Interpretation of CT images of pulmonary mucinous adenocarcinoma / 中国综合临床

Pulmonary mucinous adenocarcinoma (PMA) is relatively rare. On chest CT, it can be divided into two types: mass type and pneumonia type. Mass type PMA is more common and is difficult to distinguish from other nonsmall cell lung cancer. It is a solid or partial solid nodule or mass, predominantly located in the peripheral field of the lung with lobulation, spiculation, and more prone “vacuole sign”. Pneumonia type PMA has a poor prognosis and is more likely to develop into diffuse, multifocal and multilobular lesions similar to inflammatory manifestations, indicating dissemination along the airway. Typical signs include large areas of low density, low enhancement consolidation, and “dead tree sign”.

An investigation of comparison between TFE-EPI and TFE in non-enhanced coronary MR angiography on 3.0 T MRI / 中华放射学杂志

Objective:To investigate the feasibility of single breath-hold TFE-EPI in non-contrast coronary MRA on 3.0 T MRI.Methods:Both single breath-hold TFE-EPI and free breathing TFE were conducted in 23 healthy volunteers. Acquisition time between the two sequences were compared by paired- t-test analysis. Signal-noise-ratio (SNR), contrast-noise-ratio (CNR),image artifacts and distortion,vessel acuity were evaluated on the aorta(Ao), right coronary artery proximal(RCA-pro), right coronary artery middle (RCA-mid), left anterior descending proximal(LAD-pro) and left circumflex proximal(LCX-pro). Nonparametric analyses were conducted for the comparison. Results:The acquisition time decreased 96.51% in TFE-EPI compared with TFE [(16.3±2.2)s vs.(466.9±101.3)s, t=21.49, P<0.01]. There was no statistical significance in SNR comparison in all the vessel evaluation (all the P>0.05). TFE-EPI showed better CNR in RCA-mid than TFE ( Z=2.65, P=0.008). TFE-EPI showed less image artifacts and distortion in RCA-mid than TFE ( Z=2.00, P=0.046). TFE-EPI also showed better vessel acuity in both RCA-pro and RCA-mid than TFE ( Z=3.88, P<0.001; Z=3.42, P=0.001). Conclusion:Single breath-hold TFE-EPI could greatly shorten scan time while ensuring image quality in coronal artery imaging and has a broad application in future.

Imaging features of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions: comparison with chromophobe renal cell carcinoma / 中华放射学杂志

Objective:To compare the imaging features of renal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusion (Xp11.2 RCC) with chromophobe RCC.Methods:From November 2016 to January 2020, 28 patients with Xp11.2 RCC and 28 patients with chromophobe RCC confirmed by pathology were retrospectively analyzed in Peking University First Hospital. All 23 patients underwent preoperative CT examination, and 5 patients underwent routine MRI in each group. The clinical and imaging features were observed and recorded. The CT features including side, location, size, boundary, shape, uniform density, composition (solid, cystic-solid, cystic), hemorrhage, calcification, lymph node metastasis of the lesions and distant metastasis were observed, and the CT value of the solid part of the tumor at each stage was measured. On MRI images, the signal of the lesion in each sequence and enhancement mode were observed. The differences in clinical and imaging characteristics between the 2 groups were compared using independent samples t test or χ 2 test. Results:The Xp11.2 RCC more frequently affected young [(27±10) years] patients, while chromophobe RCC more frequently involved middle-aged [(37±7) years] patients asymptomatically, and the difference was statistically significant ( t=-4.99, P<0.001). The lesion size of Xp11.2 RCC [(5.4±2.2) cm] were significantly smaller than that of chromophobe RCC [(6.9±1.8) cm] ( t=-2.93, P=0.005). There were significant differences in the density and composition of lesions between Xp11.2 RCC and chromophobe RCC (χ 2=4.60, 18.67, P=0.032,<0.001). There were no significant differences in the side, location, boundary, shape, hemorrhage, calcification, fat, lymph node metastasis and distant metastasis between the 2 kind of lesions (all P>0.05). The CT values of solid components in Xp11.2 RCC in cortico-medullary phase and delayed phase were higher than those in chromophobe RCC, and the difference were statistically significant ( t=11.80, 20.15, both P<0.001). Five cases of Xp11.2 RCC showed iso- or slightly hyperintense signal on T 1WI and slightly hypointense signal on T 2WI. Two cases showed delayed enhancement after enhancement, and 3 cases showed a slight decrease in delayed phase enhancement. Conclusion:Compared with chromophobe RCC, Xp11.2 RCC has certain characteristics in imaging manifestations (lesion size, density uniformity, composition, CT value of post-enhanced cortico-medullary phase and delayed phase). Imaging manifestations combining the clinical manifestations (age of onset) are helpful for preoperative diagnosis of Xp11.2 RCC.

