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Objective:To analyze the value of magnetic resonance T 2 mapping in the diagnosis of early cervical disc degeneration in adolescents. Methods Patients who underwent cervical MRI examination and magnetic resonance T 2 mapping in Wenzhou Hospital of Traditional Chinese Medicine between November 2019 and September 2020 were included in this study. They were divided into observation and control groups ( n = 50 per group) according to the time of lowering their heads (≥ 2 hours) every day. The T 2 values corresponding to the nucleus pulposus of cervical intervertebral disc in each segment was compared between the two groups. Cervical disk degeneration was graded using the Pfirrmann classification. T 2 value was compared between different Pfirrmann disc grades. The efficacy of T 2 value in the diagnosis of early cervical disc degeneration in adolescents was evaluated using the receiver operating characteristic curve. The specificity and sensitivity of T 2 value in the diagnosis of early cervical disc degeneration in adolescents and the area under the receiver operating characteristic curve were calculated. Results:T 2 value measured in each cervical intervertebral disc segment in the observation group was significantly greater than that in the control group ( t = 5.06, 4.47, 3.57, 2.93, 4.98 for C2-3, C3-4, C4-5, C5-6, C6-7 segments, all P < 0.05). In the observation group, the number of patients with Pfirrmann grade II cervical intervertebral disc degeneration was highest, accounting for 42% (21/50). There was a significant difference in cervical intervertebral disc segment T 2 value between different Pfirrmann disc grades ( t = 2.62, P = 0.018, vs. Pfirrmann disc grade I ; t = 2.12, P = 0.045, vs. Pfirrmann disc grade II; t = 2.24, P = 0.049, vs. Pfirrmann disc grade III). The higher Pfirrmann grade, the lower T 2 value of cervical intervertebral disc nucleus pulposus. The receiver operating characteristic curve showed that the sensitivity and specificity of T 2 value in the diagnosis of early cervical disc degeneration and the area under the receiver operating characteristic curve were 81.2%, 79.8% and 0.756, respectively. Conclusion:T 2 mapping imaging technology can predict early cervical intervertebral disc degeneration in adolescents by quantitatively analyzing the T 2 value of cervical intervertebral disc nucleus pulposus and has a high value in the diagnosis of cervical intervertebral disc degeneration. This achievement is of innovation and science.
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Objective:To investigate the clinical value of three-dimensional arterial spin marker imaging(3D-ASL) for evaluating collateral circulation compensatory status in patients with cerebral infarction.Methods:A total of 24 patients with cerebral infarction who were treated at Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Chinese Medicine from September 2017 to January 2019 were examined by 1.5-T high-field MR scanner.The changes of cerebral blood flow(CBF) between the infarcted area and the contralateral normal area were compared when the labeled delay time(PLD)=1.5s and PLD=2.5s, and the patients were divided into the group with strong collateral circulation compensation and the group with weak collateral circulation compensation according to the difference in lesion area measured by 3D-ASL(PLD=1.5s and 2.5s). The changes of national institutes of health stroke scale(NIHSS) score and Bathel index at admission and 15 days after admission were compared.Results:3D-ASL measurement of PLD=1.5s showed that the CBF value in the infarcted area was (33.70±20.83)mL/(100g×min), which was significantly lower than that in the contralateral normal area(PLD=1.5s)[(49.93±13.13)mL/(100g×min)]( t=3.229, P<0.05). When PLD=2.5s, ASL measurement results showed that the CBF value in the infarcted area increased significantly[(58.26±23.50)mL/(100g×min) vs.(33.70±20.83)mL/(100g×min)]( t=3.831, P<0.05), and the CBF value in the contralateral normal area also increased significantly[(68.29±14.03)mL/(100g×min) vs.(49.93±13.13)mL/(100g×min)]( t=4.681, P<0.05). At this time, the CBF value in the infarcted area was still significantly lower than that in the contralateral normal area[(58.26±23.50)mL/(100g×min) vs.(68.29±14.03)mL/(100g×min)]( t=1.795, P<0.05). On the day of admission, the BI index of patients in the weak collateral circulation compensation group(12 cases) was significantly higher than that in the strong collateral circulation compensation group(12 cases)[(90.42±10.50) vs.(67.92±27.57)]( t=2.642, P<0.05), and the NIHSS score was significantly lower than that in the strong collateral circulation compensation group[(1.25±1.01) vs.(3.83±3.62)]( t=2.378, P<0.05). After 15 d of admission, there were no significant differences in BI index and NIHSS score between the two groups(all P>0.05). Conclusion:3D-ASL with different delay time can effectively and intuitively reflect collateral circulation compensation of patients with cerebral infarction, and it has very important reference value for the evaluation of patients' disease and the formulation of clinical treatment plan.
