518, P<0.001) between the BPI and BUS, between CBE and BUS, and between BPI and CBE for screening breast masses, respectively. The results of multivariate analysis of binary logistics regression indicated that the benign tumor mass was not easily detected [OR (95%CI） was 9.600（1.328, 69.400), P=0.025] and the tumor mass with breast volume ＜350 mL was easily detected [OR (95%CI） was 0.157 (0.030, 0.818), P=0.028], the diameter of tumor mass had no obvious influence on breast tumor mass screening by the BPI. ConclusionAccording to the preliminary results of this study, BPI can improve the sensitivity of detecting breast masses and make up for the lack of objective records of CBE, but BPI cannot replace CBE at present.
摘要:目的:探討血清CA153和BAKP在乳腺癌骨轉移顯像診斷中的應用。方法:對92例乳腺癌患者的核素骨顯像結果、血清CA153和BAKP結果進行回顧性研究。結果:①血清CA15-3和B-AKP的值隨著骨轉移分期的增高而逐步升高,且差異顯著(Plt;0. 01);②血清CA15-3和B-AKP與骨轉移的數目呈正相關;③血清CA15-3gt;25 U/mL時,骨轉移的陽性率為63.3%,血清CA15-3lt;25 U/mL時,骨轉移的陰性預測值為94. 5%;血清B-AKPgt;20 U/L時,骨轉移的陽性率為59. 6%時,骨轉移的陰性預測值為73.5%;當血清CA15-3lt;25 U/mL同時B-AKPlt;20 U/L時,骨轉移的陰性預測值為100%。結論:血清CA15-3和BAKP測定在乳腺癌骨顯像診斷中具有重要的應用價值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.