Interpretation of CT images of lung adenosquamous carcinoma / 中国综合临床

Lung adenosquamous carcinoma (ASC) is a rare histological subtype of lung cancer, which has a worse prognosis than simple lung adenocarcinoma and lung squamous cell carcinoma. ASC was predominantly located in the peripheral field of the lung with heterogeneous attenuation and the most common features included lobulation, spiculation, pleural tail sign, necrosis and cavitation on chest CT images. However, the imaging features of ASC are not specific. Therefore, acquring accurate pathological diagnosis and adequate treatment as soon as possible are very important.

Chest radiographic characteristics of community-acquired Legionella pneumonia in the elderly / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Legionella is an important community-acquired pneumonia pathogen. Although the elderly are especially susceptible to Legionella, few studies have looked at comparative radiographic features of Legionella pneumonia in this population. The aim of this study was to explore the chest radiographic characteristics of community-acquired Legionella pneumonia in the elderly.</p><p><b>METHODS</b>Serial chest radiographs obtained in 34 patients hospitalized with serologically proven Legionella pneumonia were retrospectively reviewed. Chest X-ray features of an aged group of ≥ 65 years were assessed and compared with a non-aged group of <65 years old with regard to initial patterns and distributions of pulmonary abnormalities, accompanying signs, and progression.</p><p><b>RESULTS</b>The most common initial presentation was a patchy alveolar infiltrate involving a single lobe, most often the lower lobe. There was no middle or lingular lobe involvement in the aged group patients, but bilateral pleural effusion was significantly more common in this group. In the aged group patients, radiographic progression following adequate therapy, despite a clinical response, was more often noted and the radiographs were less likely to have returned to the premorbid state at discharge, but the differences were not significant between the two groups.</p><p><b>CONCLUSION</b>The discrepancy between imaging findings and clinical symptoms seems more prominent in community-acquired Legionella pneumonia in the elderly.</p>

Surgical resection of primary retroperitoneal schwannoma / 中华普通外科杂志

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

Evaluation of the coronary collateral circulation with 64-sUce spiral CT: a comparative study with coronary angiography / 中华放射学杂志

Objective To evaluate the ability of 64-slice spiral CT(64-MSCT) in demonstrating the coronary collateral circulation(CCC).Methods Patients undergoing 64- MSCT coronary angiography with relatively good image quality from August 2005 to April 2007 were entered into the study according to following requirements: patients underwent a traditional coronary artery angiography (CAG) after the coronary CT imaging; the CAG showed there was stenosis greater than 90% in at least one major coronary artery.The CCCs were assessed in CAG by the Rentrop grading, and the CAG served as the gold standard to determine the accuracy of 64-MSCT angiography in detecting collateral circulations.All CCCs were grouped angiographieally into three groups of CC0, CC1 ,and CC2 by Werner collateral collection(CC) grading.In the 64-MSCT coronary angiography imaging, a new grading(MSCT-CC) was used to evaluate CCCs.The consistency between these two grading standards was analyzed by Kappa test.Resalts A total of 97 patients were entered into the study, among whom at least one CCC was found by CAG in 37 patients and at least one CCC was detected by 64-MSCT angiography.Taken the CAG results as the reference standard, the sensitivity and specificity of the 64-MSCT angiography in detecting patients with the CCCs were 89.2% (33/37) and 93.8% (60/64) respectively.The sensitivity of the 64-MSCT angiography detecting the CCCs was 75.8% (47/62). All the CCCs detected by CAG and 64-MSCT angiography were grouped into three groups according to Werner grading: 4 in CC0 group, 24 in CC1 group and 19 in CC2 group.The CCCs were grouped into three groups according to MSCT-CC: 7 in MSCT-CC0 group, 22 in MSCT-CC1 group and 18 in MSCT-CC3 group.The consistency of the two grading criteria was relatively high (Kappa = 0.857, P < 0.01).Conclusion 64-MSCT angiography can accurately evaluate the coronary collateral circulation.