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Objective:To investigate the computed tomography (CT) features of gastric neuroendocrine neoplasm (GNEN).Methods:The retrospective and descriptive method was conducted. The clinicopathological data of 30 GNEN patients who were admitted to two domestic medical centers (13 cases in Wenzhou Hospital of Traditional Chinese Medicine and 17 cases in Wenzhou People′s Hospital) from January 2010 to December 2018 were collected. There were 23 males and 7 females, aged (62±4)years, with a range from 27 to 78 years. The patients underwent abdominal CT plain scan and dynamic enhancement scan. Two associate chief radiologists with more than 20 years of work experience observed and analyzed all the images respectively. Observation indicators: (1) CT examination; (2) treatment and postoperative pathological examination; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect the survival of patients up to December 2018. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were described as M (range). Results:(1) CT examination: of the 30 patients, 14 had the tumor located in the fundus of stomach, 10 had the the tumor located in the body of stomach, and 6 had the tumor located in the antrum. The tumor was elliptical in 18 cases and irregular in 12 cases. There were 15 cases of endogenous type, 13 cases of exogenous type, and 2 cases of intramural type. Patients with G1 neuroendocrine tumor had the maximum diameter of (6.8±1.6)cm, of which 4 cases had the maximum diameter less than 5.0 cm and 4 cases had the maximum diameter of 5.0 to 10.0 cm. Patients with G2 neuroendocrine tumor had the maximum diameter of (8.3±2.7)cm, of which 1 case had the maximum diameter less than 5.0 cm, 4 cases had the maximum diameter of 5.0 to 10.0 cm, and 2 cases had the maximum diameter greater than 10.0 cm. Patients with G3 neuroendocrine carcinoma had the maximum diameter of (17.8±2.2)cm, of which 6 cases had the maximum diameter of 5.0 to 10.0 cm and 9 cases had the maximum diameter more than 10.0 cm. The tumor showed swelling growth in 14 cases and invasive growth in 16 cases. The tumor boundary was clear in 14 cases and unclear in 16 cases. CT plain scan showed homogeneous tumor density in 10 cases and heterogeneous density in 20 cases. Nine patients had iso-density in the tumor parenchymal part, and the CT value was (34.0±3.5)HU. In the 18 cases of low density, the CT value was (16.6±1.4)HU. In the 3 cases of high density, the CT value was (45.3±3.6)HU. Of the 30 patients, 21 cases had small punctate or small round necrotic cyst lesions in the tumor, 10 cases had mesenteric lymph node, peritoneum, liver metastasis and adjacent omentum invasion; 17 cases had abdominal effusion. In the CT enhancement examination, 12 cases showed mild enhancement, and the CT value was (56.5±6.3)HU; 15 cases showed moderate enhancement, and the CT value was (66.0±5.4)HU; 3 cases showed significant enhancement, and the CT value was (76.6±5.8)HU. Seven cases showed homogeneous enhancement and 23 cases had heterogeneous enhancement. There were 8 cases with tortuous vessels. (2) Treatment and postoperative pathological examination: of the 30 patients, 10 cases with mesenteric lymph nodes, peritoneum, liver metastasis and adjacent omentum invasion underwent radical total gastrectomy; 14 cases without surrounding tissue invasion or metastasis underwent radical subtotal gastrectomy; 6 cases with tumor diameter less than 4.0 cm and without surrounding tissue invasion or metastasis underwent endoscopic resection. All the 30 patients were confirmed GNEN by postoperative pathological examination, including 8 cases of G1 neuroendocrine tumor, 7 cases of G2 neuroendocrine tumor, and 15 cases of G3 neuroendocrine carcinoma. Results of immunohistochemical staining showed that 30 patients were positive for synaptophysin, 23 were positive for chromogranin A, and 9 were positive for cytokeratin. (3) Follow-up: all the 30 patients were followed up for 10-80 months, with a median follow-up time of 39 months. The 5-year survival rate of 30 patients was 43.3% (13/30). The 5-year survival rates were 6/8, 3/7 and 4/15 of patients with G1 neuroendocrine tumor, G2 neuroendocrine carcinoma, and G3 neuroendocrine carcinoma.Conclusions:GNEN has the main manifestation as abdominal pain, with G3 as pathological classification, which is common in fundus and body of stomach. The CT findings of GNEN are characterized by swelling or infiltrating growth and round or irregular low-density masses. Tumors are prone to cystic transformation, and showed the mildly to moderately heterogeneous enhancement.
