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Objective:To evaluate the safety and long-term effectiveness of endoscopic foam sclerotherapy (FS) combined with endoscopic rubber band ligation (ERBL)in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids.Methods:Consecutive patients diagnosed as having grade Ⅱ-Ⅲ internal hemorrhoids in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2020 were prospectively enrolled in the study, and randomly divided into ERBL group and FS combined with ERBL group. The 24 h visual analogue scale (VAS) for pain and 1-week degree of bleeding were evaluated after the treatment. After follow-up of 6 months, the effectiveness of treatment was evaluated.Results:A total of 84 patients with age of 54.4±7.9 years were enrolled, 57.1% (48/84) males, and 73.8% (62/84)grade Ⅱ internal hemorrhoids. Forty-three patients were assigned to the ERBL group and 41 to the FS combined with ERBL group. There was no significant difference between the two groups in baseline data ( P>0.05). In the FS combined with ERBL group, the mean amount of polidocanol foam was 13.8±2.5 mL, the mean number of injection site was 4.7±1.2, and the median scores of VAS was 0 (0, 3), which was significantly lower than that of ERBL group [2 (0, 4), Z=-2.116, P=0.034]. The bleeding rate 1 week after treatment in the ERBL and FS combined with ERBL group were 20.9% (9/43) and 29.3% (12/41), respectively, and mild bleeding was the main symptom. There was no significant difference between the two groups in the bleeding degree ( U=807.0, P=0.378). After 6 months of follow-up, the total effective rates in the ERBL group and the FS combined with ERBL group were 81.4% (35/43) and 90.2% (37/41), respectively ( U=684.5, P=0.044). Conclusion:FS combined with ERBL can effectively relieve post-treatment perianal pain, and improve the long-term effectiveness.
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Objective:To investigate the effect of water-fat separation (Dixon) and spectrally selective attenuated inversion recovery (SPAIR) on fat suppression in the neck.Methods:From June to December 2018, 35 patients, including 16 males and 19 females, aged 23-75 (46±13) years old underwent MRI examinations of cervical vertebrae in Sir Run Run Hospital Affiliated to Nanjing Medical University. The imaging data of Dixon and SPAIR fat suppression scanning were prospectively collected. The scanning sequences included Dixon VIBE-T 1WI, SPAIR VIBE-T 1WI, Dixon TSE-T 2WI and SPAIR TSE-T 2WI. According to the subjective evaluation, the quality of fat suppression was divided into 0-4 grades. The cases with clear depiction of the thyroid tissue on Dixon or SPAIR were counted. Fisher exact test and paired t test or rank sum test were used to compare the noise, SNR and CNR of mandible angle, glottis, thyroid and sternoclavicular joint. Results:There were 29 cases of grade 0, 4 cases of grade 1, 2 cases of grade 2 on Dixon VIBE-T 1WI, 4 cases of grade 3 and 31 cases of grade 4 on SPAIR VIBE-T 1WI group, and the difference was statistically significant ( P<0.05); 28 cases of grade 0, 5 cases of grade 1 and 2 cases of grade 2 on Dixon TSE-T 2WI, 33 cases of grade 3 and 4 on SPAIR TSE-T 2WI, and the difference was statistically significant ( P<0.05). There were 35 cases with clear depiction of the thyroid tissues on DIXON and 4 cases on SPAIR VIBE-T 1WI ( P<0.05); there were 35 cases on DIXON and 3 cases on SPAIR TSE-T 2WI ( P<0.05). At the level of mandible angle, for the SNR of sternocleidomastoid muscle, SNR and CNR of splenius capitis muscle on VIBE-T 1WI, Dixon images were better than those on SPAIR images, and the difference was statistically significant ( P<0.05); the noise, SNR of sternocleidomastoid and splenius capitis muscle on TSE-T 2WI images were more than those in SPAIR images, and the difference was statistically significant ( P<0.05). At the level of glottis, the SNR of sternocleidomastoid muscle and levator scapulae muscle in the sequence of VIBE-T 1WI and Dixon images were significantly higher than those on the images of SPAIR ( P<0.05); the noise and SNR of sternocleidomastoid muscle on Dixon TSE-T 2WI images were significantly higher than those on the images of SPAIR ( P<0.05). At the thyroid level, the noise of Dixon VIBE-T 1WI image was less than that of SPAIR image, the SNR of sternocleidomastoid muscle and levator scapulae muscle on Dixon images was greater than that of SPAIR image, and the difference was statistically significant ( P<0.05); For TSE-T 2WI sequence, the SNR of sternocleidomastoid muscle on Dixon image was greater than that on SPAIR image, and the difference was statistically significant ( P<0.05). At the level of sternoclavicular joint, there were no significant differences for noise, SNR and CNR between the two groups ( P>0.05). Conclusion:Dixon outperforms SPAIR in obtaining better image quality and suppression effect in terms of neck MRI scanning.
