CT and MR findings of retroperitoneal ectopic pheochromocytoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the CT and MR findings of retroperitoneal ectopic pheochromocytoma.</p><p><b>METHODS</b>To analyze retrospectively the CT and MR images of 32 patients with retroperitoneal ectopic pheochromocytoma proved by pathology.</p><p><b>RESULTS</b>The lesions (benign=28, malignant=4) were located in the anterior pararenal space (ARS) (n=12), the perirenal space (PS) (n=13) and the posterior pararenal space (PRS) (n=7). The tumors showed heterogeneous density on unenhanced CT (n=25). Among the 23 cases with enhanced CT imaging, 19 cases had marked contrast and 4 had mild contrast. The enhancement patterns included whole enhancement (n=9), solid area enhancement (n=12), peripheral enhancement (n=1), and spotted enhancement (n=1). The tumors had heterogeneous signal on unenhanced MR (n=23), and usually showed enhancement at arterial, portal and delayed phases on 22 enhanced MR, while cystic area with no enhancement. The lesions usually had cystic changes (n=18), septa (n=16), vessels inside (n=9), hemorrhage (n=3), and calcification (n=3). Besides that the morphology had statistical significance (P=0.013), other indexes had no statistical significance (P>0.05) in differential diagnosis of benign and malignant retroperitoneal ectopic pheochromocytomas.</p><p><b>CONCLUSIONS</b>Retroperitoneal ectopic pheochromocytomas have some CT and MR features, usually revealed as an oval mass, growing along the paravertebral axis, and often with cystic changes. Those signs combined with hypertension and elevated catecholamine level may lead to a correct diagnosis.</p>

Evaluation of CT findings for the differentiation of benign from malignant primary retroperitoneal tumors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Benign and malignant primary retroperitoneal tumors (RT) have different pathological manifestations, and overlapping imaging characteristics. This study aimed to evaluate the value of computed tomography (CT) for differentiating benign from malignant RT.</p><p><b>METHODS</b>One hundred and ninety-four patients with clinical and radiographic data were evaluated retrospectively following surgical resection of primary RT. There were 38.1% (n = 74) benign lesions and 61.9% (n = 120) malignant lesions. Categorical variables were tested with a chi-square test or Fisher's exact test for the diagnostic indexes and sensitivity and specificity of CT characteristics.</p><p><b>RESULTS</b>In univariate analysis, the differences in ill-defined margins, irregular surfaces, long diameter >6.75 cm, short diameter >6.25 cm, and solid or mixed texture had statistical significance; the sensitivity and specificity were 44.2% and 91.9%, 70.0% and 62.2%, 68.8% and 60.7%, 59.7% and 74.2%, 87.5% and 35.1%, respectively. In multivariate analysis, a combination of all the above indexes was the best model for differentiating malignant tumors, resulting in the most accurate diagnosis of malignancies with a sensitivity of 77.2% and a specificity of 81.1% (P < 0.0001) when the score was 4. The differences in other findings including CT attenuation, number, and calcification had no statistical significance. The unique characteristics included the spotted enhancement (mottled high density) in schwannoma (P < 0.0001), adipose tissue in liposarcoma (P < 0.0001) and paravertebral location in neurogenic tumors (P < 0.0001).</p><p><b>CONCLUSIONS</b>More accurate differential diagnosis of primary RT can be made through comprehensive analysis of the combined diagnostic indexes of CT. Some specific characteristics of CT can assist in preoperative planning.</p>

Correlation of perfusion CT findings with microvessel density and vascular endothelial growth factor expression in renal cell cancer / 中华泌尿外科杂志

Objective To study the perfusion imaging features of renal cell cancer(RCC) and their correlation with microvessel density(MVD) and vascular endothelial growth factor(VEGF) ex-pression status. Methods Dynamic contrast-enhanced multislice spiral CT was performed preopera-tively in 73 cases with histologically proven RCC (65 cases of clear cell carcinoma, 3 of papillary ade-nocarcinoma, and 5 of chromophobic carcinoma). Blood volume (BV), blood flow (BF), mean transit time (MTT), and permeability surface area product (PS) of tumors were recorded. MVD and VEGF expression status were studied by immunohistochemial staining. Results The mean BV, BF, MTT negative in 35 (47.9 %) cases, slightly positive in 24 (32.9 %) cases, moderate positive in 10 (13.7 %) cases, and intensively positive in 4 (5.5 %) cases. MVD of RCC was positively correlated with BV, BF and PS (P<0.01),and negatively correlated with MTT (P<0.05). No relationship was found be-tween the expression of VEGF and perfusion CT parameters. Conclusion Perfusion CT scan is use-ful to evaluate the angiogenesis status of RCC.