Treatment of massive proteinuria in kidney transplant recipients by losartan / 中华器官移植杂志

Objective To analyze the efficacy and safety of losartan in the treatment of massive proteinuria in kidney transplant recipients.Methods All of the 82 patients were randomized in two groups:losartan group and control group(amlodipine group).Both of the groups were divided into two different subsets according to blood pressure control Twenty-four-hour proteinuria,serum creatinine,blood pressure and adverse effects were observed.Results Losartan and amlodipine had the similar effects on blood pressure control The 24-h proteinuria in losartan group at the end of the study was significantly lower than that at the baseline,and there was significant difference between the losartan blood pressure control subset and the losartan blood pressure un-control subseL The effective rate and significant effective rate in losartan group for massive proteinuria were higher than in control group.Conclusion T Losartan can be effectively and safely used for the treatment of massive proteinuria in renal transplant recipients independent of blood pressure.

Diagnostic performance of 64-channel multislice computed tomography in assessment of significant coronary artery disease in subjects suspected as acute coronary syndrome and stable angina / 北京大学学报(医学版)

Objective:To evaluate the diagnostic accuracy of 64-channel multislice spiral computed tomography(MSCT) in subjects with presentations suggestive of stable angina or acute coronary syndrome. Methods: Subjects received both 64-channel MSCT and coronary angiography, from Feb. 2006 to Feb. 2007, were enrolled for retrospective analyses. Results of the quantitative coronary angiography were used as the "Golden criteria", accuracy of 64-channel MSCT were evaluated in the overall sample, as well as in subjects suspected of stable angina and acute coronary syndrome. Results: A total of 120 subjects were enrolled in the analyses. On the patient level, the sensitivity, specificity, and accuracy of 64-channel MSCT in detecting significant stenoses were 92.5%, 50%, and 87.5%, respectively. The overall ROC area under curve was 0.71. On the artery level, sensitivity, specificity, positive predictive value, negative predictive value, and ROC area under curve of 64-channel MSCT were 69.9%, 83.8%, 81.1%, 73.7%, and 0.77, respectively. Further analyses showed the sensitivity, specificity, positive predictive value, negative predictive value, and ROC area under curve of 64-channel MSCT in subjects presenting as stable angina and in subjects presenting as acute coronary syndrome were as follows: 70.2% vs 69.2%, 76.2% vs 86.0%, 74.7% vs 85.6%, 71.9% vs 69.9%, and 0.73 vs 0.78. Conclusion: The accuracy rates of 64-chanel MSCT in subjects presenting as stable angina and in subjects presenting as acute coronary syndrome were similar.

Coronary artery stenosis: comparison study of CT angiography with 16-detector rows scanner and convention angiography / 中华放射学杂志

Objective To evaluate the accuracy of 16-detector row computed tomography coronary angiography in detection of hemodynamically relevant stenosis(≥50%) of the coronary artery. Methods Twenty-six patients undergoing both multi-detector row CT and conventional coronary angiography were included in this retrospective study. CT scan were obtained with collimation of 16 and rotation time of 500 ms. Retrospective electrocardiographic(ECG) gating was used for image reconstrution. The stenosis degree was detected with axial scanning and three-dimensional reformation. Results With the results of conventional coronary angiography as golden standard, the sensitivity, specificity, accuracy, positive predicted value and negative predicted value of the CT angiography in detection of hemodynamically relevant stenosis(≥50%) were 90.0%, 95.5%, 94.7%, 77.6%, and 98.2% respectively. Conclusion Sixteen-detector row computed tomography coronary angiography has high clinical value with evaluating hemodynamically relevant stenosis(≥50%) of coronary artery,and could be a significant guide for diagnosis and therapy of coronary heart disease.

The investigation of the 16-slice CT angiography in diagnosis of the coronary artery disease / 中国介入心脏病学杂志

1.5 mm were included for the analysis. The results were compared with catheter coronary artery angiography. Results In all patients, 16-slice CT were performed without complications. 1?267 segments were considered as stenosis by 16-slice CT. With the results of conventional coronary angiography as the golden standard, the sensitivity of 16-slice CT was 75.43% and its specificity was 95.88%. Its positive predicted value was 74.58% while its negative predicted value was 96.01% and its accuracy was 93.05% for stenosis of greater than 50%. Conclusion 16-slice CT provides a good visualization of the coronary tree in most patients, allowing accurate non-invasive detection of significant coronary stenosis.