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Objective To compare CT performance of the hepatocellular carcinoma (HCC)with postoperative pathology and to probe their relationships with vascular endothelial growth factor (VEGF)expression in order to provide more information for the treatment.Methods Clinical data of 75 patients with HCC were enrolled,including preoperative plain and enhanced CT scans,post-operative results of HE staining and immunohistochemical one of VEGF.The CT manifestations were compared with the pathological results of the HCC,and the relationship of CT findings and the VEGF expression was anlyzed.Results There was significant differ-ence between the liver cirrhosis or lymph node enlargement on CT in 75 patients with HCC and the pathology (P 0.05).The psuedocapsule of HCC,tumor size,pathological blood vessel,and tumor necrosis were related with the VEGF expression (P 0.05).Conclusion The CT manifestations of HCC are closely related to the expression of VEGF.CT may reflect the pathological and biological characteris-tics of HCC with some limitations.
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ObjectiveTo recognize the normal CT appearances of adult pterygoid hamulus and increase the ability to recognize pterygoid hamulus abnormalities.Methods The pterygoid hamulus of 108 normal adults ( male:53 cases,female,55 cases) were studied with MIP and VR reconstructive images by 64-slice spiral CT in order to observe its normal shape,to measure its length,diameter,vertical height,horizontal width,abduct angle in coronal position and post-abducent angle in anteroposterior position.The differences between genders,two sides and age groups were compared,respectively.ResultsThe normal pterygoid hamulus had a wide basal body and a pillar caudomedial part with round or intumescentia extreme.In coronal position,the distal end towards outer direction in 214 sides and 2 sides in inner direction. In anteroposterior position,the distal end towards posterior direction in 190 sides and anterior direction in 26 sides.The pterygoid hamulus length,vertical height,and horizontal width of adult males were (8.18 ± 0.94) mm,(7.23 ±0.92) mm,(4.27 ±0.81 ) mm,respectively.They were larger than the adult females (7.31 ± 1.01) mm,(6.26 ±0.90) mm,(3.97 ±0.82) mm,and the difference was statistically significant (t values were 6.56,7.86,2.72 respectively,P ＜ 0.05).The pterygoid hamulus vertical height of age group over 60 years old (7.13 ± 1.35) mm exceeded the age groups of 18-39 (6.55 ±0.86) mm.The difference was statistically significant ( F =4.95,P ＜ 0.05 ).Conclusions64-slice spiral CT could display the shape,length and angle of pterygoid hamulus in full. It could help to recognize correlated pterygoid hamulus diseases.
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ObjectiveTo investigate the value of perfusion CT imaging in thyroid nodule. Methods Of the 40 cases of post-surgical thyroid nodule identified by pathology, nodular goiter was verified in 22 cases, thyroid adenoma in 6 cases,and thyroid carcinoma in 12 cases. All cases underwent CT perfusion scan at preoperative. The perfusion parameters including the blood flow ( BF), blood volume ( BV ), mean transit time ( MTT), and permeability of surface (PS) of region of interest (ROI) were calculated. The Mann-whitney test was used to comparing the differences of the different perfusion parameters. The ones with statistical significance would be introduced into the discriminatory analysis to distinguish the benign and malignant thyroid nodule. ResultsThe median MTT in 28 cases with benign thyroid nodule were 4. 33 s (Min 1.42 s,Max 10. 93 s), and that in 12 cases with malignant nodules were 2. 18 s( Min 1. 95 s, Max 2. 87 s). The difference had statistical significance ( P ＝ 0. 00 ) . The median BF in cases with thyroid carcinoma was 560. 23( Min 330. 66, Max 1000.00) ml ·100 g-1 ·min-1, and that in cases with the benign nodular were 374.79(Min 117.47,Max 1000.00) ml · 100 g-1 · min-1. There was a significant statistical difference ( P ＝0. 01 ). Through the discriminatory analysis, the difference of MTT between benign and malignant nodules were statistically significant (P ＝ 0. 00 ).After establing the Bayes discriminatory function, the overall diagnostic accuracy was 87.5％ (35/40).Conclusions MTT and BF are useful parameters in CT perfusion imaging to distinguish the benign and malignant thyroid nodules and the MTT is more accuracy.
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Objective To evaluate the diagnostic accuracy of ultrasonography (US) and CT for thyroid masses. Methods Seventy-one patients with thyroid masses (13 with malignant and 58 with benign tumors) confirmed by operation and pathology were collected. The apprearances of CT and US before operation were analyzed. The apperanecs of CT and US, including the clean edge of masses, calcification and cystic degeneration necrosis were compared with those of pathologic findings. Results The numbers, cystic changes, configuration, verge, calcify and enlarge cervical lymph nodes of thyroid lesions had statistical difference in CT and US (P＜0.05). There was also difference in the internal echo, ring of halo on US and the sign of halo on plane CT (P＜0.05). The edge of thyroid mass could be displayed more clearly with US than CT (P＜0.05), however, it was similar with CT in the display of calcify and cystic changes (P＜0.05). Conclusion Both CT and US can display thyroid mass clearly. Combing of CT and US could improve the accuracy rate of diagnosis.
