Research advances in liver cirrhosis complicated by portal vein thrombosis / 临床肝胆病杂志

Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. This article reviews the research advances in liver cirrhosis complicated by PVT in recent years and points out that PVT is induced by the combined effect of various factors. Hemodynamic disorder is an important basis for the development of PVT. PVT can be classified into different types according to the degree of thromboembolism and the portal vein branches involved. At present, anticoagulant therapy and interventional therapy are commonly used in the treatment of PVT. The development of PVT may not promote the progression of liver cirrhosis, but it may affect the prognosis of patients with liver cirrhosis who receive liver transplantation.

Diagnostic value of CT for head and neck pilomatricoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the CT and pathological features of head and neck pilomatricoma.</p><p><b>METHODS</b>We retrospectively analyzed the CT findings of 13 patients with head and neck pilomatricoma which were pathologically confirmed. Of them 7 patients received plain CT, 2 patients received contrast-enhancement, and 4 patients received plain CT plus contrast-enhancement.</p><p><b>RESULTS</b>All the patients presented with solitary tumors, 9 of them occurred in the parotid gland region, one in the left occipital, one in the right forehead, one in the right parietal, and another one in the left eyelid. The maximal diameter of the tumors ranged from 0.6 to 2.3 cm with a mean of 1.5 cm. All lesions were well-circumscribed, with partial attachment to the overlying skin. Most of lesions were isodense relative to adjacent skeletal muscle on non-enhanced CT scans, sand-like or nodular calcifications within the masses were showed in 8 cases, and no cystic degeneration was found. On contrast-enhanced imaging, mild to moderate homogenous enhancement was showed in 3 cases, heterogeneous moderate enhancement with patchy nonenhancing necrosis area in one case, marked enhancement in one case, and complete calcification with no enhancement in one case.</p><p><b>CONCLUSION</b>Head and neck pilomatricoma presents with certain characteristics on CT, which are useful in the clinical diagnosis and differential diagnosis.</p>

Investigation on the value of spectral CT imaging in diagnosis of benign and malignant thyroid nodules / 中华放射学杂志

Objective To explore the value of gemstone spectral imaging (GSI) in the detection and differential diagnosis of benign and malignant thyroid nodules.Methods The spectral CT images in 88 patients with thyroid nodules were analyzed retrospectively.All the patients underwent spectral CT scanning,including 33 patients undergoing biphase enhanced CT imaging.Nodules were divided into benign and malignant ones according to histopathologic results.The iodine concentration,slope of spectral curve,effective atomic number in non-enhanced and enhanced scanning were compared between benign and malignant group by the Wilcoxon rank sum test,respectively.The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic curve (ROC),sensitivity and specificity were achieved.Results A total of 106 nodules were detected,including 76 benign and 30 malignant nodules.In non-contrast CT imaging,the average iodine concentration,slope of spectral curve,effective atomic number of were 2.35 × 100 μg/ml,0.29 and 7.71 for benign group:-0.51 × 100 μg/ml,-0.06 and 7.52 for malignant group (Z value were-3.072,-3.107 and-3.055,respectively ; P ＜ 0.05).In the arterial phase,the average iodine concentration,slope of spectral curve,effective atomic number of the two group were 27.22 × 100 μg/ml,3.23 and 9.10 for benign group; 18.81 × 100 μg/ml,2.24 and 8.69 for malignant group (Z value were-2.582,-2.582 and-2.564,respectively; P ＜ 0.05).In venous phase,no significant difference was found for each parameter between the two groups (P ＞ 0.05).The optimal iodine concentration to predict malignancy was-0.35 × 100 μg/ml in non-enhanced phase with 56.7％ sensitivity and 73.7％ specificity.The optimal iodine concentration was 22.91 × 100 μg/ml in arterial phase,with 76.2％ sensitivity and 75.0％ specificity.Using iodine concentration to predict malignancy in both noncontrast phase and arterial phase,the sensitivity and specificity were 81.2％ and 73.3％,while the accuracy was 81.6％.Conclusion Gemstone spectral CT imaging can quantitatively evaluate the iodine content of thyroid nodules,having a potential value in differential diagnosis of thyroid nodules.