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Objective:To explore the relationship between split-fat sign and entering and exiting nerve sign on MRI in nerve sheath tumors (NSTs) of extremities.Methods:The MRI data of 141 patients with benign soft tissue NSTs of extremities confirmed by operation and pathology from January 2014 to July 2018 in the Second Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The patients were divided into intramuscular and intermuscular groups according to the location of the tumors. The split-fat sign and entering and exiting nerve sign in the two groups were compared using χ 2 test. Results:There were 152 NSTs in 141 patients, including 41 intramuscular NSTs and 111 intermuscular NSTs. There were 48 split-fat sign and 14 entering and exiting nerve sign in intramuscular NSTs, while 9 split-fat sign and 190 entering and exiting nerve sign in intermuscular NSTs. Statistical analysis showed that there were statistically significant differences in split-fat sign (χ 2=55.545, P<0.001) and entering and exiting nerve sign (χ 2=26.969, P<0.001) between the two groups. Conclusion:The split-fat sign mostly appeared in intramuscular NSTs, and the entering and exiting nerve sign mostly appeared in intermuscular NSTs.
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Objective@#To explore the relationship between split-fat sign and entering and exiting nerve sign on MRI in nerve sheath tumors (NSTs) of extremities.@*Methods@#The MRI data of 141 patients with benign soft tissue NSTs of extremities confirmed by operation and pathology from January 2014 to July 2018 in the Second Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The patients were divided into intramuscular and intermuscular groups according to the location of the tumors. The split-fat sign and entering and exiting nerve sign in the two groups were compared using χ2 test.@*Results@#There were 152 NSTs in 141 patients, including 41 intramuscular NSTs and 111 intermuscular NSTs. There were 48 split-fat sign and 14 entering and exiting nerve sign in intramuscular NSTs, while 9 split-fat sign and 190 entering and exiting nerve sign in intermuscular NSTs. Statistical analysis showed that there were statistically significant differences in split-fat sign (χ2=55.545, P<0.001) and entering and exiting nerve sign (χ2=26.969, P<0.001) between the two groups.@*Conclusion@#The split-fat sign mostly appeared in intramuscular NSTs, and the entering and exiting nerve sign mostly appeared in intermuscular NSTs.
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Objective@#To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids.@*Methods@#Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy.@*Results@#A total of 108 patients were enrolled, including 62 males (57.4%) with mean age of 44.0±7.6 years. There was no significant difference in gender, age, or body mass index between the FS (n = 55) group and the LS (n =53) group. The total amount of lauromacrogol injection in the FS group was 3.7±0.9 mL, which was significantly lower than that in the LS group (8.0±2.2 mL, P<0.001). In the LS group, 8 patients (15.1%) developed bleeding after needle removal, which was significantly higher than that in the FS group [5.5%(3/53), P=0.022]. Significant pain was found in 2 patients (3.8%) in the LS group and 0 in the FS group (P= 0.025). The short-term cure rate and effective rate of the FS group were 87.3% (48/55) and 9.1% (5/55), while those were 69.8% (37/53) and 22.6% (12/53) in the LS group, respectively (P=0.046).@*Conclusion@#Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids.