Evaluation of CT scanning in detecting pelvic lymph node metastasis in uterine cervix carcinoma / 中华妇产科杂志

ely in patients with uterine cervix carcinoma. The sensitivity is rather higher according to diagnostic criteria of most diameter ≥10 mm.

Imaging features and surgical treatment of chromophobe renal cell carcinoma / 中华泌尿外科杂志

Objectiye To improve the diagnosis and treatment of chromophobe renal cell carcinoma(CRCC). Methods The clinical dota of 25 patients of CRCC were reviewed.Thirteen were xmales and 12 were females and thirteen on the left and twelve on the right.The mean age was 51 years.Sixteen(64%)patients were asymptomatic.Gross hematuria,low back pain and discomfort and fever occurred in the other 9 patients.Laboratory investigations showed 1 patient had raised alanine aminotransferase and 1 had high erythrocyte sedimentation rate. Results B-ultrasound was mainly characterized by low echo renal mass with intact capsule and low blood flow signals.CT and MR of CRCC were typically well circumscribed,homogeneous(unenhanced CT was 70%,MR was 73%)with no necrosis and hemorrhage,homogenous enhancement(CT was 65%,MR was 67%)and mild enhanced(CT was 65%,MR was 67 %)renal mass.Twenty-two patients with tumors＞4.0 cm had radical nephrectomy and three with tumors≤4.0 cm had partial nephrectomy.The average diameter of tumors was 7.6 cm.The cross-sections of the tumors were grossly homogeneous,pale or dark brown solid.Light microscopy showed that the tumors were composed of trabeculae or sheets with voluminous cells in pale or eosinophilic cytoplasm.Immunohistochemical assay was positive of CK8 and negative of Vimentin.The pathologic TNM stages were 8 with T1a,9 with T1b,6 with T2 and 2 with T3a.Twenty-three patients were followed up.After mean follow-up of 28 months,22 cases were tumor free.One patient had pulmonary metastasis 58 months after operation and had no reaction to interferon-α and chemotherapy and died. Conclusions The majority of CRCC patients are asymptomatic and usually with low-stages.There are some features in CT and MR appearance of CRCC such as well circumscribed and homogenous.Surgical treatment should follow the treatment principles of renal cell carcinoma and carries an excellent prognosis for most localized tumors but there has been no effective measures to treat metastasis disease.The interval between operation and metastasis is relatively long and the time of follow-up should be prolonged in CRCC.

Diagnostic significance of ultrasonography and CT for large upper abdominal mass / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the effect of ultrasonography and computerized tomography (CT) in the diagnosis of large upper abdominal mass.</p><p><b>METHODS</b>Data from 43 cases that were clinically and pathologically confirmed were retrospectively analyzed and the effect of their preoperative ultrasonography and CT was compared.</p><p><b>RESULTS</b>Four of 10 (40 percent) cases of liver mass were diagnosed correctly using ultrasonic device, nineteen of 25 (76 percent) cases of adrenal gland mass and 2 of 4 cases of kidney mass. Two of 10 (20 percent) cases of liver mass were correctly diagnosed by CT, and so were 6 of 22 (27.2 percent) cases of adrenal gland mass. In 4 patients with spleen mass, neither ultrasonography nor CT diagnosis was correct.</p><p><b>CONCLUSION</b>Because upper abdomen organs are closely connected with each other, correct imaging localization of a large mass in this region is not easy. In this study, we compared the accuracy of ultrasonography and CT in diagnosing large upper abdominal masses, and found that ultrasonography works better for adrenal rather than liver or kidney. Neither ultrasonography or CT could accurately diagnose a large mass in the spleen.</p>