Prediction of survival of patients with cervical cancer after concurrent chemoradiotherapy based on clinical and imaging parameters / 中华放射肿瘤学杂志

Objective:To investigate the value of nomograms based on clinical parameters, apparent diffusion coefficient (ADC) and MRI-derived radiomics in predicting survival of patients with locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT).Methods:Clinical data of 423 patients with IB-IVA cervical cancer treated with CCRT at Anhui Provincial Hospital Affiliated to Anhui Medical University from March 2014 to March 2020 were retrospectively analyzed and randomly divided into the training and validation groups at a ratio of 2∶1 using the simple randomization method. The values of ADC min, ADC mean, ADC max and 3D texture parameters of diffusion weighted imaging (DWI), T 2WI, T 2WI-fat suppression of pre-treatment primary lesions in all patients were measured. The least absolute shrinkage and selection operator (LASSO) algorithm and logistic regression analysis were used to screen the texture features and calculate radiomics score (Rad-score). Cox regression analysis was employed to construct nomogram models for predicting overall survival (OS) and cancer-specific survival (CS) of patients with LACC after CCRT, which were subject to internal and external validation. Results:Squamous cell carcinoma antigen (SCC-Ag), external beam radiotherapy dose, ADCmin and Rad-score were the independent prognostic factors for OS and CS of LACC patients after CCRT and constituted predictive models for OS and CS. The area under the receiver operating characteristic (ROC) curve (AUC) of two models in predicting 1-year, 3-year, 5-year OS and CS was 0.906, 0.917, 0.916 and 0.911, 0.918, 0.920, with internally validated consistency indexes (C-indexes) of 0.897 and 0.900. Then, models were brought into the validation group for external validation with AUC of 0.986, 0.942, 0.932 and 0.986, 0.933, 0.926 in predicting 1-year, 3-year, 5-year OS and CS.Conclusion:The nomograms based on clinical parameters, ADC values and MRI-derived radiomics are of high clinical value in predicting OS and CS of patients with LACC after CCRT, which can be used as prognostic markers for patients with cervical cancer to certain extent.

The value of intravoxel incoherent motion diffusion weighted imaging parameters combined with texture analysis of primary lesion of rectal adenocarcinoma to predict preoperation non-enlarged lymph node metastasis / 中华放射学杂志

Objective:To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) parameters combined with T 2WI texture analysis of primary lesions of rectal adenocarcinoma in preoperative prediction of lymph node metastasis with short diameter ≤9 mm. Methods:Retrospective analysis was performed on 115 cases of rectal adenocarcinoma confirmed by surgical pathology in Affiliated Provincial Hospital of Anhui Medical University from June 2015 to October 2020. All patients underwent total mesorectal resection and received conventional rectal MRI and IVIM-DWI scan before surgery. According to the pathological results of lymph node, the patients were divided into lymph node metastatic group ( n=44) and non-metastatic group ( n=71). IVIM-DWI parameters of primary rectal adenocarcinoma were measured including apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D *) and perfusion fraction (f). The region of interest (ROI) of the whole lesion of rectal adenocarcinoma was delineated on axial T 2WI; then the ROIs were imported into GE Analysis Kit software to extract 3D texture feature. The differences of IVIM-DWI parameters and texture feature parameters were compared between two groups using independent sample t test or Mann-Whitney U test. The optimal texture feature parameters with independent predictive function were screened by multivariate logistic regression. Then the texture feature model and combined model based IVIM-DWI and texture feature parameters were established. The receiver operating characteristic (ROC) curves were used to evaluate the performances of IVIM-DWI, texture feature parameters, texture feature model and combined model in predicting lymph node metastasis in patients with rectal adenocarcinoma. The area under the ROC curve (AUC) were compared with DeLong test. Results:Among all the IVIM-DWI parameters, the D * and f values of primary rectal adenocarcinoma were significantly different between the lymph node metastasis group and the non-lymph node metastasis group ( Z=3.39, P=0.001, Z=-3.06, P=0.002); no statistical significance was found in the ADC and D values between two groups (both P>0.05). A total of 828 texture feature parameters were obtained based on T 2WI of primary lesion of rectal adenocarcinoma, among which 3 optimal texture feature parameters were selected, including firstorder_Skewness, shape_Sphericity and glcm_Idn. The ROC curve results showed that the AUC of D * and f were 0.689 and 0.670, respectively. The AUC of 3 texture feature parameters were 0.651, 0.628, 0.631, respectively. The AUC of texture feature model and the combined model were 0.775 and 0.803. The AUC of combined model was larger than D *, f and the three texture feature parameters (all P<0.05). Conclusion:IVIM-DWI parameters combined with T 2WI texture feature parameters in primary lesion of rectal adenocarcinoma show good diagnostic efficacy in preoperative prediction of lymph node metastasis with short diameter≤9 mm.