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Objective To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids. Methods Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy. Results A total of 108 patients were enrolled, including 62 males ( 57. 4％) with mean age of 44. 0 ± 7. 6 years. There was no significant difference in gender, age, or body mass index between the FS ( n = 55) group and the LS ( n =53) group. The total amount of lauromacrogol injection in the FS group was 3. 7±0. 9 mL, which was significantly lower than that in the LS group (8. 0±2. 2 mL, P<0. 001). In the LS group, 8 patients (15. 1％) developed bleeding after needle removal, which was significantly higher than that in the FS group [5. 5％(3/53), P=0. 022]. Significant pain was found in 2 patients (3. 8％) in the LS group and 0 in the FS group (P= 0. 025). The short-term cure rate and effective rate of the FS group were 87. 3％( 48/55) and 9. 1％( 5/55) , while those were 69.8％ (37/53) and 22.6％ (12/53) in the LS group, respectively (P=0.046). Conclusion Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids.
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Objective To analyze the radiological imagines and SPECT imaging features of primary leiomyosarcoma of bone and to improve the diagnostic level. Methods The imaging data of 16 patients in our hospital from January 2009 to May 2018 were retrospectively analyzed by two senior musculoskeletal radiologists, and they were all proved by surgery and pathology. The location of the lesions, type of bone destruction, size, soft tissue mass, mineralization, pathological fracture and periosteal reaction were detected by radiography and CT. The types of bone destruction are osteolytic, cystic and mixed. Periosteal reaction was divided into codman triangle, layered periosteal reaction and spiculate periosteal reaction. The signal intensity of lesions, size, distruction of the bony cortex, soft tissue mass and peritumoral edema were detected by MRI.Signal intensity was divided into low signal,iso?signal and high signal by taking surrounding normal muscles as reference. Enhancement scan was used to detect the form of enhancement. SPECT bone scan: compared with normal bone, SPECT bone scan signals were higher than normal bone, which was called concentrated radioactivity. Results Among the 16 cases, located in tibia(5 cases), femur (4 cases), sacrum(1 case), pubis(1 case), ilium(1 case), thoracic vertebra (2 cases) and humerus(2 cases). Radiography showed osteolytic, cystic and mixed bone destruction, among which 8 cases were osteolytic, 2 cases were cystic, 4 cases were mixed, and 1 case was normal. On CT images, 9 cases were osteolytic, 6 cases with soft tissue masses, among which 3 cases with partial sclerosis rim (2 cases with pathological fractare and obviously enhanced), 1 case with mild bone expansion and soft tissue, 2 cases with partial sclerosis rim. Four cases were mixed, all with cortical bone destruction, penetration, 1 case with soft tissue mass and periosteal reaction, 1 case which in the long bone of the extremity was central in location with periosteal reaction. Two cases were obviously and heterogeneously enhanced atter the enhanced CT scanning (1 case with bone expansion). Two cases were cystic,all with cortical destruction and penetration,1 case with soft tissue mass,1 case with partial sclerotic rim;after the enhanced CT scanning,2 case were obviously and heterogeneously enhanced. The most of the MR imagines showed the iso?intensity signal(10cases) and/or lightly lower signal(3cases), lightly higher sign(2cases) on T1WI, inhomogeneous hyperintensity on T2WI (15cases),after injected contrast medium,the tumor was inhomogeneous enhancement(14cases)with the cysts, necrosis and hemorrhage in it,11 cases with soft tissue masses,12 cases accompanied by peritumoral edema. On SPECT bone scan,10 Cases showed significant concentrated radioactivity(1 case was circumferential) and 1 case was mild concentrated radioactivity. Conclusion PLB usually occurs in the lower extremities,more frequently at the distal end of the femur, the proximal end of the tibia. The mainly appearance are central situated and osteolytic destruction with mass of the soft tissue. Although PLB has some imaging features, it is difficult to differentiate it from malignant bone tumors. Multi?imaging modalities such as radiography, CT, MRI and SPECT may suggest the diagnosis.
