ABSTRACT
Objective To investigate the characteristics and diagnostic value of multislice spiral CT (MSCT) of intestinal lipomas causing intussusception.Methods The MSCT findings of 25 cases with intestinal lipomas causing intussusception were retrospectively analyzed,the tumor location,size,shape,density,enhancement patterns and shape and length of intussusception were also observed retrospectively.Results Tumors were 1.2-6.5 cm in diameter,round or oval in shape (n =18),irregular shape (n =4),tubular shape (n =3) with uniform density (n =19),or uneven density (n =6).Under CT enhancement tumor capsule was moderately intensified.Intussusception included ileum-ileum type (n =7),jejunum-jejunum type (n =5),jejunum-ileum type (n =2),ileum-colon type (n =4),and colon-colon type (n =7).Intussusception was 5.0-5l.0 cm in length;presenting as concentric circles (n =12),round target sign (n =7),orbanana (n =6).Conclusion Intestinal liporna complicating secondary intussusception has definite MSCT characteristics which can help establish diagnosis.
ABSTRACT
Objective To investigate the characteristics and diagnostic value of multi-slice spiral computed tomography (MSCT) examination of gastrointestinal lipoma.Methods The cross-sectional study was adopted.The clinicopathological data of 96 patients with gastrointestinal lipoma including 32 from the Second Hospital Affiliated to Wenzhou Medical University,30 from the First Hospital Affiliated to Wenzhou Medical University,17 from the Ruian People's Hospital of Zhejiang,11 from the Yueqing People's Hospital,3 from the Wenzhou Central Hospital and 3 from the Wenzhou People's Hospital from December 2006 to September 2015 were collected.All patients were fasted for 8 hours prior to the examination,and partial patients underwent enhanced scan after the conventional CT scanning with breathless scanning and no abdominal pressure.Coronal and sagittal images of gastrointestinal tract including the tumor were administrated with multiple planar reconstruction (MPR)techniques of Reformat software.Based on MPR images,the curves along the gastrointestinal tract were drawn,voxel distributed along the curve track were reconstructed,and curved planar reconstruction (CPR) images were obtained.The patients received operation or follow-up according to individual characteristics after examinations.The patients undergoing operation were followed up for detecting tumor recurrence and metastasis by CT examination and patients receiving follow-up were observed by endoscopy for detecting changes of tumor size and morphology up to June 2015.The analysis indexes included tumor location and size,performance of MSCT examination (tumor shape,density,margin,intussusceptions,enhanced MSCT examination),intraoperative findings,results of pathological examination and results of follow-up.Measurement data with normal distribution were presented as i ± s.Results All the 96 patients received MSCT plain scan and the 42 received enhanced MSCT scan.The CPR images in 30 patients were collected.(1) Tumor location and size:3 tumors were located in the stomach,16 in the duodenal,27 in the jejunum,23 in the ileal,2 in the ileocecus,9 in the sigmoid colon,9 in the ascending colon,3 in the descending colon,3 in the transverse colon and 1 in the appendix.The diameter of tumor was (3.8 ± 2.3) cm.(2) Performance of MSCT examination:of the 96 patients,round or oval tumors were detected in 68 patients,tubular tumors in 15 patients and lobulated tumors in 13 patients.Tumors showed homogeneous density in 67 patients and inhomogeneous density in 29 patients.The CT value of tumors was-110--53 HU with a median value of-80 HU.Tumors of the 96 patients had clear boundaries and smooth margins.Twenty-four patients were complicated with intussusceptions with nested length of (28 ±4)cm,including 10 cases of multiple concentric rings,7 cases of double-target sign and 7 cases of banana sign.Enhanced MSCT scan showed that capsule around tumors in the 96 patients demonstrated slightly intensified,tumor body demonstrated no enhancement and that angiolipoma in 10 patients had cable strip like enhancement in the tumors.