Assessment of 64-slice spiral computed tomography angiography with image fusion for perigastric arteries anatomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical significance of 64-multislice spiral computed tomography angiography(MSCTA) with image fusion for the anatomy of perigastric arteries.</p><p><b>METHODS</b>A total of 53 patients underwent abdominal 64-MSCTA, among whom 26 patients with gastric cancer underwent gastrectomy. Using volume rendering techniques, computed tomography angiography(CTA) of perigastric arteries and the stomach were reconstructed respectively, and then the images were fused together. The branching pattern of the celiac trunk and the origins and courses along the stomach of the 10 perigastric arteries were assessed. The accuracy, sensitivity, and specificity of 64-MSCTA were determined based on intraoperative findings.</p><p><b>RESULTS</b>CTA clearly showed the celiac trunk. The most common branching pattern of the celiac trunk was Michels type I( in 46 patients(86.8%). The anatomy of perigastric arteries and stomach could be clearly demonstrated from any angle according to image fusion. The left gastric artery and the right gastroepiploic artery were shown in 100%, the left gastroepiploic artery 94.3%(50/53), the right gastric artery 83.0%(44/53), short gastric artery 58.5%(31/53), posterior gastric artery 49.1%(26/53), the replaced left hepatic artery 15.1%(8/53). The accessory left hepatic artery, accessory left gastric artery and replaced right hepatic artery were all identified in 7.5%(4/53) patients. The accuracy of preoperative CTA in term of correctly identifying perigastric arteries ranged from 84.6% to 100%, the sensitivity 82.6% to 100%, and the specificity was 100% for all the perigastric arteries.</p><p><b>CONCLUSIONS</b>64-MSCTA can clearly reveal individual perigastric arteries. The anatomy of the stomach and perigastric arteries can be shown in vivo by fused image, and can provide guidance for gastrectomy.</p>

Pilot study on MRI of human colon adenocarcinoma cells labeled with superparamagnetic iron oxide in vitro / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the feasibility of MRI of human colon adenocarcinoma cell line (Lovo) labeled with superparamagnetic iron oxide(SPIO) nanoparticles in vitro.</p><p><b>METHODS</b>Lovo cells (5 × 10(5) and 1 × 10(6)) were cultured in medium containing different SPIO nanoparticles (50 microl and 500 microl). Transmission electron microscopy was used to observe cellular ultrastructure and to determine the uptake and distribution of particles in Lovo cells at 1-, 3-, 6-hours. MRI of Lovo cells was performed with T1WI, T2WI sequences. Unlabeled cells were used as controls.</p><p><b>RESULTS</b>Uptake of SPIO nanoparticles occurred within 6 hours. On T1 weighted imaging, there was no significant difference in signal intensity between the experimental groups and the control group. On T2 weighted imaging, there was no significant difference in signal intensity between the experimental groups and the control group after culture of 1 h. Signal intensity began to decrease in 1 × 10(6) Lovo cells labeled with 500 microl SPIO nanoparticle after 3 hours culture. Signal intensity decreased in all the experimental groups after 6 hours culture.</p><p><b>CONCLUSION</b>Human colon adenocarcinoma cell line (Lovo) can be labeled with SPIO nanoparticles, and the labeled cells can be imaged with MRI equipment.</p>