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Objective To explore the MR findings of extra?abdominal desmoid?type fibromatosis and the related features of recurrence. Methods MRI and clinical data of 36 cases of extra?abdominal desmoid?type fibromatosis proved by surgical pathology were retrospectively reviewed between March 2010 and October 2016.The ages of the cases ranged from 10 years to 68 years. 14 males and 22 females were included with sex ratio 1∶1.57.the courses of the disease were varied from 1 day to 8 years. The stage was based on Church′s method. 3 cases were only with plain scan and other 33 cases with contrast enhancement. Sagittal or coronal T1WI, STIR?T2WI, PdWI and contrast enhanced T1WI in horizontal, sagittal and coronal view were examined on MR siganl 1.5T or 3.0T of GE Company. Two groups were divided based on the recurrence or not after surgery. The clinical and MR features were analyzed between the two groups with χ2 test, t test or Spearman rank correlation analysis according to the data characteristics. Results Compared with signal intensity of muscle, 34 cases were isointense and 2 cases isointense with hypointense area on T1WI; 34 cases were hyperintense and 2 cases hyperintense with hypointense area on T2WI. On contrast enhanced imaging, 22 cases were markedly enhanced, 7 cases moderately enhanced and 4 cases mildly enhanced.15 cases was with recurrence and 21 cases without recurrence. Infiltration of surrounding tissue was shown in 14 cases(38.9%), 13 cases with recurrence and 1 cases without recurrence. Band sign was shown in all cases. Tentacle sign was shown in 18 cases (50.0%), 15 cases with recurrence and 3 cases without recurrence. Split fat sign was shown in 12 cases (33.3%) and all without recurrence. Fascial tail sign was shown in 15 cases (41.7%), 13 cases with recurrence and 2 cases without recurrence. Hypointense ring around the tumor was shown in 21 cases (58.3%), 2 cases with recurrence and 19 cases without recurrence. The P value of tentacle sign, split fat sign, hypointense ring around the tumor, fascial tail sign and infiltration of surrounding tissue was less than 0.05. Gender, location and the degree of contrast enhancement was without difference of statistical significance between the two groups. There was significant correlation of the recurrence rate with the courses and the stage of the disease(χ2=7.264 , r=0.994 , P<0.05). Conclusions Tentacle sign, fascial tail sign and infiltration of surrounding tissue were attributed to the estimate of recurrence of extra?abdominal desmoid?type fibromatosis, and Be features contributes to the diagnosis and therapy of extra?abdominal desmoid?type fibromatosis.
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Objective@#To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy.@*Methods@#From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia.@*Results@#A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair.@*Conclusion@#Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.
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Objective To understand the effectiveness of peroral endoscopic myotomy(POEM)for achalasia and secondary severe malnutrition in children and the effectiveness of nutrition support before and after POEM.Method Treatment of POEM,nutrition support(tube feeding by percutaneous endoscopic gastrostomy three months before operation)in one case were recorded and analyzed.Results POEM was successful without any complication such as perforation,bleeding,and pneumoderm.The child suffered from fever after surgery,which was dissolved after symptomatic treatment three days later.Chest pain was relieved after changing position.The diet was changed from liquid to semifluid,and then to normal diet.The child did not have dysphagia.During the 6-month follow-up,the patient had normal diets by oral route.The weight was 32 kg before achalasia and decreased to 18 kg after 9 months(at admission);it then increased to 29 kg after short-time(12 days)parenteral nutrition and long-time(3 months)enteral nutrition by percutaneous endoscopic gastrostomy,and then the patient received POEM.His weight was 30,31,31,29,and 31 kg 1,4,6,9,and 13 months,respectively,after POEM.Conclusion POEM can effectively cure achalasia in pediatric patients and improve the quality of life.Rational enteral nutrition can improve nutrition status and facilitate a successful POEM.
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Objective To study MRI features of fibroma of tendon sheath(FTS)and giant cell tumor of tendon sheath(GCTTS), so as to improve the diagnosis and differential diagnosis of two lesions. Methods Seventeen patients with FTS and 27 patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. All patients were examined with MRI. The location, size, shape and the relationship with the surrounding tissue, the signal feature and enhancing pattern of the two groups were compared. Imaging features in the two groups were assessed and analyzed by using independent samples t test and Chi-square test. Results FTS were nodular or mass-like lesions(n=11). Few lesions appeared adjacent bone absorption(n=2). On T2WI, the lesions showed peripheral low signal ring(n=6)or internal mixed low-signal intensity of was striped or filamentous configurations(n=10). The volume of low-signal intensity accounted for more than 2/3 of the total lesion's volume(n=6). Enhanced T1WI, tumors revealed ring enhancement(n=6). GCTTS appeared mostly lobulated(n=16), common with adjacent bone compressive absorption(n=9). On T2WI, most of lesion had a peripheral low signal ring(n=22). Tumors revealed mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass(n=17), the area of low signal accounts for less than 1/3 of total neoplastic volume(n=18). On contrast T1WI, GCTTS appeared heterogenous enhancement. Statistical analysis showed that the shape of the lesion, the presence or absence of compressive bone absorption, the presence of a low signal ring around the lesion, the shape of the Low-signal in T2WI and the proportion, and the presence of circumferential enhancement(P0.05). Conclusion FTS and GCTTS has a different characteristic of MRI features. FTS were nodular or mass-like, T2WI signal was mixed low, the shape of the low-signal was striped or filamentous, accounting for more than 1/3 of total lesion's volume, enhanced T1WI, tumor shows ring enhancement;GCTTS appears mostly lobulated.Most of lesion has low signal ring, common with adjacent bone compress compressive absorption. T2WI, tumor reveals mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass. The area of low signal accounts for less than 1/3 of total neoplastic volume.
