ABSTRACT
Objective To investigate prospectively the changes of quantitative parameters in dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer patients before and after neoadjuvant chemotherapy (NACT).Methods Thirty-eight patients with locally advanced cervical cancer (in stage Ⅰ B2,Ⅱ A2,Ⅱ B) underwent DCE-MRI one week before and 1 month after NACT.The patients were classified into two groups:significant reaction(sCR) group and non-sCR group.The DCE-MRI pharmacokinetics parameters (mean Ktrans,mean Kep,mean Ve and mean Vp) were measured and compared between the sCR and non-sCR groups.Receiver operating characteristic (ROC) curves were constructed to describe the diagnostic accuracy of the significant parameters and their decision thresholds.Results There were 22 and 16 patients in sCR and non-sCR groups,respectively.Before NACT,the mean Ktrans was higher (P＜0.05) but the mean Ve (P＜0.05) was lower in sCR group than those in non-sCR group,and these differences were statistically significant,respectively.After NACT,the mean Ktrans (P＜0.05) and the changed value of Ktrans (P＜0.05) were significantly lower in the sCR group compared with those in the non-sCR group.The remained parameters such as Vp and Kep had no statistically difference between the two groups.When combined the parameters values before and after treatment by using ROC curves,the area under curve (AUC) of pre-mean Ktrans and /Ktrans were 0.801 (P＜0.05),0.955 (P＜0.001).The optimal cut off value for distinguishing sCR from non-sCR were the pretreatment Ktrans (0.702 0) and/Ktrans (0.043 7),and their sensitivity and specificity were 77.3％,81.2 ％,95.5％ and 81.2％,respectively.Conclusion Quantitative parameters of DCE-MRI provided a new noninvasive way to reflect the changes of hemodynamics in cervical cancer patients with NACT.The quantitative parameters,such as pre-mean Ktrans and /Ktrans could predict the treatment efficacy more precisely.
ABSTRACT
Objective To investigate the value of dynamic contrast-enhanced MRI parameters in the diagnosis of cervical squamous cell carcinoma. Methods A retrospective analysis of dynamic contrast enhanced MRI in 55 patients with pathologically diagnosed cervical squamous cell carcinoma without prior treatment. They were divided into three groups based on grade of differentiation: well differentiated ( 6 patients),moderately differentiated(28 patients)and poorly differentiated group(21 patients). Capacity volume transfer constant (Ktrans),exchange rate constant(Kep) and extravascular extracellular volume fraction (Ve) were measured in each group of patients, and comparing the correlation with ANOVA, DCE-MRI parameters and grading of squamous differentiation using Spearman rank correlation analysis. Results Ktrans of the poorly, moderately and well differentiated cervical squamous cell carcinoma were (2.42±0.58),(1.71± 0.78),(1.27±0.78)/min respectively, Kep were (4.17±1.23),(3.08±1.58),(2.55±0.87)/min respectively, Ve were 0.60 ± 0.12,0.60 ± 0.19,0.43 ± 0.17 respectively. Statistical difference of Ktransand Kep were found among the subgroups of different pathological grading.(F values were 7.518 and 4.234,P all0.05). Statistical difference of Ktransand Kep were seen in multiple comparisons, between the groups of poorly and moderately differentiated groups poorly and well differentiated groups (P all 0.05). There were moderate negative correlation between Ktrans,Kep and the pathological degree (r=-0.531 and -0.446, P=0.001 and 0.002), Ve had no correlation between pathological grade (r= -0.220, P = 0.141).Conclusion DCE-MRI parameters Ktrans and Kep reveal perfusion characteristics in different pathological grades of cervical squamous cell carcinoma.
ABSTRACT
Objective To discuss the CT manifestations of multi-parasite infection in liver to improve the diagnostic accuracy. Methods A total of 11 patients with ELISA-proved multi-parasite infection in liver were enrolled in this study.The plain and dynamic enhanced CT scans were performed.The imaging findings including the number,distribution,size,shape,density,enhancement and degree intratumaral features,cholangiectasis and abdominal lymphadenopathy were retrospectively analyzed.Results A single lesion of multi-parasite infection in liver was detected in 6 patients and multiple lesions were in other 5.The lesions in 8 patients were located in a single lobe of the liver,and involved in several hepatic lobes in other 3.The maximum diameter of the lesion ranged from 1.7 cm to 6.3 cm with an average diameter of 4.4 cm.Irregular lesions were found in 7 patients and round ones in shape were in other 4.Plain CT showed the lesions with low-intensity.All lesions were mild to moderate inhomogeneous enhancement on portal vein phase,presented honeycomb-like or separated enhancement with cholangiectasis (n=2)and abdominal lymphadenopathy (n=2).Conclusion The CT manifestations on portal vein phase in combination with clinical data are useful for the diagnosis of multi-parasite infection in liver.