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Objective To analyze the risk factors of bile leakage after operation of hepatic alveolar echinococcosis.Methods The clinical manifestations,laboratory examination,imaging features and operative data of 137 patients with hepatic alveolar echinococcosis were retrospectively analyzed.The clinical characteristics of bile leakage group (n =22) and non-bile leakage group (n =115) were compared and analyzed,and the Logistic regression model was used to explore the related factors of bile leakage.Results Preoperative liver function (AST,ALP,LDH),blood loss,blood transfusion,hepatic hilum invasion,preoperative PTCD,and regular resection were significantly different between the two groups.Logistic regression analysis showed that regular hepatectomy was a protective factor to avoid bile leakage.Hepatic hilum invasion was a risk factor for bile leakage.Conclusion The invasion of the hepatic hilum is an important factor of postoperative bile leakage.Regular hepatectomy can reduce the incidence of postoperative bile leakage.
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Objective To study the clinical manifestations,imaging and pathological features of,and to analyse our experience in diagnosing and treatment of,hepatic angiomyolipoma.Methods The clinical manifestations,imaging features,pathological morphology and immunohistochemical characteristics of hepatic angiomyolipoma from 81 patients were analyzed retrospectively.Results Twenty patients had clinical symptoms.A preoperative imaging diagnosis was made in 20 patients.Radical liver resection was performed in 61 patients,liver biopsy in 2 patients,and radiofrequency ablation after liver biopsy in 18 patients.All tumor cells expressed the markers of melanoma cells (HMB 45,mart-1) and smooth muscle cells.Recurrence of tumor was found in one patient after operation (1.2％,1/81).No patients died on follow-up.Conclusions The imaging manifestations of hepatic angiomyolipoma were varied,and the diagnosis depended on pathological findings and immunohistochemistry staining.The treatment strategy should be selected according to tumor size,location and clinical symptoms.Patients should be followed-up closely after surgery because of the malignant potential of hepatic angiomyolipoma.
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Objective To compare the image quality of chest low dose CT (LDCT) using automatic exposure control (AEC) and constant current control (CCC) and explore a more reasonable scanning protocol. Methods Two hundred and eighty participants were examined with 64 CT scanner at 7 centers in China. All were divided into 4 groups. Two groups underwent LDCT using AEC with standard deviation set at 25 (A1) and 30 (A2) respectively and the tube current ranged from 10 mA to 80 mA. The other two groups underwent LDCT using CCC with tube current set at 40 mA (C1) and 50 mA (C2) respectively. The axial and MPR images were evaluated by two radiologists who were blinded to the scanning protocols.The radiation dose, noise and the image quality of the 4 groups were compared and analyzed statistically.Differences of radiation dose and noise among groups were determined with variance analysis and t test,image quality with Mann-Whitney test and the consistency of diagnosis with Kappa test. Results There was a significant lower DLP in AEC group than in CCC group [(82.62±40.31)vs ( 110.81±18.21) mGy·cm (F =56. 88 ,P ＜ 0. 01 )], whereas no significant difference was observed between group A2 and group A1 0. 05]. The noisy of AEC group was higher than that of CCC group both on lung window(41.50±9.58 vs 40.86±7.03) and mediastinum window (41.19±7.83 vs 40.92±9.89), but there was no significant difference( Flung =0.835, P=0.476, Fmediastinum =1.910, P=0.128).The quality score of axial image in AEC group was higher than that in CCC group (superior margin of the brachiocephalic vein level: 4.49±0.56 vs4.38±0.64,superior margin of the aortic arch: 4.86±0.23 vs 4.81±0.32,the right superior lobar bronchus Level:4.87±0.27 vs 4. 84 ± 0. 22, the right middle lobar bronchus Level: 4.90±0.25 vs 4.88±0.21) except on the right inferior pulmonary vein level(4. 92 ±0. 25 vs 4. 93 ±0. 17) and superior margin of the left diaphragmatic dome level (4. 91±0.27 vs 4.93±0.22) on lung window, but no significant differences (F=0.076-1.748, P＞0.05) were observed. A significant higher score in AEC group was observed on mediastinum window compared with CCC group on superior margin of brachiocephalic vein level (2.57±0.77 vs 2. 46 ± 0. 59, F = 8. 459, P ＜ 0. 05 ), however, the score of AEC group was lower than that of CCC group on other levels without significant differences (superior margin of the aortic arch:3.36 ±0. 63 vs 3.45 ±0. 60,the right superior lobar bronchus level: 3.94 ±0. 56 vs 3. 95 ±0. 51 ,the right middle lobar bronchus Level: 3.80 ±0. 58 vs 3. 87 ±0. 50,the right inferior pulmonary vein level: 3.72 ±0. 56 vs 3.78 ±0. 53, superior margin of the left diaphragmatic dome level: 3.58 ± 0.63 vs 3.68±0.56,F=0.083-3.380,P ＞ 0.05 ). The MPR image quality of AEC group was better than that of CCC group both on lung window and mediastinum window (Zlung =-2.258, Zmedlastinum=-1.330, P＞0.05). For all participants including the underweighted group, the normal group and the overweighted group, the image quality of A1 group was better than that of A2 group without significant differences (the underweighted group: Zlung=0.000, P=1.000, Zmedastinum= 0.000, P=1.000;the normal group: Zlung =-0.062, P=0.950, Zmediastinum =-0.746, P = 0.456; the overweighted group: Zlung = - 1.177, P = 0.239,Zmediastinum =-1.715, P=0.144) both on lung and mediastinum windows, and for the higher BMI participants, a better image quality was obtained in A1 group than in A2 group on the mediastinum window (Z = -1. 715, P = 0. 144). Conclusions The total radiation exposure dose of AEC group is significantly lower than that of CCC group, but no statistical significant differences are observed between both groups in image quality and noise level. The AEC technique is highly recommended in thoracic LDCT scan for screening program, and the SD25 ( SD value = 25) scan protocol is suggested for higher BMI population while the SD30 (SD value = 30) scan protocol for lower BMI population.
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To some problems on imaging teaching in traditional Chinese medical university,the countermeasures are as follows: the teacher team constructions and research work were perfected;the teaching contents were compiled by full time teachers;carefully preparing,supervising and guiding teachers could improve class teaching.The clinic should face to practice,society and future,the objective of which is to cultivate practical graduates with knowledge,skill and creativity who can adapt to clinic fast.The various examination forms were applied.By above means,imaging teaching quality has been improved perfectly.
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0.05).The lobular sign was markedly more in peripheral pulmonary squamous carcinoma than in other histopathological group(P0.05).Conclusion There are certain relation between spiral CT appearance and histopathology in peripheral pulmonary carcinoma.CT appearance may be one of the evidence in diagnosing the histopathological type in peripheral pulmonary carcinoma.