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Objective To explore the MRI characteristics of saddle transverse carpal ligament (TCL)of patients with idiopathic carpal tunnel syndrome (CTS). Methods The clinical diagnosis of 21 cases of idiopathic CTS patients (22 wrists) were retrospectively analyzed and as the idiopathic CTS group. Thirty two patients without CTS symptoms or TCL and volar soft tissue lesions (33 wrist joints) were selected as the control group. Patients in two groups were both conducted with sagittal and axial MRI scan of wrist joint to observe the form of the TCL, determine whether the TCL saddle and calculate the TCL palmar concave curvature and the median nerve compression rate. The differences of the morphology of the TCL of patients in two groups were compared by Chi?square criterion, and the difference of the TCL palmar concave curvature were compared by non parametric test. The relativity of TCL palmar correlation concave curvature and compression ratio of the median nerve of patients with idiopathic CTS was evaluated by the Pearson correlation analysis.Results The sagittal plane of patients with idiopathic CTS was upper, saddle shaped TCL was dented to the palmar and the concave point most frequently located in the hamate hook. Thirty one patients were with saddle shaped TCL (20 patients with idiopathic CTS and 11 patients in the control group) and 24 patients were with non saddle shaped TCL (2 patients with idiopathic CTS and 22 patients in the control group) as the standard of saddle shaped TCL concave 0.25 mm and the difference of the morphology of the TCL of patients in two groups had statistical significance (χ2= 17.791, P<0.01). The median of TCL palmar concave curvature of patients with idiopathic CTS and patients in the control group was 8.49%and 0.00%, respectively, the difference of which was statistically significant (Z=-4.79, P<0.01). The level of the median nerve, the TCL palmar concave curvature [(7.88+4.28)%] and the median nerve compression rate [(39.36 + 19.43)% ] of patients with idiopathic CTS were positively correlated (r=0.714, P<0.01). Conclusions Saddle shaped TCL is the characteristic manifestation of patients with idiopathic CTS. The TCL sagittal concave palm and median nerve compression percentage rate are both helpful to the accurate diagnosis.
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Discoidin domain receptor 1(DDR1)is a kind of receptor tyrosine kinases(RTKs),which is expressed abnormally in many tumors. It is involved in the development,invasion and metastasis process of tumors and may become a potential target of tumor therapy. This article reviewed the expression and significance of DDR1 in tumors of digestive system.