Comparative study on imaging and pathological features of elastofibroma dorsi / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Elastofibroma dorsi has an extremely low incidence. At present, comparative study on imaging manifestations and pathologic findings of elastofibroma dorsi has not been reported in China. This study was to investigate clinical manifestations, computed tomography (CT) and magnetic resonance imaging (MRI) appearances, and pathologic features of elastofibroma dorsi and to improve preoperative imaging diagnosis of this disease.</p><p><b>METHODS</b>The clinical manifestations, imaging findings, and pathologic appearances of 6 cases of elastofibroma dorsi were retrospectively analyzed and related literatures were reviewed. All patients were examined with MRI, and 4 of them were examined with CT scan.</p><p><b>RESULTS</b>All patients were above 30 years old without obvious symptoms. The tumors presented as a lenticular soft-tissue mass in the deep subscapular region. The tumor's density on plain CT scan or signal intensity on MR T1-weighted image was approximately equal to that of muscle with some interlaced fat-like areas within mass suppressed by fat-suppression MR sequences, which corresponded to dense collagen tissue and interspersed mature adipose tissue observed microscopically.</p><p><b>CONCLUSIONS</b>CT and MRI can reflect the histological features of elastofibroma dorsi. On the basis of their imaging characteristics, a correct preoperative diagnosis of elastofibroma dorsi can easily be made.</p>

Application of 64MDCT multislice perfusion imaging in colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the correlation of time-density curves (TDC), parameters revealed by 64-multidetector-row CT (64MDCT) perfusion imaging with clinicopathological factors (staging, serosal invasion, lymph node metastasis, distant metastasis and CEA) in colorectal carcinoma (CRC).</p><p><b>METHODS</b>64 MDCT perfusion imaging was performed in 33 patients with pathologically verified CRC. TDC was created from the region of interest (ROI) drawn over the tumor, target artery and vein by 64MDCT with perfusion functional software. The parameters of individual perfusion maps included blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability-surface area product (PS). Tumors were staged according to TMN classification. TDC was classified according to their shapes. The correlation between CT perfusion parameters and clinicopathological factors was studied.</p><p><b>RESULTS</b>TDC of 64MDCT perfusion imaging could be classified into five types. TDC in different stages could demonstrate one or more types of the five types. There was no significant difference of CT perfusion parameters among different stages. BV and MTT were significantly higher in the patients with serosal invasion than in those without serosal invasion (t=-2.63,-2.24, P=0.0137, 0.0331, respectively). BV was significantly correlated with tumor size (r=0.41, P=0.02). BF and PS were not correlated with staging, serosal invasion, lymph node metastasis, distant place metastasis and CEA (all P>0.05).</p><p><b>CONCLUSIONS</b>64MDCT multislice perfusion imaging can reveal the blood perfusion of CRC and has potential value of clinical application.</p>

Evaluation of microvessel density and vascular endothelial growth factor in colorectal carcinoma with 64-multidetector-row CT perfusion imaging / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the correlation of 64-multidetector-row CT (64MDCT) perfusion imaging with microvessel density(MVD) and vascular endothelial growth factor(VEGF) in colorectal carcinoma.</p><p><b>METHODS</b>64MDCT perfusion imaging was performed in 33 patients with pathologically verified colorectal carcinoma. Time-density curves (TDC) were created from the region of interest (ROI) drawn over the tumor, target artery and vein by 64MDCT with perfusion functional software. The individual perfusion maps generated were for blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability-surface area product (PS). MVD and VEGF expression of surgical specimens were examined by immunohistochemical staining with anti-CD34, anti-VEGF monoclonal antibody. MVD and VEGF were compared among the different types of TDC in colorectal carcinoma. The correlation of CT perfusion parameters with MVD and VEGF was also examined.</p><p><b>RESULTS</b>TDC of colorectal carcinoma was divided into five types according to their shapes. MVD in the colorectal carcinoma was 22.61+/-9.01. VEGF staining was found in 25 of 29 tumors (86.2%). The score of VEGF expression was 4.15+/-1.09. No significant differences of MVD and VEGF expression among TDC types were found (F=2.59, 1.11, P>0.05). There were also no correlations of MVD and VEGF expression with any dynamic CT parameters (P>0.05).</p><p><b>CONCLUSION</b>64MDCT perfusion imaging, MVD and VEGF may reflect angiogenic activity, but no significant correlations are found among them.</p>