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OBJECTIVE To study the clinical usability of virtual endoscopy(VE) in tympanoplasty.METHODS A total of 102 patients (204 ears) were observed by virtual endoscopy. Tympanoplasty was performed in 72 cases (75 ears) including 53 cases (55 ears) with chronic otitis media and 19 cases (20 ears) with congenital microtia and middle ear dysmorphia. Ossicular chain reconstruction was conducteded in 65 ears at the same time. RESULTS The ossicular chain was showed eroded in 19 ears of 23 patients with cholesteatoma otitis media pre-operatively by VE, but was found eroded in all of 23 ears during operation. The ossicular chain was showed eroded in 29 ears of 32 patients with osteitis otitis media pre-operatively by VE, but during operation it was found 23 ears with malleus and incus eroded, 11 ears without head of stapes or up-structure of stapes. VE showed 18 ears with congenital microtia and middle ear malformation and 2 ears with small tympanic cavity and no ossicular chain preoperatively, and operation proved 17 ears with severe ossicular malformation, 2 ears without stapes, 1 ear with vestibular window atresia. There were 2 ears with sudden hearing loss after tympanoplasty, the VE showed ossicular displacement. The coincidence rates between VE and operation view were 92 % in patients with otitis media and 100 % in patients with congenital microtia and middle ear malformation. CONCLUSION VE can supply reliability data for evaluation of the damaged ossicular chain and efficacy of tympanoplasty.
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Objective To improve the recognition of abnormal image of soft tissue in cheeks. Methods Images of 47 cases with abnormal soft tissue in cheeks were retrospectively studied. Results (1) 15 cases were originated from soft tissue of the cheeks in which 8 cases were benign and 7 cases were malignant.6 cases were invaded by maxillofacial affection nearby,in which 1 case was benign and 5 cases were malignant.26 cases were involved by lesions of jaw bones,including benign tumor of jaw bones in 9, malignant tumor of jaw bones in 14 and chronic osteomyelitis of jaw bones in 3 and all had bony destruction; (2) According to originated position,21 cases were not originated from jaw bones,in which there were 5 cases (23.8%) with destruction of jaw bones;(3)In the 26 cases with abnormal soft tissue of cheeks originated from jaw bones, 9 were benign tumors in which all the soft tissue masses were mainly localized inside of the jaw bones, while 14 cases were malignant tumors in which all the soft-tissue masses were localized both inside and outside of the jaw bones. There was remarkable difference between the two groups(P=0.000).All 9 cases of benign tumors appeared as dilated destruction of jaw bones, while in the 14 cases of malignant tumors, 12 cases showed osteolytic bone destruction and the other 2 cases showed ossific bone destruction,there was significant difference between the two groups(P=0.000).Conclusion CT and MRI are of significance in judging original position, extent and differential diagnosis between benign and malignant lesions of abnormal soft tissue in cheeks.
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Objective To study the imaging features of cervical lymphnode enlargement so as to improve the diagnosis of cervical lymph node disease.Methods CT and MRI appearances of 66 patients with pathologically-proved cervical lymph nodes disease were comparatively analyzed.Results There were significant difference in distribution of the multiple metastatic lymph node and lymph node tuberculosis(P=0.006).The ring-shaped enhancement were found in 20 cases with metastatic lymph nodes,19 of which were shown as thin-wall enhancement,its rate was 95%, and 5 ring-shaped enhancement of lymph node tuberculosis were shown as thick-wall enhancement.The former of which was significant difference than that of the latter(P=0.000).Of all central necrosis,it was significant difference between the metastatic lymph nodes(78%) and lymphoma(36%)(P=0.018).Conclusion According to the imaging features of cervical lymph nodes enlargement,their location and distribution,all of them may be diagnosed correctly.