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Objective To evaluate the value of MR threedimensional arterial spin labeling (3D-ASL) perfusion imaging and intravoxel incoherent motion(IVIM) DWI in differential diagnosis and quantitative analysis of musculoskeletal tumors.Methods Forty-four patients with musculoskeletal tumors were included.According to pathologic results,there were 12 cases of benign tumors,10cases of intermediate tumors and 22 cases of malignant tumors.3D-ASL and IVIM DWI were both performed on forty-four patients to gain tumor blood flow (TBF),standard ADC (ADCstandard),slow ADC (ADCslow)and fast ADC (ADCfast).Immunohistochemical staining of specimens was performed by using CD34 monoclonal antibody to calculate microvessel density (MVD) counts.MVD,TBF,ADCfast and ADCslow of different groups were compared by one-way ANOVA analysis.ADCstandard was compared by Kruskal-Wallis test.ROC curve was used to analyze ASL and IVIM DWI,in order to determine the threshold and diagnostic reliability.Results The MVD of benign tumors was 10±4,the MVD of intermediate tumors was 15±6,and malignant tumors was 33 ± 1 1.There was significant difference among three groups of MVD(F=28.33,P＜0.05).There was better intra-observer agreement for ADCstandard,ADCfast,ADCslow and TBF(ICC=0.970,0.885,0.778,0.891,respectively,P＜0.05).The TBF of benign tumors was(30±10)ml· min-1· 100 g-1,intermediate tumors was(30± 12) ml·min 1· 100 g-1,and malignant tumors was(84±29)ml·min 1· 100 g-1.There was significant difference among three groups of TBF(F=32.34,P＜0.05).According to the ROC analysis,when the cut-offvalue of TBF was 45.5 ml·min-1· 100 g-1,the area under ROC curve was 0.95 1,and the sensitivity and specificity of TBF in diagnosing malignant tumors were 90.9％ and 95.5％ respectively.There was no significant difference among three groups of ADCstandard,ADCfastand ADCslow of benign tumors were(9.9±5.1)× 10-3,(1.9±0.5) × 10-3mm2/s respectively.ADCfast and ADCalow of intermediate tumors were(8.2 ± 3.6) × 10-3,(1.5 ± 0.6) × 10-3mm2/s respectively.ADCfast and ADCalow of malignant tumors were (16.9 ± 5.8) × 10 3,(1.4 ± 0.6) × 10-3mm2/s respectively.There were significant difference of ADCfast and ADCslow among three groups (F=12.75,5.60,P＜ 0.05).According to the ROC analysis,when the cut-off value of ADCfast was 9.4× 10-3mm2/s,the area under ROC curve was 0.861,the sensitivity and specificity of them in diagnosing malignant tumors were 95.5％ and 68.2％ respectively.Conclusion 3D-ASL and IVIM DWI are valuable in the differential diagnosis of musculoskeletal tumors.
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Objective To explore the relationship between the tumor angiogenesis index (microvessel density,MVD)and biological behavior of the tumor.To analyze the correlations between TBF,standard ADC,fast ADC,slow ADC and MVD counts.Methods From March 2013 to June 2013,a total of 40 patients were involved in the study.3D-ASL and IVIM DWI were both performed on patients with musculoskeletal tumors.TBF,standard ADC,slow ADC,fast ADC were measured by regions of interest.Immunohistochemical staining of specimens were performed by using CD34 monoclonal antibody to calculate MVD counts.Group differences in MVD were assessed by using one-way ANOVA.The correlations between TBF,standard ADC,fast ADC,slow ADC and MVD counts were evaluated using Pearson correlative analysis.Results The MVD of benign tumors was (10.38±4.58)/0.26 mm2,the MVD of intermediate tumors was (14.64±6.69)/0.26 mm2,and the MVD of malignant tumors was (32.97±11.61)/0.26 mm2.The differences of MVD among three groups were statistically significant (F=28.83,P＜0.05).The differences of MVD between benign and malignant group were statistically significant (P＜0.05),as well as intermediate and malignant group (p=0.000).There was a significant positive correlation between TBF and MVD (r=0.784,P=0.000),as well as the correlation between TBF and fast ADC(r=0.727,P=0.000).There was a moderate positive correlation between fast ADC and MVD (r=0.516,P=0.000).There were no significant correlation between slow ADC and MVD,or between standard ADC and MVD.Conclusion The MVD represents the angiogenesis of musculoskeletal tumors,reflecting biological behavior of the tumor.ASL and IVIM DWI can be applied to evaluate the angiogenesis of musculoskeletal tumors by reflecting MVD of musculoskeletal tumors in vivo as a completely noninvasive technique.