Comparative study of barium enema, computed tomography and magnetic resonance imaging in preoperative diagnosis of colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the diagnostic value of barium enema (BE), computed tomography (CT) and magnetic resonance imaging(MRI) in primary colorectal carcinoma.</p><p><b>METHODS</b>A total of 64 patients with suspected colorectal carcinoma received BE (n=39), spiral CT (n=31) and MRI (n=42). The detective results were compared with the surgical results.</p><p><b>RESULTS</b>Among 64 patients, 54 cases were pathologically proved as colorectal carcinoma. The diagnostic sensitivity of BE,CT and MRI was 96.9% ,96.2% and 97.1% ,and the overall accuracy was 92.3% 83.9 % and 90.5% respectively. The overall accuracy of CT and MRI for tumor T staging was 73.1% and 82.9% respectively.</p><p><b>CONCLUSION</b>BE can be considered as a primary approach for diagnosing colorectal carcinoma, CT and MRI be necessary diagnostic approaches. Combined BE with MRI is the best choice for diagnosing of colorectal carcinoma.</p>

Correlation between CT perfusion and vascular endothelial growth factor in neoplasm of head and neck / 中华放射学杂志

Objective To investigate the correlation between the CT perfusion and microvessel density (MVD),expression of vascular endothelial growth factor(VEGF)in neoplasm of head and neck.Methods Eighty-eight lesions of head and neck were scanned by spiral CT.The largest axial surface of the mass was searched on unenhanced imaging,and at this level the dynamic contrast enhanced scan series was acquired.Time-density curves (TDC)were created from circular or oval regions of the interest drawn over the mass,target artery by Toshiba Xpress/SX spiral CT with perfusion functional software.The parameters were measured including:peak height (PH ),peak time (PT ),mean transit time (MTT), contrast enhancement ratio(RPH),and perfusion flow (PF).Histopathological slides of 35 masses were carefully prepared for the anti-CD34 and VEGF immunohistochemical staining and tumor microvessel density and calculation of VEGF expression scores.The parameters of CT perfusion were correlatively study with MVD and VEGF.Results(1)The TDC of CT perfusion imaging could be classified into 3 types.The TDC of 53/77 (68.9% )malignant tumors presented the type with rapid ascending and rapid descending after injecting contrast.The TDC of 6/9 malignant lymphomas showed low platform curve。(2)The PF median of thyroid carcinoma was 82.2(41.0,183.4)ml?min~(-1)?100 g~(-1).There was significantly difference in the parameters of CT perfusion among thyroid carcinoma and squamaous cell cancer (Median 23.8 (7.0, 108.4)ml?min~(-1)?100 g~(-1))and lymphomas (Median 24.5(13.2,78.6)ml?min~(-1)?100 g~(-1)).(3) MVD in benign tumors was (44.7?3.4),and in malignant tumors,it is (49.6?14.8 ).There was no significantly difference in MVD between benign and malignant tumors.High VEGF expression was found in 15 malignant tumors and 1 benign tumors,low VEGF expression was found in 9 malignant tumors and 10 benign tumors.(4)There were no significantly difference in VEGF expression and MVD.There was good correlation between MVD (M 40.0 )and PH (M 26.9 ),RPH (M 14.5 ),PF (M 46.8 )(r = 0.35,45.49, 0.41 ).There was correlation between VEGF(M 4.0)and MTT(M 16.7 )(r = -0.41 ).Conclusion The TDC and CT perfusion could be helpful to differentiate benign from malignant tumors. CT peffusion in neoplasm of head and neck is correlated with MVD and VEGF,and may reflect MVD and expression of VEGF.