(3) Intraoperative findings:of the 96 patients,59 patients underwent surgical resection with single tumor,24 patients were concomitant with intussusceptions,9 patients showed aphtha in the center of tumors and 1 patient had partial lipoma in the prepyloric region dropped into the duodenal.Thirty-seven patients received endoscopic examination,showing submucous nodular protrusive lesions of 1.7-3.5 cm.(4) Results of pathological examination:of 59 patients undergoing surgical resection,submucosal,subserous and intramural tumors were detected in 45,9 and 5 patients,respectively,with complete capsule and pedunculated or non-pedunculated.Of the 59 patients,tumors showed round or oval shape in 41 patients,tubular shape in 10 patients and lobulated shape in 8 patients.The section of tumors showed yellowish-white.Specimens from endoscopic and surgical resections were observed under microscopy,the tumors were composed of mature-differentiated adipocytes,different quantities of fibrous connective tissues,blood vessels and mucus ingredients.Tumor cells were round shape with hypochromatic cytoplast and became polygeal and vacuolated after squeezing,nucleus was compressed to peripheral area and cytoplasm was full of lipid droplets.The results of immunohistochemistry stain showed Vimentin,CD34,D2-40,CD68 were positive and AE1/3 and Calretinin were negative.All tumors were diagnosed as benign lipomas.Fifty-nine patients who underwent surgical resection were followed up for 0.5-5.0 years and 37 patients of which specimens were obstained by endoscopic resection were followed up for 1.0-2.0 years after the pathological diagnosis with no significant change.Conclusion The MSCT finding of the gastrointestinal lipoma has characteristic appearance,and MSCT examination can clearly show lipoma location,size,shape and properties,with a widespread application value.
ABSTRACT
Objective To compare the difference of entrance dose between CR and amorphous silocon DR system in chest imaging, and to discuss their optimum exposure dose. Methods For CR and DR, different entrance dose was measured by dosimeter in chest phantom. The value of IQFinv was analyzed by CDRAD2. 0 software. Image quality difference between CR and DR was assessed by group t-test. The relationship between image quality and entrance dose was tested by using Pearson correlation analysis. The best IQFinv values in CR and DR system were achieved via ROC curve analysis, and the exposure dose was then calculated. Results There were direct correlation values between entrance dose and the value of IQFinv in CR and DR system, respectively( r =0. 893 ,0. 848 ,P < 0. 01 ) . The linear regression equation for DR was IQFinv =0. 0050 +3. 359, and for CR was IQFinv =0. 005D + I. 651 , where D was entrance dose. The difference of IQFinv value between CR and DR was significant(t = 5. 455 ,P < 0. 05). The best IQFinv value of the two groups from ROC analysis was 3.55. Conclusions With the entrance dose increased, the detection ability of contrast-detail was elevated in the two digital radiography systems. With equal entrance dose, the detection ability of DR in contrast-detail was superior to CR. With equal image quality, DR obviously decreased the radiation dose to the patients.
ABSTRACT
Objective To evaluate the value of CT in diagnosing primary small intestinal lymphoma. Methods CT features of 11 cases of primary small intestinal non Hodgkin′s lymphomas were retrospectively analyzed. Results The most frequent location of the diseases were at ileum (10/11). According to the main CT features from all 11 cases, it could be classified into two types: bowel wall thickening type ( n =7) and luminal polypoid mass type ( n =4). 5 of 7 cases in the first type showed aneurysmal sign, while 3 of 4 cases in the second type were combined with intussusception. 7 cases from the two types were found to have mesenteric lymph nodes enlargement, among them 1 case showed “sandwich” sign, 4 showed long range or multicentric intestinal lesions. The tumor detection rate was 81.8%, and the correct diagnosis rate was 63.6% by CT. Conclusion Bowel wall thickening and luminal polypoid mass were two different types of CT features in the primary small intestinal lymphoma, and polymorphic lesions accompanied by multifocal mesenteric lymph nodes enlargement, aneurysmal sign, “sandwich” sign, long range or multicentric intestine lesions were the main characteristic CT features, which may lead to the correct diagnosis by CT.