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<p><b>OBJECTIVE</b>To evaluate the controlled attenuation parameter (CAP) assessment of fatty liver and choose a cut-off value of hepatic steatosis more than 5%.</p><p><b>METHODS</b>Consecutive patients, 18 years or older, who had undergone percutaneous liver biopsy and CAP measurement were recruited from five liver healthcare centers in China. All enrollees were categorized as hepatic steatosis grade S0 (<5%) or S1 (5%). An M-probe equipped FibroScan 502 was used to capture CAP values. Receiver operating characteristic (ROC) curves were plotted, and the areas under (AU) the curves were calculated to determine the diagnostic efficacy. The CAP cut-off values at the optimal thresholds were defined by maximum Youden indices; sensitivity and specificity were also calculated.</p><p><b>RESULTS</b>A total of 332 patients were enrolled in the study, including 67 patients with non-alcoholic fatty liver disease (NAFLD) and 265 with chronic hepatitis B (CHB) viru: infection. The median age (inter quartile range, IQR) of the study cohort was 39.0 (32.0-50.5) years-old. There were 46 males (68.7%) in the NAFLD group, with a median age of 37.0 (28.0-45.0) years-old, and 182 males (68.7%) in the CHB group; the differences between the two groups in median age and male: female ratio did not reach statistical significance. Multivariate linear regression analysis identified steatosis grade and body mass index (BMI) as independently associated with CAP. The median (IQR) CAP values among patients with S0 and S1 grade steatosis were 215.0 (190.0-241.0) dB/m and 294.0 (255.0-325.5) dB/m (P<0.001), respectively. For all patients, when BMI was <25 kg/m2, the ability of the AUROC of the CAP to discriminate hepatic steatosis more than or equal to 5% was 0.853, and the optimal cut-off value was 244.5 dB/m; however, when BMI≥25 kg/m2, the AUROC was 0.835 and the optimal cut-off value 269.5 dB/m.</p><p><b>CONCLUSION</b>CAP can identify hepatic steatosis more than or equal to 5% and is applicable for the diagnosis of fatty liver if it is adjusted for BMI.</p>
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Adult , Female , Humans , Male , Middle Aged , Area Under Curve , Bile , Biopsy , Body Mass Index , China , Fatty Liver , Hepatitis B, Chronic , Linear Models , Multivariate Analysis , ROC Curve , Tissue ExtractsABSTRACT
Background:Pancreatic cancer is obscure in onset and progresses rapidly with very poor prognosis. Photodynamic therapy( PDT)has been developed as a novel anti-tumor treatment modality since 1980s. At present,there are only limited researches on pancreatic cancer treated with PDT in vivo. Aims:To investigate the efficacy of quantum dots-RGD ( QDs-RGD)based PDT combined with gemcitabine for treatment of pancreatic cancer xenograft in nude mice. Methods:QDs-RGD probe was synthesized and nude mice bearing pancreatic cancer xenograft was established. Nude mice were imaged at 1,5,10 and 24 hours after injection of QDs-RGD and QDs by in vivo imaging system. Forty model nude mice were randomly divided into five groups:control group( without any treatment),simple illumination group( laser 630 nm, 120 J/cm2,20 min),PDT group(QDs-RGD 0. 5 nmol+laser irradiation),gemcitabine group(gemcitabine 50 mg/kg)and combination group(QDs-RGD 0. 5 nmol+laser irradiation+gemcitabine 50 mg/kg). All the nude mice were sacrificed 18 days later. Tumor weight and volume were measured and tumor inhibition rate was calculated. Results:Fluorescence of tumor was shown 1 hour after injection and became clearest at the 5th hour,then showing a decrescendo trend. Density of QDs surrounding tumor was significantly less than that of QDs-RGD and faded away at the 10th hour. Tumor weight and volume in PDT group,gemcitabine group and combination group were all significantly lower than those in control group and simple illumination group(P0. 05),as well as between PDT group and gemcitabine group(P >0. 05). Tumor inhibition rate in combination group,gemcitabine group and PDT group was 70. 5%,43. 5% and 37. 1%, respectively. Conclusions:QDs-RGD based PDT combined with gemcitabine can inhibit the growth of pancreatic cancer xenograft in nude mice,which introduces a new idea to the treatment of pancreatic cancer.
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Integrins are a family of cell adhesion receptors that mediate cell-cell and cell-extracellular matrix adhesion, and interact with cytokines through a bidirectional signal transduction,thus regulating the biological behavior of pancreatic cancer cells,such as proliferation,apoptosis,invasion,and migration etc. Molecular and animal studies indicated that integrins targeted methods might benefit the early diagnosis and drug therapy of pancreatic cancer,which offered a new approach for the study of diagnosis and treatment of pancreatic cancer.