Nomogram based on IVIM-DWI and radiomics in predicting recurrence after concurrent chemoradiotherapy for patients with cervical cancer / 中华放射肿瘤学杂志

Objective:To investigate the value of nomogram based on intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and MRI-derived radiomics for predicting recurrence after concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC).Methods:Clinical data of 111 patients with ⅠB-ⅣA cervical cancer who underwent CCRT at Anhui Provincial Hospital from December 2014 to December 2019 and were continuously followed up were retrospectively analyzed. Pre-treatment IVIM-DWI parameters (ADC, D, D * and f) and pre- and post-treatment 3D texture parameters (from axial T 2WI) of the primary lesions were measured. Least absolute shrinkage and selection operator (LASSO) algorithm and multivariate logistic regression analysis were used to filter texture features and calculate radiomics score (Rad-score). A Cox regression model was used to analyze independent risk factors for recurrence after CCRT in patients with LACC and construct a nomogram. Results:External beam radiotherapy dose, f value , pre-treatment Rad-score and post-treatment Rad-score ( HR=0.204, 3.253, 2.544, 7.576) were the independent prognostic factors for recurrence after CCRT in cervical cancer patients and jointly formed the nomogram. The area under curve (AUC) of the nomogram for predicting 1-, 3- and 5-year disease-free survival (DFS) was 0.895, 0.888 and 0.916, with internal validation C-indexes of 0.859, 0.903 and 0.867, respectively. The decision curves analysis showed that the nomogram has a higher net clinical benefit compared to other models, and the clinical impact curves further visualized its predictive accuracy. Conclusions:The nomogam based on IVIM-DWI and radiomics has high clinical value in predicting recurrence after CCRT in patients with LACC, providing reference for prognostic assessment and individualized treatment of cervical cancer patients.

The value of quantitative CT body composition analysis in prediction of prognosis in patients with hepatic cell carcinoma treated with transcatheter arterial chemoembolization / 中华放射学杂志

Objective:To investigate the value of quantitative CT (QCT) body component parameters before and after transcatheter arterial chemoembolization (TACE) as prognostic indicator for patients with hepatic cell carcinoma (HCC).Methods:Retrospective analysis was performed on 40 patients with advanced HCC who received TACE treatment in Anhui Provincial Hospital Affiliated to Anhui Medical University from November 2013 to May 2017, all of them received QCT scanning before and after treatment. The information were recorded, including gender, age, alpha-fetoprotein (AFP), TNM stage, liver function Child-Pugh grade, portal venous thromboembolism, cirrhosis, maximum tumor diameter, tumor type, and frequency of interventional therapy. QCT parameters were measured before and after treatment, including L1, L2 bone mineral density (BMD), L3-level paravertebral muscle area (MA), subcutaneous fat area (SFA) and visceral fat area (VFA), and the change rate of QCT parameters (ΔBMD, ΔMA, ΔSFA, ΔVFA) before and after TACE were calculated after the QCT scan interval was standardized. The cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were obtained by drawing the ROC curves. The Kaplan-Meier method was used to calculate the survival rate, the Log-rank method was used for univariate analysis, and the Cox regression analysis model was used for multivariate analysis to screen out independent factors affecting the prognosis of HCC patients after TACE.Results:ROC curve analysis showed that the cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were -8.64%, -6.84%, -9.84% and 5.70%, respectively. Univariate analysis showed that AFP, TNM stage, liver function Child-Pugh grade, portal venous thrombosis, tumor type and ΔMA, ΔSFA, ΔVFA had statistically significant effects on prognosis ( P<0.1). Multivariate analysis showed that ΔMA, ΔVFA and portal venous thromboembolism were independent influencing factors for the prognosis of HCC patients after TACE treatment ( P<0.05). Conclusions:ΔMA, ΔVFA and portal venous thromboembolism have reference value for prognosis assessment of TACE treatment for HCC patients, and QCT body composition analysis is helpful to evaluate the prognosis of HCC patients.