Analysis and prospects for major musculoskeletal imaging articles at home and abroad during the last decade / 中华放射学杂志

Objective To evaluate the situation of musculoskeletal imaging research at home and abroad and the disparity and consistency between them.Methods Statistic analysis was done with the musculoskeletal articles published in those journals during the last decade,including Chinese Journal of Radiology,Journal of Clinical Radiology,Radiology,American Journal of Roentgenology(AJR)and the British Journal of Radiology(BJR).Results The development of museuloskeletal imaging research was very imbalaneed among different areas and hospitals in China.The rate of clinical research treatise and imaging technique articles at home was 76.3%(357/468)and 10.0%(47/468),respectively,while that was 75.7%(731/966)and 10.8%(105/966),respectively abroad.The rate of MR image technique articles in China was lower than that abroad.The rate of articles on basic research at home and abroad was 5.3%(25/468)and 7.9%(76/966),respectively.The rate of articles about museuloskeletal imaging simply using CT or MR at home was 20.1%(94/468)and 29.7%(139/468),respectively,while that was 5.1%(49/966)and 60.4%(548/966),respectively abroad.The rate of articles about interventional therapy and synthetic imaging at home was 9.2%(43/468)and 29.3%(137/468),respectively,while that was 4.7%(45/966)and 22.5%(217/966),respectively abroad.With regard to the diseases category,the research focused on the bone tumors and the tumor-like disease in China,while in other countries,the research focus had been diverted to the trauma of bone and joint,and the anatomy and disease of muscle and ligament,which was unsatisfactory in China.More focus had been put on imaging anatomy, cartilage disease and osteoporosis in other countries than in China.The research on the radiation dosage the subject received in the examination,the apphcation of Micro-CT and Micro-MR to musculoskeletal imaging was developed in other countries,but it had not been reported in China.Conclusion Although great success has been achieved in the research of musculoskeletal imaging in the last decade,there is still much disparity comparing with other countries,and the research is very imbalanced among different areas and hospitals in China.We should emphasize the application of MRI to musculoskeletal system and pay more attention to the basic research and imaging anatomy research,especially the research on ligament,muscle and cartilage.

Single-dose three-dimensional dynamic contrast-enhanced MR angiography of soft-tissue hemangioma of limbs / 中华放射学杂志

Objective To investigate the feasibility and role of single-dose three-dimensional dynamic contrast-enhanced magnetic resonance angiography(SD 3D DCEMRA)in evaluating soft-tissue hemangioma of limbs.Methods The transit time(TT),signal intensity of peak enhancement(SPE)and duration of peak enhancement(DPE)of the femoral,popliteal and anterior tibial arteries at the level of the middle section were assessed in 30 healthy volunteers after intravenous bolus injection of single-dose contrast media at the rate of 3 ml/s.Forty-five patients with soft-tissue hemangioma and 9 patients with schwannoma of the extremities underwent both conventional MRI and SD 3D DCEMRA.The acquisition time of SD 3D DCEMRA ranged from 10 to 12 s,and early arterial,late arterial and venous phases of SD 3D DCEMRA images were acquired consecutively.The conventional MRI and SD 3D DCEMRA findings of the 45 patients with hemangioma were observed and compared with those of the 9 cases of sehwannoma.Results(1)The TT,SPE and DPE of the femoral,poplitcal and anterior tibial arteries were(15?5)s,(400?50),(11.9? 2.6)s;(19?7)s,(320?45),(16.8?3.6)s and(27?10)s,(270?39),(22.0?6.6)s respectively. The comparison of TT(F=6.91,P0.01).The tumoral feeding artery was visualized in all cases(100%).(3)Two cases of hemangioma missed on conventional MRI were correctly diagnosed on SD 3D DCEMRA owing to the visualization of both the tumoral mass and the feeding artery.(4)For schwannoma,neither the dynamic visualization of tumoral mass nor the feeding artery was demonstrated on SD 3D DCEMRA.Conclusion SD 3D DCEMRA is technically feasible to evaluate the limb soft-tissue hemangioma.Dynamic visualization of tumoral mass and demonstration of the tumoral feeding artery are the characteristic features of the tumor on SD 3D DCEMRA.