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investigate the clinical and imaging features of primary peripheral primitive neuroectodermal tumors (pPNETs) of bone. Methods Clinical and X-ray, CT and MRI findings of 6 cases of primary bone pPNETs in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang, Yueqing People′s Hospital of Zhejiang, and Wenzhou People′s Hospital of Zhejiang were retrospectively analyzed. Results There were 4 males and 2 females, aged from 2 to 38 years, with an average age of (18.5 ± 12.0) years old. Local pain was found in all cases, including 4 cases with mass, with an average survival of (22.2 ± 16.9) months. Iliac bone tumor was found in 2 cases, sacrum in 2 cases, scapula in 1 case and femur in 1 case. Digital radiography(DR) examination was performed in 4 cases:4 cases showed osteolytic destruction, including 1 case with mild swelling changes, 1 case with laminar periosteal reaction and radial bone needle, and 3 cases with soft tissue mass. CT examination was done in 4 cases, and there were 4 cases of osteolytic destruction accompanied by soft tissue mass without periosteal reaction. Among them, 1 case had irregular sclerosis at the edge of bone destruction and 2 cases had fine calcification in soft tissue mass. MRI examination in 4 cases:there were 3 cases with equal signal on T1WI and 1 case with moderate to high signal on T1WI, 3 cases with inhomogeneous medium and high signal on T2WI and STIR, and 1 case with homogeneous high signal on T1WI, and 4 cases with soft tissue masses and peritumoral edema. Conclusions Bone pPNETs is characterized by osteolytic destruction with soft tissue masses, periosteal reaction with or w ithout periosteal reaction, and intratumor al calcification. Im aging exam ination is helpful to under stand the extent of lesions, formulation of therapeutic measures and evaluation of therapeutic effect.
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Objective@#To investigate the clinical and imaging features of primary peripheral primitive neuroectodermal tumors (pPNETs) of bone.@*Methods@#Clinical and X-ray, CT and MRI findings of 6 cases of primary bone pPNETs in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang, Yueqing People′s Hospital of Zhejiang, and Wenzhou People′s Hospital of Zhejiang were retrospectively analyzed.@*Results@#There were 4 males and 2 females, aged from 2 to 38 years, with an average age of (18.5 ± 12.0) years old. Local pain was found in all cases, including 4 cases with mass, with an average survival of (22.2 ± 16.9) months. Iliac bone tumor was found in 2 cases, sacrum in 2 cases, scapula in 1 case and femur in 1 case. Digital radiography(DR) examination was performed in 4 cases:4 cases showed osteolytic destruction, including 1 case with mild swelling changes, 1 case with laminar periosteal reaction and radial bone needle, and 3 cases with soft tissue mass. CT examination was done in 4 cases, and there were 4 cases of osteolytic destruction accompanied by soft tissue mass without periosteal reaction. Among them, 1 case had irregular sclerosis at the edge of bone destruction and 2 cases had fine calcification in soft tissue mass. MRI examination in 4 cases:there were 3 cases with equal signal on T1WI and 1 case with moderate to high signal on T1WI, 3 cases with inhomogeneous medium and high signal on T2WI and STIR, and 1 case with homogeneous high signal on T1WI, and 4 cases with soft tissue masses and peritumoral edema.@*Conclusions@#Bone pPNETs is characterized by osteolytic destruction with soft tissue masses, periosteal reaction with or without periosteal reaction, and intratumoral calcification. Imaging examination is helpful to understand the extent of lesions, formulation of therapeutic measures and evaluation of therapeutic effect.
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Objective To explore the relationship between serum creatinine ( Scr ) , blood urea nitrogen ( BUN) and lung image changes in uremic patients .Methods According to the chest CT ,X-ray and related findings , 256 patients with uremia were divided into 84 cases of uremia ( uremic lung group ) and non-uremic lung 172 cases ( non-uremic lung group ) .The chest CT and X-ray examination ,Scr and BUN levels were observed .Results Uremic lung group had five types of image findings,including alveolar edema (67.86%),pulmonary interstitial edema (16.67%),pulmonary congestion syndrome(8.33%),pleural effusion(4.76%) and pulmonary interstitial fibrosis (2.38%).The Scr[(1 145.6 ±236.4)μmol/L]and BUN [(38.9 ±6.1)mmol/L]levels in uremic lung group were significantly higher than those in the non-uremic lung group[(905.3 ±138.9)μmol/L,(23.8 ±5.6)mmol/L](t=8.128,4.782,all P<0.05).Conclusion The image of uremic lung is mainly pulmonary edema ,and radiological and pathological changes are closely related with Scr and BUN levels .