Schwannoma originating from the common bile duct is rare. We presented a patient who was diagnosed with biliary cystadenoma preoperatively and pathologically confirmed as a choledochal Schwannoma, analyzed the CT and MRI imaging manifestations, and illustrated its anatomical and pathological basis, and to improve the understanding of clinicians and radiologists for choledochal Schwannoma.
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.
Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.
Objective To investigate the effects on myocardial perfusion of simultaneous antegrade/retrograde cardiopiegia （SARC） through a single coronary artery and coronary sinus （CS）. Methods SARC was conducted in isolated pig hearts through CS in conjunction with the left anterior descending （LAD）, the left circumflex （LCX）, or the right coronary artery （RCA） respectively. After injecting magnetic resonance （MR） contrast agent （gadolinium diethyienetriamine pentaacetic acid, Gd-DTPA） into arterial or venous route, the distribution of Gd-DTPA with magnetic resonance imaging（MRI） was monitored and the effluent from the venting coronary arteries to assess the efficacy of SARC for myocardial perfusion was measured. Results Injection of Gd-DTPA into a perfusing artery during SARC resulted in increased signal intensity not only in the territory of the perfusing artery but also in the areas normally served by the other two venting coronary arteries （including the right ventrieuiar free wall）. With Gd DTPA given into the CS during SARC, the myocardium in the territories of the two venting coronary arteries was lightened. Signal intensity of the myocardium in the perfusing artery territory and right ventricuiar free wall remained unchanged. Moreover, a significant amount of effluent was collected from the venting coronary arteries during SARC： the LAD 10.5-17.7 ml/min; LCX 9.7-15.2 ml/min, and RCA 4.7-7.8 ml/min. Conclusion SARC through a single coronary artery and CS can provide homogeneous perfusion to the entire heart and is sufficient to prevent ischemic injury in the myocardium normally supported by the venting coronary arteries.
Objective To observe the performance of hyperspectral non-mydriatic fundus camera prototype and its application on ocular fundus diseases. Methods The narrow band filters was inserted into the optical path of the Canon non-mydriatic retinal camera (CR-DGi). The image was converted to digital data by charge-coupled device (CCD), and then analyzed by hyperspectral data software. Twelve volunteers were examined by hyperspectral nonmydriatic fundus camera prototype to confirm the characteristic wavelength spectrums of ocular fundus diseases and the repeatability of prototype. Fifty-nine patients with ocular fundus diseases who underwent fluorescein angiography were also examined by hyperspectral non-mydriatic fundus camera prototype, to compared the images of prototype and fluorescein angiography. Results Each of the highest power of the light at the focus point and the power per unit were safe. 536, 547, 579 nm were selected as the specific retinal imaging spectrums and 608 nm as the specific choroidal imaging spectrum. The intra-observer and inter-observer reproducibility was equal or greater than 0.85. The correlation between hyperspectral non-mydriatic fundus camera prototype and fluorescein angiography in choroidal neovascularization patients were 0.782 and 0.833. Conclusions The hyperspectral nonmydriatic fundus camera prototype is safe and reliable. It shows pathological retinal and choroidal structures with specific spectrums. There are good prospects for the application in clinical diagnosis, especially for macular diseases.
Aiming at motion artifacts and off-resonance artifacts in multi-shot diffusion magnetic resonance imaging (MRI), we proposed a joint correction method in this paper to correct the two kinds of artifacts simultaneously without additional acquisition of navigation data and field map. We utilized the proposed method using multi-shot variable density spiral sequence to acquire MRI data and used auto-focusing technique for image deblurring. We also used direct method or iterative method to correct motion induced phase errors in the process of deblurring. In vivo MRI experiments demonstrated that the proposed method could effectively suppress motion artifacts and off-resonance artifacts and achieve images with fine structures. In addition, the scan time was not increased in applying the proposed method.
Objective To observe the optical coherence tomography (OCT) features of Best vitelliform macular dystrophy (BVMD) at different stages.Methods Twenty-eight BVMD patients (56 eyes) were enrolled in this study. All the patients were examined for visual acuity, slit-lamp microscopy, direct ophthalmoscope, fundus photography, electrooculogram, fundus fluorescein angiography (FFA) and OCT. Fifty-six eyes were classified into stage 0 (eight eyes)、Ⅰ (two eyes)、Ⅱ(10 eyes)、Ⅱa （12 eyes）、Ⅲ (six eyes) 、Ⅳa (six eyes)、Ⅳb (five eyes) and Ⅳc (seven eyes) accordingly. The OCT features of BVMD at different stages were observed.Results The OCT results showed that the macular area was normal in eyes of stage 0; disturbance of retinal pigment epithelium (RPE) and subretinal hyporeflective area were found in eyes of stage I; the location of the yellowish material between RPE and the inner segment and outer segment (IS/OS) with normal appearance in RPE and IS/OS interface were found in eyes of stage Ⅱ. In all the other progressing stages from Ⅱa、Ⅲ and Ⅳ, the vitelliform material appeared as a thicker highly reflective lesion located between the outer nuclear layer and RPE layer, usually accompanied by optical hyporeflective lesion. Images of stage Ⅳc were in similar appearance besides edema of retina. OCT images of Ⅳb stage were demonstrated atrophy of retinal layer and IS/OS loss with fibrosis. Conclusions OCT demonstrated the location of the yellowish material between RPE and IS/OS. Optical hyporeflective lesion between the outer nuclear layer and RPE layer accompanied thicker highly reflected lesion might be the characteristic image in stages II a to IV of BVMD.