CT findings of benign lymphoepithelial lesion of major salivary glands / 中华放射学杂志

Objective To analyze the CT findings of benign lymphoepithelial lesion (BLEL) of major salivary glands.Methods The CT findings of 11 cases with BLEL which were clinically and pathologically confirmed were analyzed.The relevant literatures were reviewed.All the patients received plain CT.Among them,5 patients had contrast CT as well.The location,number,shape,margin,density,and enhancement characteristics of the lesions were observed.Results Of 11 BLEL,8 lesions were located in the parotid gland,three in the submandibular gland.There were 7 cases with bilateral multiple lesions,and 4 cases with unilateral solitary lesion.BLEL of major salivary gland could be classified into three types according to the CT findings,including multinodular type,solitary mass type,and diffusely infiltrating type.Multinodular type was the most common type.The typical CT findings of the lesion included diffusely enlargement of bilateral parotids and (or) submandibular glands,heterogeneous increase of density of the parenchyma with multiple soft tissue density nodules,and multiple cystiform hypodense.On contrast-enhanced CT,the lesions mostly manifested as heterogeneous enhancement.The solid part of the nodules showed moderate or marked enhancement.However,the cystiform hypodense showed no enhancement.Conclusion Although the CT findings of BLEL of major salivary glands are variable,they still share some common characteristics,which are useful in the clinical diagnosis.

Imaging presentations of multiple gastric duplication cysts inside the mediastina / 中华消化外科杂志

Gastrointestinal duplication cyst is a rare congenital disease which can occur in any part of the digestive tract between the root of tongue and the anus,and it is commonly seen in the ileum.About 45％ of the gastrointestinal duplication cyst occurs in the ileocecus and the epityphlon.Multiple gastric duplication cyst is a rare type of the gastrointestinal duplication cyst,which accounted for 3.8％-5.0％.Gastric duplication cyst mostly occurs in the greater curvature of the stomach,and it connects with the stomach wall.Multiple gastric duplication cysts in the mediastina is rarely seen.In this article,the imaging presentations of 1 patient with multiple gastric duplication cysts inside the mediastina were analyzed.

Spectral CT imaging in the evaluation of composition of kidney stones / 中华放射学杂志

ObjectiveTo evaluate the feasibility of determining the chemical composition of kidney stones using gemstone spectral imaging ( GSI ).Methods One hundred and sixty eight extracted human kidney stones immersed in a 10 cm deep water tank underwent CT (Discovery CT750 HD) scans with GSI mode and conventional polychromatic imaging ( CPI,120 kVp) mode.All GSI data were transferred to Workstation AW 4.4 to acquire monochromatic images of 50 keY,effective atomic number (Zeff) mapping images,water (calcium)-based images and calcium (Water)-based images with GSI Viewer.CT numbers of stones were measured and compared at 50 keV monochromatic images and 120 kVp polychromatic images,the mean Zeff,calcium density and water density were measured at Zeff mapping images,Calcium (Water) -based images and Water (Calcium)-based images,respectively.The mean Zeff,spectral HU curve slope and calcium water ratio (CWR) were compared with ANOVA and Wilcoxon test.The composition of kidney stones was determined by infrared spectrometer after CT examination.According to the result of stone composition determined by infrared spectroscopy,108 pure kidney stones were divided into five groups:Uric acid stones ( UA,n = 13 ),struvite stones ( STR,n = 24),cystine stones ( CYS,n = 14),calcium phosphate stones ( CaP,n = 18),and calcium oxalate stones ( COX,n = 39).ResultsThe mean Zeff,CWR,the mean CT numbers at 50 keV images,120 kVp images and spectral HU curve slope of each group were listed as the following:UA [ 7.4 ± 0.4,0.0085 ± 0.0021,( 503 ± 168 ) HU,(495 ± 106 ) HU and - 0.77 ] ; STR [ 11.8 ± 0.9,0.1743 ± 0.0677,( 1056 ± 290 ) HU,( 799 ± 165 ) HU and 18.72 ] ; CYS [ 11.2 ± 0.6,0.1253 ± 0.0297,( 740 ± 172 ) HU,( 565 ± 129 ) HU and 12.79 ] ; CaP [ 16.0 ± 0.4,0.6781 ± 0.0952,( 2567 ±178 ) HU,( 1602 ± 200 ) HU and 37.14 ] ; COX [ 15.4 ± 0.4,0.5683 ± 0.0759,( 2267 ± 385 ) HU,( 1489 ±284) HU and 36.36 ],there were significant differences among groups ( P ＜ 0.01 ).The differences in the mean Zeff,CRW,spectral HU curve slope were statistically significant among the five groups ( P ＜ 0.05 ).Conclusion Spectral CT imaging provides a new method to characterize the kidney stones with the information orovided by mean Zeff,CRW and the CT numbers at 50 keV.