Diagnostic performance of ADC value and texture features based on T 2WI fat suppressed image to distinguish benign and malignant soft tissue tumors / 中华放射学杂志

Objective:To investigate the value of ADC derived from DWI combined with texture analysis derived from T 2WI fat suppressed images in distinguishing benign and malignant soft tissue tumors. Methods:The MRI and DWI images of 94 patients with soft tissue tumors (44 cases with malignant and 50 cases with benign) confirmed by pathology were analyzed retrospectively in the First Affiliated Hospital of USTC West District. ADC values of solid components were measured at GE ADW4.6 workstation. The texture features were extracted by manually drawing the ROI on the maximum level of the T 2WI fat suppressed images; the ADC values and texture parameters between the two groups were statistically analyzed by SPSS17.0, and the multivariate logistic regression model were conducted to analyze and calculate the diagnostic performance. Results:ADC value of benign and malignant soft tissue tumors was (1.6±0.3)×10 -3 mm 2/s, (1.2±0.5)×10 -3 mm 2/s, respectively, and the difference was statistically significant( t=-5.382, P<0.05). Taking 1.28×10 -3 mm 2/s as the critical value, the area under curve (AUC) for the diagnosis of benign and malignant soft tissue tumors was 0.783, the sensitivity was 92.00%, and the specificity was 65.91%. Among the texture features, the AUC of frequency size, skewness, Inertia All Direction_offset7, Inverse Difference Moment angle0_offset1, Inverse Difference Moment angle0_offset7 and Haralick Correlation All Direction_offset4_SD distinguishing benign and malignant soft tissue tumors were 0.825, 0.739, 0.826, 0.816, 0.820 and 0.783, respectively. The AUC, sensitivity and specificity of the best predictive model distinguishing benign and malignant soft tissue tumors were 0.930, 88.00% and 86.36% respectively using multivariate logistic regression analysis. Conclusion:ADC combined with texture analysis is of great value in preoperative differentiation of benign and malignant soft tissue tumors.

Predictive value of IVIM-DWI and DCE-MRI quantitative parameters on the early efficacy of concurrent chemoradiotherapy for cervical squamous cell carcinoma / 中华放射肿瘤学杂志

Objective:To evaluate the application value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and dynamic contrast enhancement MRI (DCE-MRI) in the prediction of the early efficacy of concurrent chemoradiotherapy (CCRT) for cervical squamous cell carcinoma.Methods:Fifty patients with cervical squamous cell carcinoma confirmed by pathology were included. Before CCRT, IVIM-DWI and DCE-MRI were scanned, and the values of quantitative parameters including ADC, D, D * and f of IVIM-DWI and K trans, K ep, V e and V p of DCE-MRI before treatment were measured for all patients. MRI reexamination was performed 1 month after the end of CCRT, and all patients were divided into the cure group and the residual group according to the tumor remission. The parameters of IVIM-DWI and DCE-MRI before treatment were statistically compared between two groups. The optimal predictive parameters and predictive thresholds were determined by drawing the receiver operating characteristic (ROC) curve. Results:Twenty-four patients were assigned into the cure group and twenty-six patients in the residual group. The ADC, D and V e values before treatment in the cure group were significantly lower than those in the residual group (all P<0.05), whereas the f and K trans values were significantly higher than those in the residual group (both P<0.05). The other parameters did not significantly differ between two groups (all P>0.05). The area under ROC curve (AUC=0.823) of D value was the largest, followed by K transvalue (AUC=0.754). The combined prediction efficacy of D and K trans (AUC=0.867) was higher than that of either D or K trans alone. The sensitivity was 88.5%, 85.8% and 88.8%, and the specificity was 70.8%, 66.7% and 79.2%, respectively. Conclusions:Quantitative parameters of IVIM-DWI and DCE-MRI before treatment have certain predictive value for the early efficacy of CCRT in cervical squamous cell carcinoma, among which the predictive efficacy of D value is the highest, and the combined application of D and K trans can improve the predictive efficacy.