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Objective To determine the expression of TM4SF1 mRNA in 5 human pancreatic cancer cell lines,and investigate its effect on the proliferation,migration and invasion of pancreatic cancer cells.Methods The expression of TM4SF1 mRNA in MPanc96,MiaPaCa-2,PANC1,AsPC-1,HPAC cells was determined by qRT-PCR,and the results were compared with that of human pancreatic ductal epithelial (HPDE) cells.RNA interference method was used to transiently transfect siRNA targeting at TM4SF1 and negative control siRNA into MPanc96,MiaPaCa-2 cells.The proliferation of cells were measured by MTS method,and migration and invasion of cells were determined by Transwell.Results The expression levels of TM4SF1 mRNA in pancreatic cancer cell lines MPanc96,MiaPaCa-2,PANC1,AsPC-1 and HPAC were 1.205 ± 0.073,1.096 ± 0.260,1.382 ± 0.075,1.374 ± 0.363 and 0.744 ± 0.096,which were significantly highly than that in HPDE (0.020 ± 0.003,P ＜ 0.01).Compared with cells transfected with negative control siRNA,the proliferation of MPanc96 and MiaPaCa-2 cells transfected with siRNA targeting at TM4SF1 was not significantly changed,but the migration abilitiy was decreased by (62.5 ± 7.6) ％ and (72.8 ± 4.0) ％,and invasion abilitiy was decreased by (69.5 ± 5.7) ％ and (78.6 ± 6.3) ％.Conclusions TM4SF1 is highly expressed in pancreatic cancer cells and appears to promote the migration and invasion abilities of the cancer cells.
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Objective To explore the imaging appearances of periprosthetic osteolysis after total hip arthroplasty(THA).Methods Imaging appearances of periprosthetic osteoleysis after THA in 24 cases confirmed by surgery and pathological examination were retrospectively analyzed.Twenty-four patients underwent X-ray examinations,and 17 of them underwent CT scanning additionally.Results (1) Location and type:Of the 24 cases with periprosthetic osteoleysis,23 femurs were involved (95.8％,expansile type in 15 cases and liner type in 8 cases).Lesions were located in Gruen 1-2 and 6-7 region (34.8％) in 8 cases,in Gruen 1 and 7 region in 8 cases (34.8％),in Gruen 1-7 region in 6 cases (26.0％),in Gruen 2-3 and 6 region in one case (4.3％).A total of 21 actabulums were involved (87.5％,expansile type in 14 cases and liner type in 7 cases included),with lesions located in Delee Ⅰ-Ⅲ in 14 cases (66.7％),in Delee Ⅰ and Ⅲ in 4 cases (19.0％),in Delee Ⅱ-Ⅲ in 2 cases (9.5％) and in Delee Ⅰ-Ⅱ in 1 case (4.8％).(2) Features of lesions:Adjacent cortex of the lucency lesion appeared irregular thin in 24 cases (100％),focally discontinuous in 18 cases (75.0％),disrupted in 16 cases (66.7％),and accompanied by a few tiny bony fragments in 10 cases (41.7％).Cortical thickening were seen near the lucency lesion in 3 cases(12.5％).Twenty-one cases (87.5％) presented with sclerotic margins,18 cases (75.0％) with crateriform interface.Of the 17 cases which underwent the CT scanning,16 cases (94.1％)had soft tissue mass.(3) Change of the prosthesis:Twenty-one cases (87.5％) presented with linear wear,11 cases (45.8％) with bony defect near the screw.The screw penetration was seen in 3 cases (12.5％),fractured screws were seen in 2 cases (8.3％),and screw invagination was seen in 1 case (4.2％),metal debris was seen in 12 cases (50.0％).(4) Complications:Nineteen cases (79.2％) presented with femur periprosthetic loosening,16 cases (66.7％) with actabulum periprosthetic loosening.Eleven cases (45.8％) presented with femur periprosthetic fractures,5 cases (20.8％) with actabulum periprosthetic fractures.Two cases (8.3％) had periprosthetic dislocation.Conclusions Linear or expansile lucent lesion of the bones around the prosthesis after THA,together with soft tissue mass and the imaging of linear wear can be diagnosed as the periprosthetic osteolysis.