ABSTRACT
@#【Objective】 To discuss the diagnostic value of LI- RADS（v2013） and the criteria proposed by AOS clinical guideline for small hepatocellular carcinoma. 【Methods】This retrospective trial included 289 liver lesions with diameter no more than 30 mm in 220 patients and 129 liver lesions diameter less than 20 mm in 106 patients. These patients all with chronic liver diseases had taken the examination of multi-layer spiral CT and/or high field MRI ，with pathology being the golden standard，to compare the diagnostic efficiency between LI-RADS（v2013）and AOS criteria， which included sensitivity ，specificity ，positive predictive value ，negative predictive value and their AUC values.【Results】① For lesions with diameter no more than 30 mm，the sensitivity，specificity，positive predictive value and negative predictive value of LI-RADS（v2013）for small hepatocellular carcinoma were 100%，67.53%，72.97%，100%，and the positive predictive value for score LR3 to LR5 in LI-RADS（v2013）were 50%，73.02% and 91.18% respectively， and the sensitivity，specificity，positive predictive value and negative predictive value of AOS criteria for small hepatocellular carcinoma were 54.81% ，92.21% ，86.05% ，70% respectively，and the AUC value of LI- RADS（v2013）and AOS were 0.83 ，0.74 respectively. ②For lesions diameter less than 20 mm，the sensitivity，specificity，positive predictive value and negative predictive value of LI- RADS（v2013）for small hepatocellular carcinoma were 100% ，73.56% ，64.62% ，100% ，and the positive predictive value for score LR3 to LR5 in LI-RADS（v2013）were 56.67%，83.33% and 63.64% respectively，and the sensitivity，specificity，positive predictive value and negative predictive value of AOS criteria for small hepatocellular carcinoma were 42.86%，93.10%，75% ，64.80% respectively，and the AUC value of LI- RADS（v2013） and AOS were 0.87，0.68 respectively.【Conclusions】The diagnostic value of LI-RADS（v2013）for small hepatocellular carcinoma was higher than AOS criteria. The sensitivity of LI- RADS（v2013）was much higher than AOS ，though the specificity was a little lower. However，the different treatment principles of LI-RADS（v2013）according to different scores can avoid excessive medical care，which can to a certain extent avoid the bad effect of its relatively lower specificity.
ABSTRACT
·AIM: To observe the therapeutic effect of visual perception training combined with total nutrition meal sequential therapy in the treatment of myopic amblyopia.·METHODS:Totally 73 children ( 135 eyes ) with myopic amblyopia were divided into control group ( 36 cases, 67 eyes) and treatment group (37 cases, 68 eyes) according to random number table. The control group were treated with traditional spectaculars and grating covering combined with fine eyesight training;the treatment group were treated with visual perception training combined with total nutrient meal sequential therapy. The visual acuity, diopter and average diopter of two groups were compared before and after treatment at 3, 6mo and 1a. The curative effect of two groups of children was compared after 1a treatment. And the adverse reactions were recorded in two groups during the treatment period. The recurrence rate of amblyopia in 1a follow-up was compared between two groups.·RESULTS: The difference of visual acuity between two groups was not significant at 3mo (P>0. 05). The visual acuity of the treatment group was significantly higher than that of the control group at 6mo and 1a (P<0. 05). There was no significant difference in diopter between the two groups after 3, 6mo and 1a (P>0. 05), but the average annual refractive changes in the treatment group were significantly lower than that in the control group ( P<0. 05). The basic cure rate and total effective rate of the treatment group were significantly higher than that of the control group (P<0. 05). There were no severe adverse reactions occurred between two groups during the treatment period. The recurrence rate of amblyopia in the treatment group was significantly lower than that in the control group (P<0. 05) after 1a follow-up.· CONCLUSION: Visual perception training combined with total nutrition meal sequential therapy in the treatment of myopic amblyopia in preschool children can significantly improve patients' visual acuity, reduce the average annual diopter changes, improve the therapeutic effect, reduce the recurrence rate of amblyopia.