Characteristic findings of the liver iron overload on MRI and the feasibility of quantitative evaluation by IDEALGIQ / 实用放射学杂志

Objective To explore the classic MRI appearance of secondary hemochromatosis (SHC)related liver iron overload, and the feasibility of quantitative evaluation of liver iron overload by iterative decomposition of water and fat with echo asymmetry and leastGsquares estimationGiron quantification (IDEALGIQ).Methods 20 patients with SHCGrelated liver iron overload (experimental group)and 20 healthy adults (control group)underwent routine liver MRI and IDEALGIQ.The MRI images were comparatively analyzed to assess the hallmark of liver iron overload.In both two groups,the R2 ? values were measured on R2 ? maps,which were generated by IDEALGIQ,then the differences in age,gender and R2 ? value between two groups were comparatively analyzed.In experimental group,the serum ferritin (SF)was detected,and a correlation analysis was tested with R2 ? value.Results For all of the 20 patients, there was signal drop of liver parenchyma on T1 and T2 Gweighted images,signal loss with susceptibility artifact on DWI images,and signal dropped on inGphase images relative to outGofGphase images.Among the 20 patients,18 cases appeared "a dark liver parenchyma"on T2 G weighted images,and the spleen signal in 3 cases was similar to liver parenchyma’s hallmark.The R2 ? values in experimental group and control group were 395.58±255.75 Hz and 41.18±7.86 Hz (t＝－6.12,P＝0.00),respectively.No significant differences between two groups were found in gender and age (χ2＝0.10,P＝0.10 and t＝0.09,P＝0.93).The liver iron overload R2? value was not correlated with SF (r＝0.1 5 3 , P＝0.15).Conclusion On MRI,the typical appearance of liver iron overload is hypointense on T1 and T2Gweighted images,especially"a dark liver parenchyma"on T2 WI,signal drops on inGphase images relative to outGofGphase images,and signal loss with susceptibility artifact on DWI images.R2 ? value of IDEALGIQ can quantitatively evaluate the liver iron overload,without a correlation with SF.

A comparative study of CT enhanced effect in abdominal vessels with different iodine concentrations of contrast agent / 实用放射学杂志

Objective To investigate CT enhanced effect in abdominal vessels with three different iodine concentration with the fixed iodine delivery rate and total iodine load.Methods 90 patients were randomized into 270 (270 mg I/mL),320 (320 mg I/mL) and 370 (370 mg I/mL)groups.On arterial phase images,the CT values of abdominal aorta (AA)were measured at the level of the porta hepatis,the right renal artery and the bifurcation of iliac artery.On portal veins phase images,the CT values of the main portal vein,the left branch and the right branch of portal vein were also measured.The differences in subj ective scores of image quality,CT values,signal to noise ratio (SNR),contrast to noise ratio (CNR)between the AA and portal vein were analyzed.Results The CT values of AA in 270,320 and 370 groups in arterial phase at the level of the porta hepatis were(302.28±24.81)HU,(302.14±33.76)HU and (303.49±35.85)HU,those at the right renal artery level were(304.01±25.55)HU,(305.22±33.63)HU and(306.14±31.51)HU,and at the bifurcation of iliac artery level were (306.85±23.26)HU,(308.68±31.80)HU and (310.22±29.76)HU.There were no significant differences among the three groups (P>0.05).The CT values of the main portal vein in portal phase were (133.94±8.41)HU, (1 3 5.6 3 ± 11.82)HU and(135.43±10.08)HU,those of the left branch were(134.21±6.04)HU,(135.12±9.97)HU and(135.31±8.82)HU, those of the right branch were (133.77±7.06)HU,(134.09±11.53)HU and (136.04±10.61)HU.There were also no significant differences among the three groups (P>0.05).No statistical differences were observed among the three groups in the scores of image quality, SNR and CNR(P>0.0 5).Conclusion Similar CT enhanced effect and excellent image quality can be obtained by using different iodine concentration of contrast agent with the fixed iodine delivery rate and total iodine load in abdominal vessels.