MRI diagnosis of myxoid liposarcoma of extremities / 中华放射学杂志

Objective To explore the clinical and MR imaging features of myxoid liposarcoma.Methods Clinical and MR imaging data of 7 patients with histologically confirmed myxoid liposarcomas on extremities were retrospectively analyzed.The age of the patients ranged from 41 to 59 years with a median age of 51 years.Results Three tumors occurred in thigh,two in calf,one in foot and one in shoulder.Six tumors were situated deeply,and one was superficial.On T_1-weighted images,all 7 tumors showed predominant isointense or slightly hypointense signals relative to muscle,with 6 having lacy,linear or amorphous loci of high signal intensity.The major portion of each tumor displayed hyperintense signals compared with fat on T_2-weighted images.Following the injection of Gd-DTPA,all tumors showed inhomogenous and strong enhancement.All tumors had septa and were well defined without obvious surrounding edema and invasion of the adjacent bones.Conclusion Myxoid liposarcomas usually show predominant isointense or slightly hypointense signals relative to muscle on T_1-weighted images and hyperintense signals relative to fat on T_2-weighted images.The fat components within the tumors may be identified as linear,lacy or amorphous foci of high signal intensity on T_1-weighted images.The contrast enhancement of the mvxoid liposarcomas is usually pronounced and heterogeneous.

Initial study of optimal single-voxel ~1H-MR spectroscopy parameters on femoral bone marrow / 中华放射学杂志

Objective To choose proper proton magnetic resonance spectroscopy(~1XH-MRS) parameters to fit for practical femoral marrow cavity and to produce short-timed,well-repeated and excellent ~1H-MRS images.Methods The tentative study of ~1H-MRS on the normal femoral bone marrow in 26 volunteers was performed with a 1.5 T MR after the informed consent.The single-voxel spectroscopy and stimulated echo acquisition mode were used for ~1H-MRS collection.~1H-MRS parameters for 12 volunteers were 128 acquisitions,1 cm?1 cm?1 cm volume of interest(VOI)size and repeatedly 2—3 times within the same location.~1H-MRS parameters for another:14 volunteers were different numbers of acquisition (128 and 256 times,respectively)and different VOI sizes(2 cm?2 cm?2 cm and 1 cm?1 cm?1 cm, respectively).Results For ~1H-MRS with 1 cm?1 cm?1 cm size of VOI and 128 times of acquisition with the full width haft max of water≤8—12 Hz,the base-line was steady and the signal-noise ratio was high up to 11.31.~1H-MRS was different in the different femoral locations showing the maximum peak sites at near 0.90 ppm(?10~(-6))or 1.65 ppm,but~1H-MRS within the same location was always same or similar with different VOI sizes(1 cm?1 cm?1 cm or 2 cm?2 cm?2 cm)or different numbers of acquisition(128 or 256 times).~1H-MRS acquisition time was not related with the size of VOI but with the numbers of acquisition.128 and 256 times of acquisition cost 199 s and 391 s,respectively.Conclusion With the technique of small size of VOI(1 cm?1 cm?1 cm)and decreased numbers of acquisition(128 times),it is propable to get well-repeated and excellent ~1H-MRS within less time.It is also more practical for clinics to achieve ~1H-MRS of the femoral marrow with the proper technique.

Primary carcinoid tumors of the pancreas:CT findings / 中华放射学杂志

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.

Differentiation of soft tissue lipoma from well-differentiated liposarcom on MRI / 中华放射学杂志

Objective To evaluate the value of magnetic resonance imaging features in differentiating soft tissue lipoma from well-differentiated liposarcoma.Methods MR images of 30 patients with histologically verified fat-containing tumors(22 lipomas and 8 well-differentiated liposarcomas)were retrospectively reviewed.Well-differentiated liposarcomas and benign lipomas were compared in terms of the size of the lesion,percentage of adipose component,number of thick septa,nodular and(or)patchy nonadipose component,contrast enhancement patterns and the margin characters of the lesion.Results The mean size of lipomas[(64?35)mm]was significantly smaller(t=4.263,P