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Objective:To evaluate the diagnostic value of relative lesion length in differentiating extrahepatic bile duct infiltrating cholangiocarcinoma with inflammation.Methods:From October 2014 to February 2018, 24 cases of infiltrating extrahepatic cholangiocarcinomas confirmed operatively and pathologically and 23 cases of extrahepatic bile duct inflammation confirmed clinically from the Third People′s Hospital of Datong City were respectively enrolled in this study. Upper abdomen MR and/or CT image data of all patients were respectively reviewed. The extrahepatic duct wall was defined as wall thickening with obvious enhancement. The length of the lesion was measured. L lesion/L duct was referred as the ratio of the lengths of lesion to extrahepatic bile duct (common hepatic duct+common bile duct)was calculated. The difference in the average values of L lesion/L ductbetween the cholangiocarcinomas group and inflammation group was analyzed with t test, and the differential diagnostic efficacy of L lesion/L ductratio was analyzed with receiver operating characteristic curve (ROC) test. Results:Significant difference was found in the length of lesion between the extrahepatic cholangiocarcinoma group [(22.01±1.86) mm] and the cholangitis group [(47.36±2.81) mm] ( P<0.01). The average ratio of L lesion/L ductwere 0.26±0.02 for the cholangiocarcinomas group and 0.54±0.03 for the inflammation group, respectively ( P<0.01). The area under the ROC curve of L lesion/L duct in diagnosis of the infiltrating extrahepatic cholangiocarcinomas was 0.92. With <0.40 as cut-off point, the diagnostic sensitivity and specificity were 87.5% and 82.6%, respectively. Conclusion:The L lesion/L ductmight be taken as an important diagnostic sign in differentiation between infiltrating extrahepatic cholangiocarcinomas and extrahepatic bile duct inflammation.
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Objective To investigate the correlations between the mass and fat infiltration of intercostal muscles and their severity of airflow obstruction in patients with chronic obstructive pulmonary disease(COPD). Methods One hundred and sixty-three COPD patients and 102 normal subjects between August 2015 to March 2017 underwent chest MSCT scans and all data were analyzed retrospectively. All subjects underwent pulmonary function tests (PFT). According to the global initiative for chronic obstructive lung disease(GOLD, updated 2015), the COPD patients were classified into GOLD 1(n=37), GOLD 2(n=46), GOLD 3 (n=48), GOLD 4 (n=32) by pulmonary function results, respectively. The mass and fat infiltrations of intercostal muscles were quantified as the cross-sectional area (CSA) and attenuation of these muscles using CT histogram analysis. Intercostal indexes and attenuation indexes were defined as intercostal CSA and attenuation divided by body mass index(BMI). Comparison of intercostal indexes and attenuation indexes between the COPD and control groups was perfomed using t test. The comparisons between the 4 COPD subgroups were carried out using ANOVA test, and comparison between the two groups by LSD. The correlation between intercostal indexes and attenuation indexes and PFT were evaluated by the Spearman rank correlation test. Results The CSA and attenuation indexes of COPD patients groups were(4.3 ± 2.1) mm2 · m2 · kg-1,(-1.6 ± 6.9)HU · m2 · kg-1, respectively,both were significantly lower than that of the control group [(6.9 ± 1.7)mm2 · m2 · kg-1,(11.6 ± 5.7)HU · m2 · kg-1]. The difference was statistically significant(t=12.82,10.87,P<0.01). The CSA and attenuation indexes of COPD patients in any subgroups and the control group were of significant difference(F=92.79, 8.80, P<0.01).The CSA and attenuation indexes were negatively correlated with the GOLD grades, the difference was statistically significant(r=-0.615,-0.551, P<0.05). Conclusions Mass and fat infiltration of intercostal muscles of COPD patients measured by CT histogram analysis were correlated with their severity of airflow obstruction. In other words, a decrease in intercostal mass and an increase in intercostal fat are associated with worsening of COPD severity.
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Objective To explore the correlation between ostiomeatal complex(OMC)variation, nasal septum deviation and nasosinusitis with CT imaging.Methods The clinical and imaging data of 256 patients undergoing nasal and paranasal CT examination from June 1, 2015 to May 30, 2016 were retrospectively analyzed. Patients with paranasal sinus fractures, tumors and artifacts were not included in this study.Taking the image of standard coronal MPR built with thin axial sections at the level of middle of semilunar fissure as observing image,and the direction,location and extent of OMC variations were observed and recorded. The patients were divided into two groups according to the presence or absence of nasal septum deviation.OMC mutation,the incidence of unilateral mutation,incidence of paranasal sinusitis and the incidence of unilateral bilateral nasal sinusitis between the two groups was analyzed by χ2test with two independent samples. Then according to the presence or absence of OMC mutation, the patients were divided into two groups.The incidence of paranasal sinusitis and bilateral paranasal sinusitis were compared between the two groups. Results Two hundred and fifty six cases of CT imging of parannasal sinus were included in the study,96 cases were with nasal septum deviation, 160 were with non-deviation of nasal septum. The incidence rate of OMC variation between the two groups showed significant difference(χ2=38.40,P<0.05).The incidence rate of unilateral and bilateral OMC variation showed significant difference(χ2=13.70,P<0.05),among which 54 were unilateral variations,50(92.6%)variations were located at the same side of nasal deviation(side of the nasal cavity widened).The incidence rate of sinusitis between the two groups showed non-significant difference(χ2=0.50,P>0.05).The incidence rate between unilateral and bilateral nasosinusitis showed non-significant difference(χ2=2.25,P>0.05).Of the 256 cases,128 were with OMC variations,and 128 were with non-OMC variation.The incidence rate of nasosinusitis between the two groups showed non-significant difference(χ2=0.56,P>0.05). The incidence rate between unilateral and bilateral nasosinusitis showed non-significant difference(χ2=3.57,P>0.05). Conclusion Ipsilateral OMC variation occurred in nasal septum deviation might be a compensation to nasal cavity widening while not a obstructive factor in causing nasosinusitis.
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Objective To study the consistency in the diagnosis of preoperative TNM rectal cancer staging using high resolution magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) combined with carcinoembryonic antigen (CEA) and postoperative pathological TNM.Methods 156 cases pathologically proven were retrospectively analyzed and divided into 4 groups including preoperative MRI group (39 cases),TRUS group (39 cases),MRI and TRUS group (39 cases),MRI and TRUS combined with CEA group (39 cases).The differences between preoperative T,N staging and postoperative pathologic T,N staging were analyzed.Results There were statistically significant differences in the diagnosis of preoperative T and postoperative pathological T in 4 groups (T: Kappa =0.685,P =0.000; N: Kappa =0.544,P =0.000),but there were no significant differences in preoperative N and postoperative pathological N staging in preoperative MRI group,TRUS group,MRI and TRUS group (Kappa =0.142,P =0.329; Kappa =0.154,P =0.645; Kappa =0.154,P=0.229),and significant difference was observed in MRI and TRUS combined with CEA group (Kappa =0.544,P =0.000).There were no significant differences in the accuracy of T staging among the 4 groups (x2 =0.326,P =0.574; x2 =0.562,P =0.719; x2 =0.287,P =0.986),but significant difference in the accuracy of N staging were showed among the 4 groups (x2 =4.643,P =0.026; x2 =6.643,P =0.026; x2 =5.243,P =0.019).Conclusion Preoperative evaluation by the MRI add TRUS combined with CEA can improve the accuracy of preoperative staging,which can provide more reliable basis for decision-making and improve the coincidence rate of operative procedures in line with the estimate.It also provides the basis fur the accurate preoperative diagnosis and individualized treatment.