ABSTRACT
Objective To investigate the feasibility of differentiating lymph node metastases of four types of primary tumors (lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma) using gemstone spectral imaging (GSI) . Methods Three cases with lymphoma (28 lymph node), five cases with lung adenocarcinoma(30 lymph node), four cases with lung squamous cell carcinoma(24 lymph node) and two cases with cholangiocarcinoma( 10 lymph node) were evaluated by germstona spectra imaging CT scans. Imaging protocol included unenhanced conventional CT scan (120 kVp) ,enhanced GSI (80/140 kVp) on arterial phase and conventional CT scan (120 kVp) on portal phase. CT attenuation values of lymph nodes in the monochromatic images at 11 sets of keV levels (40-140 keV, 10 keV step) and the iodine and water contents of these lymph nodes were measured. All results were analyzed with ANOVA and t test. Results The optimal monochromatic level was 70 keV for the optimal contrast-noise ratio (CNR) of metastatic lymphadenopathy. The CT attenuation values of metastatic lymphadenopathy were (81.36 ±9. 81 ), (58.33 ± 21.55 ), (56. 47 ± 10.62) and (73. 57 ±4. 43 ) HU,respectively, at 70 keV( F = 17.29, P ＜0. 01 ). There were significant differences in CT attenuation values between lymphoma and lung adenocarcinoma, between lymphoma and lung squamous cell carcinoma and between lung squamous cell carcinoma and cholangiocarcinoma (P ＜ 0. 05 ). The differences in CT attenuation values were significant between cholangiocarcinoma and lung squamous cell carcinoma, between cholangiocarcinoma and lymphoma ( P ＜ 0. 05 ). There was no difference in CT attenuation values at all 11 sets of keV levels between lung squamous cell carcinoma and lung adenocarcinoma ( P ＞ 0. 05 ). The iodine contents of lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma were ( 1. 93 ± 0. 04 ), ( 1.16 ± 0. 15 ), ( 1.25 ± 0. 21 ) and ( 1.44 ± 0. 04 ) g/L, respectively. The water contents of lymphoma, lung adenocarcinoma, lung squamous cell carcinoma and cholangiocarcinoma were (1029.40 ± 20. 85), (1024.98 ± 11.19), (1022.12 ± 12. 94) and (1030.87 ± 10.10) g/L,respectively. Except between lung squamous cell carcinoma and lung adenocarcinoma, the differences in the iodine contents of metastatic lymphadenopathy were significant among tumors ( P ＜ 0. 05 ). There was no difference in the water contents of metastatic lymphadenopathy among tumors ( P ＞ 0. 05 ). Conclusions Although CT spectral imaging fails to differentiate metastatic lymphadenopathy of lung adenocarcinoma and lung squamous cell carcinoma, it is also a promising method of distinguishing metastatic lymphadenopathy of malignant tumors by CT attenuation values in monochromatic images and iodine contents in material density images. The optimal monochromatic level was determined to be at 70 keV for providing the optimal CNR of metastatic lymphadenopathy.
ABSTRACT
Objective To investigate the value of CT in localization diagnosis of the neoplasm of the transverse mesocolon.Methods 26 cases of neoplasm of the transverse mesocolon proved by surgical pathology or pathology from May 1998 to Dec.2007 were retrospectivley studied.All cases underwent CT scan.Image analysis was focused on the relation between neoplasm and SMA,SMV,middle colonic vessels,duodenum,and the small bowel.Readipose sarcoma (n=1),transverse colonic carcinoma invaded the transverse melocolon (n=2),pancreatic carcinoduodenum in 22 cases.Superior mesenteric artery and vein were displaced in 21 cases;middle colonic vessels were showed different CT manifestation.Conclusion The relation between neoplasm and adjacent structure is helpful for the localizing neoplasm of the transverse mesocolon.
ABSTRACT
Objective To investigate the correlation of the expression of vascular endothelial growth factor(VEGF) and microvessel density(MVD) value with spiral CT(SCT) features in lung carcinoma.Methods Pre-and post-enhanced SCT scans were performed in 41 cases of lung carcinoma proved surgically and pathologically.There were 29 men and 12 women.22 cases were peripheral lung carcinoma,and 19 cases were central lung carcinoma.SCT characteristics of all cases were analyzed and recorded.SP immunohistochemical technique was experimented on each pathologic specimen.The enhanced range of lesions and the expression of VEGF,MVD value were analyzed using stepwise regression.Chi-square test was performed to determine the correlation between the expression of VEGF,MVD value and CT features in peripheral lung carcinoma.Results CT enhanced degree of lesions increased with the increased level of positive expression of VEGF and MVD value by stepwise regression analysis(standardized coefficients were 0.498 and 0.399,respectively,P3cm in diameter were significantly higher than those of the group with tumor size ≤3 cm.The MVD value increased significantly in cases with deep lubulation sign,spiculate protuberance and vessel convergence(P
ABSTRACT
Objective To study the correlation between the features of peripheral lung carcinoma on spiral CT(SCT) and bFGF expression and angiogenesis. Methods 22 cases of peripheral lung carcinoma proved pathologically and examined with CT(SCT) both plain scan and contrast-enhanced scan were analyzed retrospectively . The expressions of bFGF and angiogenesis were detected with immunohistochemical SP method. The SCT features were compared with immunohistochemical results such as bFGF expression, microvessel density (MVD). Results The positive expression of bFGF was 59.9%, and the mean MVD was 46.10?18.18. There was significantly positive correlation between bFGF and MVD (P
ABSTRACT
Objective To study the correlation between the contrast enhancement features on spiral computed tomography (SCT) and different clinicopathological characteristics in hepatocellular carcinoma (HCC).Methods Fifty cases (54 lesions) of HCC proved pathologically and examined with enhancement dual-phase SCT scanning (arterial phase and portal vein phase) were included in this study. The SCT features and the clinical details about resection and pathological differentiation were recorded. All the features of SCT were compared with some clinical and histopathological characteristics of HCC.Results The features of SCT were correlated with pathological characteristics of HCC. The pseudocapsula patterns were related with Edmondson's grade, and the enhancement patterns were associated with the diameter of tumor and intratumoral necrosis. There was a significant correlation between the high infiltration and severity (intrahepatic daughter foci, tumor-emboli in portal veins, lymphatic metastasis) on the SCT images and the diameter of tumor. The same correlation was found between the diameter of tumor on the SCT images and AFP value, and also between hepatic cirrhosis on the SCT images and HBsAg, the diameter of tumor.Conclusion This research confirms that SCT features are correlated with some clinicopathological characteristics of HCC.
ABSTRACT
Objective To evaluate the correlation between the contrast enhanced features on spiral computed tomography(SCT) and microvessel density(MVD),TP,TGF-?_1 expression.Methods Forty seven cases with hepatocellular carcinoma(HCC) proved pathologically were examined with enhanced dual-phase SCT scanning at the arterial phase and the portal vein phase.The SCT features including the size of HCC lesions,enhanced patterns,capsule patterns,the diameter of tumor,intrahepatic daughter foci and tumor-emboli in portal veins were studied.The expression of TP,TGF-?_1 and MVD were detected by immunohistochemical SP method.The enhanced features of SCT were compared with the immunohistochemical results and clinicopathological characteristics of HCC.Results TP and MVD were correlated with metastasis and capsule patterns(P0.05).Conclusion The expression of TP,TGF-?1 and angiogenesis of HCC can be evaluated by some SCT features in a certain degree.