Spectral CT in preoperatively quantitative evaluation on histodifferentiation of rectal adenocarcinoma / 实用放射学杂志

Objective To explore the value of spectral CT imaging in the preoperative evaluation on histodifferentiation of rectal adenocarcinoma.Methods 90 patients with rectal adenocarcinoma underwent dual-phase enhanced spectral CT scan,and were divided into well,moderately and poorly differentiated adenocarcinoma groups according to the pathology.Single-energy images with energy levels from 40 to 140 keV were generated by GSI Viewer software,and the slope K value of the energy curves were calculated.Iodine concentrations were derived from iodine-based material-separation images and normalized to the iodine concentrations in the aorta. ROC curves were derived to evaluate the differentiation diagnosis efficiency of normalized iodine concentration (NIC)and slope K in rectal adenocarcinoma,respectively.Results There were 22,50 and 18 cases in the well,moderately and poorly differentiated group,respectively.The iodine concentration,NIC and slope K value were statistically different both in the arterial and venous phase (P76% and the specificity>74% in the arterial phase,and the sensitivity>77% and the specificity>70% in the venous phase by choo-sing the appropriate threshold.Conclusion The spectral CT can provide a new method for preoperatively evaluating the histodiffer-entiation of rectal adenocarcinoma.

Optimization of Monochromatic Imaging in Reducing Iodinated Contrast Dose in CT Pulmonary Angiography / 中国医学影像学杂志

Purpose To explore the feasibility of optimizing monochromatic images in reducing iodinated contrast dose in CT pulmonary angiography (CTPA). Materials and Methods Sixty-eight patients undergoing CTPA were randomly divided into two groups, with half in research group and half in conventional group to evaluate image quality. Research group underwent spectral CT imaging with the injection of 30 ml Omnipaque (300 mgI/ml) and optimal monochromatic images were postprocessed using the software of GSI viewer. Conventional group underwent conventional CTPA with the injection of 80 ml Ultravist (370 mgI/ml). The CT values were measured respectively in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery. The contrast noise ratio (CNR) in two groups were calculated, and image quality were subjectively assessed. Results The total iodine intake in research group (9000 mg) was significantly lower than that of conventional group (29 600 mg). CNR in the main pulmonary artery, left pulmonary trunk, right pulmonary trunk, left lobe artery and right lobe artery in research group was significantly higher than that of conventional group (t=2.07-2.71, P0.05), while there was a good agreement between the two readers (Kappa=0.8, P<0.05). Conclusion It is possible to reduce iodinated contrast dose using spectral CT imaging and improve the image quality of CTPA.

Application of DWI with high b value in staging of cervical cancer at 3.0T MRI / 实用放射学杂志

Objective To evaluate the value of 3.0T MRI diffusion-weighted imaging (DWI)in diagnosis and staging of cervical cancer. Methods A total of 65 cervical carcinoma patients were enrolled and performed T2 WI,DWI and LAVA-Flex dynamic contrast-enhancement before operation.MR images were analyzed by two radiologists to evaluate the staging performance.Results All the cervical cancers were detected in DWI,while three lesions were missed in T2 WI and one lesion was missed in LAVA-Flex dynamic contrast-enhanced MRI.Respectively,the accuracy of staging with DWI,T2 WI and LAVA-Flex dynamic contrast-enhanced MRI was 90.8%,78.5%and 87.7%.Accuracy of DWI was significantly higher than that of T2 WI(P =0.04),while there was no significant difference of accuracy between DWI and LAVA-Flex dynamic contrast-enhanced sequence (P =0.39).Conclusion DWI shows relatively higher accuracy than T2 WI in the staging of cervical cancer which makes it an ideal method to replace LAVA-Flex dynamic contrast-enhanced MRI for exact staging.