Clinical Value of 64-slice Computed Tomography in the Diagnosis of Complex Congenital Heart Disease / 实用放射学杂志

Objective To study the clinical value of 64-slice spiral computed tomography(64SCT) contrast-enhanced scan and three-dimensional reconstructed techniques in the diagnosis of complex congenital heart disease(CCHD). Methods 39 patients with CCHD underwent CT angiography and transthoracic echocardiograms (TTE). Of them, the electrocardiographic-gating technique was used in 8 cases. The accurate rates in diagnosing CCHD with CT, TTE and CT with or without electrocardiographic-gating were analysed compared with that of operation and χ~2 test using SPSS13.0 tool. Results A total of 102 cardiac deformities con-firmed by operations,those included 47 intracardiac deformities,the diagnostic accuracys with CT and TTE were 85.1% and 95.7%, respectively, and there was no obvious difference among them (χ~2=2.68, P>0.05). 55 extracardiac deformities, the definite diagnos-tic rates with CT and TTE were 98.2% and 78.2%, respectively. CT was superior to TTE in the indentification of extracardiac de-formities(χ~2= 14.64 ,P<0.01). There was no obvious difference between with and without electrocardiographic-gating technique during CT scanning in diagnosis of cardiac deformities(χ~2=1.84, P>0.05). Conclusion 64SCT has significant value in diagnosis of CCHD,and there was no obvious difference in diagnosis of cardiac deformities by 64SCT between with and without electrocardio-graphic-gating technic.

Application of CT perfusion imaging and fine needle aspiration cytology in diagnosis of salivary gland tumors / 实用口腔医学杂志

Objective:To analyze the value of fine needle aspiration cytology and CT perfusion imaging in differential diagnosis of benign and malignant salivary gland tumors. Methods: Perfusion CT and fine needle aspiration cytology were performed in 36 patients of salivary gland tumors(26 cases in parotid gland, 8 cases in submandibular, 1 case in sublingual gland and 1 case in pars palatalis) and perfusion parameters, including: blood flow(BF), blood volume(BV), mean transit time(MTT), permeability surface(PS). Pathological diagnosis was performed on all salivary gland tumors. Results: 13 cases of 36 patients eventually were diagnosed as malignant salivary gland tumors. The sensitivity, specificity and accordance rate for malignancy of fine needle aspiration cytology were 84.6%(11/13), 95.7%(22/23) and 91.7%(33/36), respectively. The values of BF, BV and PS of the malignant tumors were higher than those of benign tumors significantly(P<0.05). However, the MTT values showed no significant difference between benign and malignant tumors(P>0.05).The sensitivity, specificity, and accordance rate for malignancy of CT perfusion were 92.3%(12/13), 86.9%(20/23) and 88.9%(32/36), respectively. The negative cases of fine needle aspiration cytology can be correctly identified as malignant by CT perfusion imaging. Conclusion: CT perfusion imaging can provide salivary gland tumors with information of microcirculation perfusion. It contributes to the identification of benign and malignant tumors. Paralled with fine needle aspiration cytology can greatly improve the accuracy of salivary gland tumors.

Influence of various doses and injection rates of contrast agent on CT perfusion in rabbits' liver with deconvolution method / 中国医学影像技术

Objective To study the influence of various doses and injection rates of contrast agent on CT perfusion in rabbits' liver with a deconvolution mathematical model. Methods Eight rabbits were enrolled in the experiment. Randomized block design was adopted. The treatment factor (contrast medium injection rate) was classified into 0.5, 1.0, 1.5 ml/s, while the subjects were divided into 3 blocks with contrast medium injection dose of 0.5, 1.0 and 1.5 ml/kg. The data obtained at CT perfusion imaging were then transferred to the workstation. Absolute values of 7 perfusion parameters (hepatic arterior fraction, blood flow, blood volume, permeability surface, mean transmit time, hepatic artery perfusion and portal vein perfusion) were measured with perfusion software (Perfusion 3). Results The dose of contrast medium had significant effect on peak enhancement of the aorta, the portal vein and liver tissue (P0.05). Conclusion CT perfusion imaging with a deconvolution mathematical model can quantify the hemodynamic functional status in liver with stable results. This technique does not need strict confinement to dose and injection rate of contrast medium, and has great potential value to be put into clinical use.