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Objective: To compare the effect of microwave ablation (MWA) and uterine artery embolization (UAE) for treatment of single intramural uterine leiomyoma. Methods: Data of 49 patients with single intramural uterine leiomyoma were retrospectively analyzed, including 27 cases received MWA (MWA group) and underwent UAE (UAE group). The therapeutic effect and prognosis were compared between 2 groups. Results: After treatment, menorrhagia, dysmenorrhea, anemia and other symptoms relieved and gradually disappeared in both groups. Complications, such as fever, abdominal pain and vaginal discharge were found but cured after symptomatic treatment or without treatment. The volume and maximum diameter of uterine leiomyoma in MWA group were less than those in UAE group 3 and 6 months after therapy (all P0.05). Conclusion: Both MWA and UAE are effective and safe for treatment of single intramural uterine leiomyoma, and the former has better effect.
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Objective To summarize the imaging characteristics of the hepatic epithelioid hemangioendothelioma (EHE).Methods The clinical data of 6 patients with hepatic EHE who were admitted to the Yantaishan Hospital (3 patients), Zhangzhou Hospital of Traditional Chinese Medicine (2 patients) and Zhangqiu Hospital of Traditional Chinese Medicine (1 patient) between March 2007 and June 2014 were retrospectively analyzed.All the patients underwent plain scan and dynamic enhanced scan of computed tomography (CT), and the number,shape, size, location, density or signal, level and method of enhancement of the lesions were observed and analyzed.Six patients were followed up by outpatient imaging examination up to June 2014, and the changes of lesions were observed.Results Among the 6 patients, 1 solitary lesion and 5 multiple lesions were detected, and the total lesions were 125 including 1 patient with 75 lesions.The lesions were round or round-like and originated commonly from the right lobe of liver and hepatic subcapsular with a maximum diameter of 0.5-3.5 cm.Plain scan of CT showed that the lesions in 6 patients had low density with the clear boundary.MRI showed that low T1 WI signal and high or slightly high T2WI signal of the lesions were detected in 4 patients.Two patients had liver capsular retraction sign.The ring-like enhancement of 1 lesion and homogeneous enhancement of 5 lesions were found by dynamic enhanced scan of CT in 6 patients and enhanced scan of MRI in 4 patients.Enhanced signal in all the lesions was detected in the delayed phase.Veins into or through lesions were found in 3 lesions, with normal or narrowing vascular cavity.One patient had visible lollipop sign.Of the 6 patients, 5 were confirmed as with metastatic carcinoma of liver, and 1 was suggested as with cholangiocarcinoma.Six patients were diagnosed with hepatic EHE by pathological examination using hepatic biopsy technique.Among the 2 patients with hepatic EHE who didn't receive antineoplastic treatment after the diagnosis, 1 patient received CT examination at year 2 after first visit, which showed capsular retraction sign, and then was diagnosed as with secondary hepatic cirrhosis by MRI at 4 years after first visit.Another patient was diagnosed as with hepatic cirrhosis by CT examination at year 6.5 after first visit.One patient was diagnosed with tumor recurrence of hepatic left lobe by CT reexamination at postoperative year 4, and underwent ultrasound-guided radio frequency ablation (RFA) treatment based on no enlargement of tumor during 1-year follow-up, and then returned a normal condition after half year follow-up.Other 3 patients undergoing operation were followed up at postoperative year 1 , 4, 5 with no recurrence and metastasis.Conclusions Intrahepatic single or multiple nodules and delayed reinforcement by dynamic enhanced scan of CT and MRI are the typical imaging performances of hepatic EHE.There are certain characteristics in the liver the lollipop sign, capsular retraction sign and veins into or through the lesions.Mutual fusion and fibrosis of lesions leading ultimately to secondary liver cirrhosis may be characteristics of EHE growth.
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Objective To discuss the procedural problems and solution correlatively of CT-guided percutaneous biopsy of spinal diseases,with simultaneous evaluation of the safety and clinical application.Methods Sixty-eight cases with spinal diseases were taken CT-guided percutaneous biopsy under local anesthesia and CT guidance,including 9 in cervical spine,19 in thoracic spine,28 in lumbar spine and 12 in sacral spine.The program of carrying out the procedure was decided according to the site,approach route of the lesion with the destination of sampling,under CT guidance.Results The successful rate of needle puncture was 100%(68/68)with diagnostic accuracy of 92.6%(63/68),and false-negative rate of 7.4%(5/68),together with complications rate of 5.9%(4/68).Conclusions CT-guided vertebral biopsy is safe,reliable,less complication,high accuracy and together with clear demonstration of the position of puncture needle and the complex anatomic structures nearby,providing basic information for further clinical treatment and worthy to be recommended.
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Objective To improve the imaging recognition of the lymphangiomyomatosis.Methods The manifestations of 2 patients with lymphangiomyomatosis confirmed by pathological assessment were analyzed retrospectively and relevant literature were reviewed.Results Multiple,well-defined and thin-walled cysts were found on the chest HRCT.The size of the cystic airspace was different,and the wall of cysts ranged being fainted perceptible to near l mm in thickness.The retroperitoneal lymphangiomyomatosis were found in the 2 patients on CT images,and some lymphadens were confluence.The diameter of the largest lymphadens was 25 mm,no enhancement were found on contrast-enhanced CT scan.The right renal angioleiomyoma and retroperitoneal leiomyoma were presented in one patient,which were moderately homogeneous enhanced on contrast-enhanced CT scan.Conclusion Lymphangiomyomatosis is a rare lymphangial disease with smooth muscle abnormal hyperplasia.The diffuse cysts in bilateral lungs were its characteristic changes on CT images.Lymphangiomyomatosis can incorporate with renal angioleiomyoma,retroperitoneal leiomyoma and lymphangiomyomatosis.
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Objective To investigate the MRI manifestations and its pathologic foundation of adrenal myelolipoma.Methods MRI images of 13 patinets with adrenal myelolipoma confirmed by pathological assessment were analyzed retrospectively.MRI fingings were also studied in correlation with surgical pathology.Results The MRI diagnosis of adrenal myelolipoma in 13 patients were correct preoperative.Huge mass in the adrenal were found in 11 patients with T 1WI high signal intensity and mixed with conclamata and stripe low signal intensity.The high signal intensity was mature fatty tissue and the low signal intensity was myeloid tissue on pathologic examination.2 patients appeared as mixed signal intensity principle isointensity on T 1WI images,and the pathological findings was tumor hemorrhage.The high signal intensity changes to low signal intensity and slight higher than the signal of subcutaneous fatty tissue on T 1WI or T 1WI with fatty suppression.The low signal intensity of the myeloid tissue and the hemorrhage were high sinal intensity.No enhancement were found in all patients.Partly capsule enhancement were found in 2 patients with tumor hemorrhage and infection.The inferior cava vena was displaced to the anterior and internal side in all patients.Conclusion The characteristic manifestation of adrenal myelolipoma is high signal intensity change of the fatty tissue and no enhancement on contrast-enhanced MRI image.MRI could give correct diagnosis of the adrenal myelolipoma preoperative.