The preliminary study of using low concentration of isotonic contrast agent on bronchial artery CTA / 实用放射学杂志

Objective To evaluate the value of low concentration of isotonic contrast agent combined with 80 kV and adaptive statistical itera-tive reconstruction (ASiR)technique for bronchial artery with CT angiography (CTA).Methods 40 patients (18.5 kg/m2 ≤ body mass index(BMI)≤25 kg/m2 )with lung cancer were randomly divided into two groups and performed enhanced chest CT examina-tion.20 patients (low concentration group)were scanned with Visipaque 270mg I/mL,scanning protocol of (80 kV,260 mA)and other 20 patients (high concentration group)were scanned with Ultravist 370 mg I/mL,scanning protocol of (120 kV,1 50 mA). The CT value,signal noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR)and effective dose (ED)of the two groups were compared and analyzed statistically.Differences between the two groups were determined with t test(P <0.05).Results The mean CT value of the low concentration group (31 7.33 HU±70.44 HU)was higher than that of the high concentration group (256.39 HU±37.38 HU)(P <0.05).SD,ED and dose length product (DLP)of the low concentration group (SD:7.55 ±1.51 HU;ED:1.74±0.14 mSv;DLP:124.94±9.9 mGy/cm)were lower than those of the high concentration group (SD:9.36±1.26 HU;ED:3.20±0.35 mSv;DLP:228.82±25.13 mGy/cm)(P <0.05).CNR and SNR of the low concentration group (CNR:59.71± 17.36;SNR:44.01±14.71)were higher than those of the high concentration group (CNR:37.61±6.16;SNR:27.75±4.72)(P <0.05).The subjective scores of the two groups were (3.73±0.66)and (3.81±0.59),respectively,with no statistical difference.Conclusion For the patients with normal body mass index ,it can reduce 47% radiation dose and 27% iodine dosage using low concentration of isotonic contrast agent combined with 80kV and ASiR technique for bronchial artery CTA,while maintaining similar excellent image quality.

A preliminary study of improving quality of CT angiography on small feeding arteries of abdominal tumors with optimizing gemstone spectral imaging technique using single source dual-energy CT / 中华放射学杂志

Objective To investigate the optimal monochromatic parameters of CT angiography (CTA) on small feeding arteries of abdominal tumors using single source dual-energy CT with gemstone spectral imaging (GSI) technique.Methods The clinical and medical imaging data of 32 patients with abdominal malignant tumor were analyzed retrospectively during January to April 2012.Three phase-enhanced CT scans (Discovery CT750 HD,GE Heahhcare,Milwaukee,USA) of the abdomen were recorded using the GSI technique on 32 patients.The minor feeding arteries of tumor with diameter between 1.5 mm to 3.0 mm were reconstructed by 140 kVp mixed energy,66 keV,and optimal monochromatic mode respectively.After CT scanning,the original data were processed with layer and interval of 0.625 mm,the 140 kVp mixed energy images and 70 keV monochromatic images were obtained with standard algorithm.The original images were conveyed to AW4.5 work-station to process furthermore,then the data of the optimal monochromatic group and 66 keV group were reconstructed.Comparative parameters include contrast-to-noise ratio (CNR),signal-to-noise ratio (SNR) and subjective scores of the small feeding arteries CTA quality.Subjective scores were evaluated by two radiologists according to the sharpness and resolution of the small feeding arteries.One-way ANOVA was used to for statistical analysis.Results CNR of the optimal monochromatic group,the 66 keY group,and the 140 kVp mixed energy group were 21.70 ±9.74,16.63 ±7.60,and 9.85± 6.76,respectively.SNR were 35.05 ± 17.75,26.77 ± 11.51,and 16.32 ± 9.5,respectively.Subjective scores were 4.58 ± 0.40,3.55 ± 0.57,and 2.75 ± 0.46,respectively.CNR,SNR and subjective scores had significant difference among groups (F =17.11,15.73 and 116.01,P ＜ 0.01).The optimal monochromatic group was superior to the 66 keV group and the 140 kVp mixed energy group.Conclusion The optimal monochromatic mode can improve CTA quality of small feeding arteries of abdomen malignant tumors with GSI technique using single source dual-energy CT.

