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Objective To compare the puncturing hit rate,positive rate of pathological diagnosis and the incidence of complications between color Doppler ultrasound-guided and CT-guided percutaneous biopsy for the qualitative diagnosis of ultrasonic-visual chest lesions.Methods A total of 112 patients,who were encountered from January 2015 to June 2016 in authors' hospital and whose imaging materials suggested the presence of ultrasonic-visual chest lesions,were enrolled in this study.There were no bones or lung air between the thoracic skin and chest lesion to hinder imaging observation.Ultrasound-guided puncturing was employed in 52 patients (ultrasound-guided group) and CT-guided puncturing was adopted in 60 patients (CT-guided group).The puncturing hit rate,positive rate of pathological diagnosis and the incidence of complications were compared between the two groups.Results The puncturing hit rate in ultrasound-guided group was 100％ (52/52),which was higher than 91.7％ (55/60) in CT-guided group.The positive rate of pathological diagnosis in ultrasound-guided group was 96.2％ (50/52),which was higher than 80.0％ (48/60)in CT-guided group.The incidence of complications in ultrasound-guided group was 3.8％ (2/52),which was lower than 18.3％(11/60) in CT-guided group.Conclusion For the qualitative diagnosis of ultrasonic-visual chest lesions,ultrasound-guided percutaneous biopsy is more reliable than CT-guided percutaneous biopsy.
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Objective To investigate the value of multimodality MRI in diagnosis of breast lesions with ring enhancement (internal enhancement pattern) on dynamic contrast enhanced (DCE) MRI.Methods Data of 67 patients with breast lesions confirmed by surgical pathology who underwent DCE MRI and DWI examinations were analyzed retrospectively.Finally,67 patients with breast lesions manifested as ring enhancement on DCE MRI were included in the study.According to the pathological findings,all patients were divided into benign group and malignant group.The overall morphology,morphology of "enhanced ring",time-signal intensity curve (TIC) types on DCE MRI,the distribution location of limited diffusion on DWI between the two groups were compared.Also the differences in semi-quantitative parameters on DCE-MRI and multi-point ADC values of the "enhanced ring" between the two groups were compared.Using pathological results as the dependent variables,indexes with statistical differences as the independent variables,the Logistic regression model was established to construct the newly combined parameters and to evaluate the diagnostic efficacy of the stepwise combined parameter.Results There were significant differences of different wall shapes concerning "enhanced ring" (x2 =14.19,P=0.001),wall nodules (x2 =12.48,P=0.001) and distribution locations of limited diffusion on DWI (x2 =19.60,P=0.003) between the two groups.There were also significant differences of the semi-quantitative parameters including early enhancement ratio (EER;t=2.35,P=0.02),maximum enhancement time (Tmax;t=-4.66,P=0.007),ADC ringi (t=1.35,P=0.001) and ADC ring wall(t=-2.88,P=0.005)between the two groups.The maximum Youden index of a newly-constructed parameter combination(morphological indexes of "enhanced ring"+distribution locations of limited diffusion on DWI+Tmax+ADCring inner) was 0.83 for combined diagnosis.The area under ROC curve was 0.87 (95％CI [0.82,0.91]),and the diagnostic sensitivity and specificity was 91.96％ and 91.31％,respectively.Conclusion Multimo dality MR can provide high diagnostic efficacy for breast lesions with ring enhancement
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Objective The chief aim of the present work is to investigate features of sternum of Chinese adults and to establish the sex determination method to evaluate its effect based on 3D recombinant morphology indicators. Methods Based on chest spiral CT scans, 2D images of multi-level recombination and 3D model of volume rendering, the experiment concludes an sex determination equation from 8 measurement indicators of the sternum and 3 ratio indicators. The 8 measurement indicators include full-length, handle length, body length, maximum width of the handle, maximum width of the body, maximum thickness of the handle, maximum thickness of the body, and thickness of the upper body. Results According to the 11 indicators of sex differences in statistics (P<0.05), especially indicators of the full-length, body length, maximum width of the handle and maximum thickness of the body, the body's sex is easier to be determined. All indicators equations, length indicators discriminant equations and stepwise discriminant equations have higher reliable rate (88.6%) which was consistent with the recent foreign research reports. Conclusion The method of sex determination based on multislice spiral CT 3D recombinant techniques is practicable and has an relatively high accuracy. It is expected to be applied to researches in age estimation by sternum and other virtual bones.
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Objective To investigate the value of CT findings in predicting the need for surgery in patients with small bowel obstruction (SBO).Methods Seventy patients with SBO were classified into non-operation and surgery groups according to the clinical treatment.The CT findings were retrospectively compared between the two groups,and the predictive value for surgery of useful CT findings was analyzed.Results Thirty three of 70 patients were cured with non-operative treatment and other 37 with surgery.The incidences of complete collapse of transitional zone,mesenteric edema,ascites,engorgement of mesenteric veins,decreased enhancement of bowel wall,decreased enhancement of mesenteric arteries and veins in surgery group were statistically higher than those in non-operation group,with odds ratios for surgery of 10.56,5.13,4.72,5.45,5.77,3.02 and 6.59,respectively.The diameter of dilated bowel,bowel wall thickness,and the incidence of target sign,intestinal pneumatosis,displacement,convergence and tortuosity of mesenteric vasculatures were not statistically different between the two groups.Conclusion Multiple CT findings of SBO are useful to predict the need for surgery,and may provide important information for clinical management of SBO.
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Objective To investigate the clinical pathological features and imaging findings of primary pulmonary sarcomatoid carcinoma. Methods Fifteen patients with a pathologically verified primary pulmonary sarcomatoid carcinoma were reviewed retrospectively. Fourteen patients had CT examinations and I0 of them had contrast-enhanced CT scan. Nine patients had chest plain films. Results Of 15 patients, 14 were peripheral and 1 was central, diameters ranging from 2.5 cm to 9.5 cm. Five located in the upper, 3 in the middle and 4 in the lower lobe of the right lung. The other 3 located in the upper left lobe. All cases presented with a spheroid solid lung mass on chest plain film and CT examinations. Three had irregular eccentric cavities. Six were well demarcated, 2 were ill defined, 4 were lobulated and 3 were speculated. The central case had obstructive pneumonia and showed ill defined. Ten showed irregular peripheral heterogeneous contrast enhancement. The center part of the tumor showed no enhancement or inhomogeneous enhancement. Seven had thoracic wall or pleural invasion, 4 had hilar or mediastinal lymphopathy and 2 had metastasis. Histopathologically, 8 were pleomorphic carcinoma, 2 were spindle cell carcinoma, 3 were giant cell carcinoma and 3 were pulmonary blastomas. Conclusion The X-ray and CT findings of the primary pulmonary sarcomatoid carcinoma are not specific. The clinicopathologic features were the evidence of diagnosis.