Liver Stiffness for Evaluating Change of Condition in Patients with Acute-on-chronic Liver Failure / 中山大学学报(医学科学版)

@# 【Objective】To study the correlation between hepatocellular jaundice and liver stiffness measurement and reflect the changes in patients with acute-on-chronic liver failure（ACLF）.【Methods】Between January 2015 and March 2016，a total of 150 patients with ACLF-HBV infection were enrolled to collect clinical data，2D-SWE and biochemical variables. According to data distribution，correlation of total bilirubin with LSM by 2D-SWE was assessed by Pearson correlation analysis.【Results】One hundred and twenty-one patients were analyzed and divided into two groups：descended TB group and elevated TB group. For descended TB group，LSM decreased 5.1（2.2～6.6）kPa. For elevated TB group， LSM increased 6.2（1.2～12.8）kPa. A significant parallel correlation between TB and LSM value either the descended TB group or the elevated TB group. For descended TB group，accompanied with the decrease of LSM，patients reached clinical improvement standard and their average hospitalization time was 30 ± 15 days. Six patients underwent liver trans⁃ plantation in the elevated TB group，and showed TB level higher than twenty ULN（the upper limit of normal），ac⁃ companied with increased LSM value. Histological characteristics of these patients showed submassive hepatic necrosis. 【Conclusion】The degree of hepatic necrosis aggravation in patients with ACLF，which results in the continuous increase of TB and LSM，reflects the aggravation of patients′ condition；on the contrary，the decline in value of LSM reflects the improvement of patients′ condition.

Application of 64MDCT multislice perfusion imaging in colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the correlation of time-density curves (TDC), parameters revealed by 64-multidetector-row CT (64MDCT) perfusion imaging with clinicopathological factors (staging, serosal invasion, lymph node metastasis, distant metastasis and CEA) in colorectal carcinoma (CRC).</p><p><b>METHODS</b>64 MDCT perfusion imaging was performed in 33 patients with pathologically verified CRC. TDC was created from the region of interest (ROI) drawn over the tumor, target artery and vein by 64MDCT with perfusion functional software. The parameters of individual perfusion maps included blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability-surface area product (PS). Tumors were staged according to TMN classification. TDC was classified according to their shapes. The correlation between CT perfusion parameters and clinicopathological factors was studied.</p><p><b>RESULTS</b>TDC of 64MDCT perfusion imaging could be classified into five types. TDC in different stages could demonstrate one or more types of the five types. There was no significant difference of CT perfusion parameters among different stages. BV and MTT were significantly higher in the patients with serosal invasion than in those without serosal invasion (t=-2.63,-2.24, P=0.0137, 0.0331, respectively). BV was significantly correlated with tumor size (r=0.41, P=0.02). BF and PS were not correlated with staging, serosal invasion, lymph node metastasis, distant place metastasis and CEA (all P>0.05).</p><p><b>CONCLUSIONS</b>64MDCT multislice perfusion imaging can reveal the blood perfusion of CRC and has potential value of clinical application.</p>

CT diagnosis of midgut malrotation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the diagnostic value of CT in midgut malrotation.</p><p><b>METHODS</b>The CT appearances of 16 patients with midgut malrotation were analyzed retrospectively.</p><p><b>RESULTS</b>The features of CT manifestation in 16 cases were as follows: (1) Horizontal part of duodenum could not reach medioventral line or could reach it but encircled right-down behind the superior mesenteric artery(SMA). (2) Ectopic ileocecal junction. (3) Jejunum located in right-middle abdomen while ileum in left abdomen. (4) A clockwise or counterclockwise rotation of the superior mesenteric vein (SMV) around the SMA. (5) Mid-gut volvulus.(6)Accompanied by other malformations.</p><p><b>CONCLUSION</b>Ambulation of duodenum, location of the small intestine and colon as well as anatomical position of mesenteric vessels should be intensively observed in order to exclude midgut malrotation.</p>

Evaluation of microvessel density and vascular endothelial growth factor in colorectal carcinoma with 64-multidetector-row CT perfusion imaging / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the correlation of 64-multidetector-row CT (64MDCT) perfusion imaging with microvessel density(MVD) and vascular endothelial growth factor(VEGF) in colorectal carcinoma.</p><p><b>METHODS</b>64MDCT perfusion imaging was performed in 33 patients with pathologically verified colorectal carcinoma. Time-density curves (TDC) were created from the region of interest (ROI) drawn over the tumor, target artery and vein by 64MDCT with perfusion functional software. The individual perfusion maps generated were for blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability-surface area product (PS). MVD and VEGF expression of surgical specimens were examined by immunohistochemical staining with anti-CD34, anti-VEGF monoclonal antibody. MVD and VEGF were compared among the different types of TDC in colorectal carcinoma. The correlation of CT perfusion parameters with MVD and VEGF was also examined.</p><p><b>RESULTS</b>TDC of colorectal carcinoma was divided into five types according to their shapes. MVD in the colorectal carcinoma was 22.61+/-9.01. VEGF staining was found in 25 of 29 tumors (86.2%). The score of VEGF expression was 4.15+/-1.09. No significant differences of MVD and VEGF expression among TDC types were found (F=2.59, 1.11, P>0.05). There were also no correlations of MVD and VEGF expression with any dynamic CT parameters (P>0.05).</p><p><b>CONCLUSION</b>64MDCT perfusion imaging, MVD and VEGF may reflect angiogenic activity, but no significant correlations are found among them.</p>

Primary carcinoid tumors of the pancreas:CT findings / 中华放射学杂志

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.