ABSTRACT
Objective To investigate the clinical features and CT appearances of primary adenosquamous carcinoma (ASC)of the liver and to improve the understanding of this disease for the sake of misdiagnosis.Methods The clinical features and CT appearances in 7 patients proved by operation and pathology were reviewed,retrospectively.Results All of the patients had dull pain in upper abdo-men,fever,chills and a long history of cholangitis and biliary calculi.In addition,all patients had not the history of hepatitis B and liver cirrhosis.And the serum AFP level was normal.The single lesion was found in every patient including 4 lesions in the left lobe of liver and the other 3 in the right lobe.Plain CT showed all masses with hypodensity,heterogeneity and unclear edge in liver,and multiple irregular and more hypodense areas in lesions were found.Slight heterogeneous honeycomb-like enhancement in the arterial phase was showed.In the venous phase,persistent honeycomb-like enhancement with uneven separations,nodular bulge and hypo-dense necrotic area was found.In the delayed phase,further honeycomb-like enhancement with hypodense necrotic area and obvious-ly enhanced nodular bulge was showed.The bile ducts in the liver and around the mass were dilated and had pneumatosis in company with lithiasis in choledochus and intrahepatic bile duct in 5 patients.Conclusion Primary hepatic ASC has certain clinical character-istics in older patients.The CT characteristic features included:honeycomb-like lesions with persistent,heterogeneous,delayed en-hancement and heterogeneous separation,uneven inner edge and enhanced nodular bulge.
ABSTRACT
Objective To compare different delayed scanning methods in multi-slice spiral CT angiography (MSCTA)in diagnosis of pulmonary embolism (PE). Methods Sixty patients with suspected PE were divided into three groups (A, B and C). MSCT with same Iodine concentration, injection rate, contrast medium but different delayed scanning methods was performed after injection of contrast medium. Patients in group A were examined with fixed time method (15 s), in group B with small dose-density curve method, while in group C with contrast medium track and triggering technoligy. The number, position and the shapes of emboli were evaluated with MIP, MPR and VR. Results The successful examination rate of group A was 55.00% (11/20), while of group B and C was both 100%. The coincidence rate of MSCTA compared with DSA in each group was 96.04% (291/303). Conclusion The best delayed scanning method in MSCTA for diagnosis of pulmonary embolism is contrast medium tracking and triggering technology.