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the diagnostic value of 3.0 T diffusion-weighted imaging with background suppression (DWIBS) magnetic resonance (MR) for lymph node metastasis in rectal cancer.</p><p><b>METHODS</b>Thirty-five patients with rectal cancer who underwent preoperative routine MRI+DWI examination were enrolled in the study and were treated by rectal cancer resection plus lymph node dissection. Metastatic and non-metastatic lymph nodes were confirmed by postoperative pathology. Apparent diffusion coefficient (ADC) values, long-axis and short-axis diameters of lymph nodes were measured. Receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy of ADC, long-axis and short-axis diameters for differentiating metastatic lymph nodes from non-metastatic lymph nodes.</p><p><b>RESULTS</b>A total of 151 lymph nodes were confirmed with exact location in 35 patients. Sixty-five metastatic lymph nodes and 86 non-metastatic lymph nodes were identified. The ADC values of metastatic lymph nodes and non-metastatic lymph nodes were(0.86±0.14)×10(-3) and (0.94±0.16)×10(-3) mm(2)/s respectively. The long-axis diameter were(9.78±3.13) and (7.90±1.77) mm, respectively. The short-axis diameter were (7.65±2.00) and (6.45±1.19) mm, respectively. There were statistically significant differences between metastatic and non-metastatic lymph nodes in ADC values, long-axis diameter, and short-axis diameter(all P<0.01). The areas under the ROC curve of ADC value, long-axis diameter, and short-axis diameter were 0.648, 0.706, and 0.692, respectively. Optimal cutoff values for these parameters were 1.05×10(-3) mm(2)/s, 7.95 mm, and 5.90 mm, respectively, and the corresponding sensitivities and specificities were 93.8% and 30.2%, 75.4% and 61.6%, 90.8% and 38.4%.</p><p><b>CONCLUSIONS</b>Quantitative measurement of ADC value may reflect the degree of diffusion restriction of metastatic lymph nodes by DWIBS at 3.0 T MR. Accurate diagnosis of metastatic lymph nodes in rectal cancer demands comprehensive evaluation combining ADC value with diameter measurement.</p>
Subject(s)
Humans , Diffusion Magnetic Resonance Imaging , Methods , Lymph Node Excision , Lymph Nodes , Pathology , Lymphatic Metastasis , Rectal Neoplasms , Diagnosis , PathologyABSTRACT
<p><b>BACKGROUND</b>Diffusion weighted imaging with background suppression (DWIBS) is potentially useful in detecting metastatic lymph nodes. This study aimed to evaluate the efficacy of DWIBS at 3T magnetic resonance (MR) for diagnosing metastatic lymph nodes in cervical cancer.</p><p><b>METHODS</b>This retrospective study included 25 patients with cervical cancer who underwent MR examination and were treated by hysterectomy and lymphadenectomy. The metastatic and non-metastatic lymph nodes were histologically proven by operation. Apparent diffusion coefficient (ADC) values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of all the identifiable lymph nodes were measured and compared.</p><p><b>RESULTS</b>Twenty-five primary tumor lesions, 17 metastatic lymph nodes and 140 non-metastatic lymph nodes were pathologically confirmed in 25 cases with cervical cancer. The difference of ADC values between primary tumor lesions, metastatic and non-metastatic lymph nodes were statistically significant (F = 7.93, P = 0.001). There was no statistically significant difference between primary tumor lesions of cervical cancer and metastatic lymph nodes (t = -0.75, P = 0.456), and the difference between primary tumor lesions and non-metastatic lymph nodes was statistically significant (t = 4.68, P < 0.001). The ADC values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of metastatic and non-metastatic lymph nodes were (0.86 ± 0.36) × 10(-3) mm(2)/s vs. (1.12 ± 0.34) × 10(-3) mm(2)/s, (1.51 ± 0.41) cm vs. (1.19 ± 0.36) cm, (1.16 ± 0.35) cm vs. (0.77 ± 0.22) cm, 0.78 ± 0.17 vs. 0.68 ± 0.19 respectively, and statistically significant difference existed between two groups.</p><p><b>CONCLUSIONS</b>DWIBS at 3T MR has the distinct advantages in detecting pelvic lymph nodes of cervical cancer. Quantitative measurement of ADC values could reflect the degree of restriction of diffusion of metastatic and non-metastatic lymph nodes. The combination of size and ADC value would be useful in the accurate diagnosis of metastatic lymph nodes.</p>