Objective To evaluate the sensitivity， specificity, and accuracy of magnetic resonance imaging （MRI） in characterizing adnexal masses. Methods The databases such as the Cochrane Library, PubMed， EMbase， CNKI， and WanFang Data were searched on computer from 1991 to 2011. 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 acquired pooled sensitivity, specificity， and summary receiver operating characteristic curve （SROC） were used to describe the diagnostic value. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Results Ten case-control studies involving 649 women who were suspected to have pelvic masses were included and 729 masses were confirmed by the postoperative histopathology. The pooled statistical results of meta-analysis showed that：the sensitivity and specificity of MRI were 〔89%（84%-92%）， P=0.046 6〕 and 〔87% （83%-90%）， P=0.000 2〕 respectively, the positive and negative likelihood ratios of MRI were 6.25（P=0.008 5） and 0.14（P=0.029 1） respectively, and the area under the SROC curve （AUC） was 0.941. The sensitivity and specificity of ultrasound were 〔87%（82%-91%）， P=0.000 0〕 and 〔73%（69%-77%）, P=0.000 0〕 respectively, the positive and negative likelihood ratios of MRI were 3.07（P=0.000 0） and 0.18（P=0.000 1） respectively， and the AUC was 0.897. The speci?city and accuracy of MRI in characterizing female pelvic masses were higher than ultrasound obviously. Conclusion According these evidences， the MRI should be recommended to the women who are suspected to have pelvic masses as a preferred.
ObjectiveTo observe the characteristics of blue light(BLAF) versus near infrared wavelength (IRAF) fundus autofluorescence in central serous chorioretinopathy (CSC) patients. MethodsSeventy-seven eyes of 81 patients diagnosed with CSC were enrolled in this study. According to the duration of disease, patients were divided into acute CSC group and chronic or recurrent CSC group. All patients were examined with fundus fluorescein angiography, including BLAF and IRAF. There were forty-six patients (47 eyes) with acute, thirty-one patients (34 eyes) with chronic or recurrent CSC. The characteristics of BLAF and IRAF in CSC were compared. ResultsIn acute CSC, there were nineteen eyes (40.4%) showed scattered hyper-fluorescence corresponding to the leaking points, eleven eyes (23.4%) showed mottled hypo-fluorescence in BLAF; while 17 eyes (36.2%) showed normal change corresponding to the leaking points. There were 35 eyes can be observed serous retinal detachments in the BLAF images, 21 eyes (60.0%) showed hypo-fluorescence and 14 eyes (40.0%) showed hyper-fluorescence. In the IRAF images, 25 eyes (53.2%) showed mottled fluorescence corresponding to the leaking points, 11 eyes (23.4%) presented with scattered hyper-fluorescent spots and normal fluorescence. The serous retinal detachments of 26 eyes exhibited hypo-fluorescence in the IRAF images. In chronic or recurrent CSC, 19 eyes (55.9%) showed scattered hyper-fluorescence corresponding to the leakage points; followed by no abnormal change in 10 eyes, accounting for 29.4%; few showed mottled hypo-fluorescence (5 eyes 14.7%). There were 35 eyes (41.2%) can be observed serous retinal detachments in the BLAF images. IRAF mainly displayed mottled hypo-fluorescence (22 eyes, 64.7%), ten eyes (29.4%) presented with scattered hyper-fluorescence and 2 eyes (5.8%) presented without abnormal change. The serous retinal detachments of 3 eyes (8.8%) exhibited hypo-fluorescence in the IRAF images. ConclusionsFor acute CSC, a variety of fluorescence were showed in BLAF images and the proportion of the various fluorescences was similar; hypo-fluorescence was showed in the IRAF images. For chronic CSC, hyper-fluorescence was showed in BLAF while hypo-fluorescence in the IRAF images.
ObjectiveThis review has summarized in detail the advances in computed tomography (CT) and magnetic resonance imaging (MRI) imaging in evaluating the efficacy of targeted therapy for gastrointestinal stromal tumor (GIST).MethodsTo summarize the image-related guidelines, consensus, international conference reports, and relevant knowledge of clinical research on the evaluation of the efficacy of GIST targeted therapy in recent years.ResultsThe CT and MRI manifestation after targeted treatment of GIST was closely related to pathological changes, including necrosis, cystic degeneration, and bleeding. CT was the preferred imaging method. Functional magnetic resonance imaging, such as diffusion weighted imaging (DWI), had made some progress. The main criteria for evaluating the efficacy of GIST targeted therapy were RECIST 1.1 and Choi criteria.ConclusionCT and MRI play an important role in evaluating the efficacy of targeted therapy for GIST.