Effect of antidepressant intervention on mood state of at or around the time of radiation therapy / 中华行为医学与脑科学杂志

Objective To explore the effect of antidepressant intervention on mood state of at or around the time of radiation therapy. Methods 62 hospitalized patients with cancer receiving radiotherapy were divided into two groups by the order of the time when they accept the radiotherapy which called intervention group ( antidepressant fluoxetine group) and control group. And the two groups patients filled out Hamilton Anxiety Scale( HAMA )and Hamilton Depression Scale (HAMD) at or around the time of radiation therapy to investigate the effects of fluoxetine on anxiety and depression. Results The scores of HAMA and HAMD showed that there was no differences between the intervention group and the control group before the radiotherapy. There was significant difference during the radiotherapy ( 6.41 ± 2.30 ) vs ( 9.29 ± 5.62 ); ( 8.80 ± 3. 048 ) vs ( 12.22 ± 8.32 ) and two weeks after the end of the radiotherapy ( 4.90 ± 1.71 ) vs ( 12.32 ± 7.24 ); ( 6.83 ± 2.47 ) vs ( 16.09 ± 8.61 ) between antidepressant fluoxetine group and control group(P ＜ 0.05 ). Conclusion More attention should be paid to mental health and antidepressant can alleviate anxiety and depression of the cancer patients'at or around the time of radiotherapy.

CT and MRI findings and classification study of brain schistosomiasis granuloma / 中华放射学杂志

Objective To study CT and MRI features and classification of brain schistosomiasis granuloma. Methods CT and MRI data of 30 cases of brain schistosomiasis granuloma were reviewed.All cases were proved by the surgery or pathological examination and clinical laboratory test.There were 20 males and 10 females, and their age ranged from 5 to 58 years, mean 29.2 years.Plain and enhanced CT were performed in all patients with GE MAX 640 scanner.Ten patients were examined by plain and enhanced MRI with GE Signa profile 0.2 Tesla open scanner.Results The lesions located in supratentorial region in 27 cases and in infratentorial region in 3cases.The nodules were isodense or slight hyperdense on CT plain scan, iso or hypointense on T_1WI, hyperintense on T_2WI, Slight hyperintense on FLAIR.After the contrast material was injected intravenously, CT and MRI findings were multiple or single enhanced nodules at the cortical or subcortical area.There were four types of imaging features: (1) multiple small nodules in 5 cases (presenting as bright stars in the dark sky); (2) single large nodule in 8 cases; (3) mixed nodules in 14 cases; (4) circle-enhanced nodules in 3 cases.Conclusion The brain schistosomiasis granuloma has typical CT and MRI findings.CT and MRI classification is not only helpful to its diagnosis and differential diagnosis, but also might be useful for the choice of clinical treatment.

CT characteristic findings of pancreatic rupture caused by closed abdominal trauma / 中华放射学杂志

Objective To study CT characteristic findings of pancreatic rupture caused by closed abdominal trauma.Methods The clinical and CT data of 6 patients with pancreatic rupture caused by closed abdominal trauma were analyzed retrospectively.CT plain scan and the tripple-phased enhancement scan were performed,multi-planar reformation(MPR)and maximum intensity projection(MIP)were used after CT scanning.Thin slice of CT scan and post-processing technique of imaging were used furthermore.Results The rupture of pancreatic neck and tail were shown in 2 cases,the rupture of pancreatic head and body in 1 case.Main CT findings were such as following:(1)Hematomas in pancreas or in pancreatic surrounding tissues were shown in 6 cases,they were hyperintensity or slight hyperintensity in plain scan and were not enhanced in three-phase dynamic scan of pancreas.(2)Pancreatic splits,which were relative hypointensity after administration of CT contrast agent in the pancreatic phase,were found in 6 cases,they were like slit-shaped or wedge-shaped or pancreas separated completely in situs.In the pancreatic phase,pancreas parenchyma enhanced obviously but hematoma in the splits did not enhanced,and this drew the outline of pancreatic splits clearly.(3)Contrast agent in the pancreatic hematomas,which leaked from vessels of pancreas,were shown in two patients,like dot or nodule or pond,were highly intensity in artery phase,and there were more leaking of contrast agent in the pancreatic phase,whose intensity was same as abdominal aorta in the same slice image.In the delayed phase,the volume of leaking contrast agent enlarged and they had higher intensity while intensity of abdominal aorta in same slice image decreased obviously.(4)Dilation of the Wirsung duct,which was like curved-tube,was shown in one patient.(5)Meanwhile the contusion of liver,kidney or spleen with pancreatic rupture were found in 4 patients.Conclusion The pancreatic rupture has typical CT findings.It is helpful to improve the accuracy rate of diagnosis with reasonable scanning techniques and understanding correctly CT appearances of pancreatic rupture.