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Objective To evaluate the role of CT diagnosis of the benign or malignant mass in nasal cavity and sinus.Methods 100 cases of benign or malignant masses in nasal cavity and sinus were reviewed retrospectively,and their CT findings were analyzed in details.According to what the lesion involved,the masses were defined into three states : A、The mass only localized in nasal cavity;B、 The massinvolves nasal cavity and(or) nasal sinus;C、The mass involved the adjacent structure beyond the nasal cavity and(or) nasal sinus.Results In what the lesion involved,benign mass group: A,53 cases;B,1 case;C,6 cases;malignant mass group: A,3 cases;B,9cases;C,28 cases,the difference between the two groups had statistical significance(P
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Objective To improve the cognition of abnormal changes of the medial soft tissue of styloid process (MSTSP) in nasopharyngeal carcinoma after radiotherapy. Methods CT scans of nasopharynx in 39 cases with NPC that had change at the MSTSP in NPC after radiotherapy were performed.CT findings of recurrence and non-recurrence at MSTSP were studied and compared carefully.Results In the recurrence cases, the MSTSP was thickening and compactness in all cases, in the non-recurrence cases ,only 37.04% (10/27) were thickening and compactness at MSTSP. In all the cases which had thickening and compactness of the MSTSP, the borders were slightly protruding in 9 cases and the borders were straight in 3 cases in the recurrence cases, while the borders were straight in 7 cases and the borders were slightly hollow in 3 cases,and there wasn't any case appeared as protruding of borders in the non-recurrence cases. All the cases were dealt with statistic methods and had remarkable difference between them(P
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Objective To recognize CT signs of parapharyngeal space (PPS) changing in nasopharyngeal carcinoma (NPC) further.Methods 30 patients with proven NPC by biopsy were performed CT and MR scanning before radiotherapy. Results According to CT findings,four types of PPS display in 30 cases were found,each of which was observed and compared with MR findings and were as follows: (1)PPS ,which had no changing on CT, showed fat-filled triangular space continuously on MRI. (2) PPS, which became narrow and linear hypodense on CT,showed that fat intensity was pressed, but continuously on MRI; (3) PPS, which became narrow and linear hyperdense on CT,showed fat intensity,was pressed exceedingly but continuously either on MRI. (4)PPS,which was diminished on CT, showed the mass occupied PPS and lateral pterygoid muscles was pushed, medial fatty space of which was diminished, but intensity of medial or lateral pterygoid muscles was normal or abnormal on MRI. Conclusion (1)When PPS becomes narrow on CT,whether PPS shows hyperdense or hypodense,the mass makes a breakthrough PPS. (2) When PPS is diminished completely on CT,the mass steps PPS to the infratemporal fossa.
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Objective To investigate the correlation between degree of deeper infiltration of NPC on CT scan,prognosis and expression of P53 protein,in order to further recognize bilogical features of NPC.Methods Collect 70 NPC biopsy specimens,which had performed CT scan before radiotherapy and had detailed clinical records.The expression of P53 protein was examined by means of S-P immunohistochemical technique.The correlation between expression of P53 protein and peripheral deeper infiltration and prognosis was analysed in detailed.Results The results of these cases showed that the positive rate of over expression P53 were 68.57%,which had no relation with the histological types and pathological grades.The positive rate of P53 in Ⅱ、Ⅲ types had a higher positive rate than that of the Ⅰ type of NPC.Expression of P53 protein had no relation with neck lymph node metastasis,but had significant correlation with the size of metastatic lymph node,which is the positive rate of P53 in diameter of metastatic lymph node ＜4 cm was higher than that of diameter ≥4 cm.Expression of P53 had no relation with local recurrence and distant metastasis after radiotherapy.Conclusion With the tumor infiltrating the deeper layer of nasopharynx,the positive rate of P53 expression is more and more high,and degree of malignant is increasing.The three types on CT scan represents the biological features of NPC.
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Objective To improve the differential diagnostic accuracy of abnormal image in the nasopharyngeal cavity and wall.Methods Sixty-five cases with abnormal image in the nasopharyngeal cavity and wall were collected.Twenty cases were proven by operation and pathology.Forty-five cases were proven by biopsy and pathology. All the patients were examined by using CT and (or) MRI. Their imaging features were analyzed in details.Results In 19 cases, polyp and inverted papilloma in the nasal cavity and choanal projected into the nasopharyngeal cavity. Small air bubbles or contact between the lesion and the nasopharyngeal wall were detected in 18 of them. The edge of the polyp was regular, while the margin of the inverted papilloma was irregular. In 11 cases, nasopharyngitis or adenoidal hypertrophy located in the posterosuperior wall. The anterior borders were almost straight or curve toward inside, and the contrast enhanced CT and MRI scans showed that the mucous membrane lines were continuous. Oropharyngitis in the right side spread to the right wall of the nasopharynx without clear borderline and the space occupying effect was little in 1 case. There were 33 cases of nasopharyngeal carcinoma (NPC) and 1 case of non-Hodgkin′s lymphoma (NHL), and the anterior borders of the masses were evaginated like a curve, and most of them were accompanied with shallowing or disappearing of pharyngeal recess and tumefaction of the levator muscle of palatine velum.Conclusion According to the imaging features, most of the abnormalities in the nasopharyngeal cavity and wall can be diagnosed correctly.