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Objective To investigate the predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors (GISTs). Methods The MSCT manifestations of 120 GISTs patients confirmed by operation, pathology and immunohistochemistry were analyzed retrospectively. The age of tumor onset, location, maximum diameter, morphology, growth pattern, cystic necrosis, calcification, peritumoralfat space, enhancement pattern, peritumoralor intratumoral vessels, peak period of enhancement, metastasis, and the relationship between Ki-67 proliferation index and pathological risk grade were also analyzed. Results Among 120 cases, there were 55 cases of extremely low and low risk, 28 cases of moderate risk, and 37 cases of high risk. There were significant differences in location, tumor diameter, morphology, growth pattern, cystic necrosis, peritumoral fat space, enhancement pattern, peritumoral or intratumoral vessels, peak period of enhancement, and Ki-67 proliferation index of GISTs (P < 0.05). There was no significant difference in calcification, CT plain scan, enhanced scan (3 phase), peak value and Ap、Vp、Dp of GISTs with different risk (P > 0.05). Conclusion There are differences in the performance of multi-layer spiral CT (MSCT) in GISTs with different risk levels. It is closely related to the classification of pathological risk. For the diagnosis of GISTs, clinical treatment plan formulation and prognosis, it has important reference value.
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Objective To compare the normal thickness of the esophageal wall measured by contrast?enhanced three?dimensional ( 3DCT ) , four?dimensional ( 4DCT ) , and cone beam computed tomography ( CBCT) ,and to provide a basis for target volume delineation in esophageal cancer. Methods From 2009 to 2016,thoracic contrast?enhanced 3DCT and 4DCT simulations were performed in 50 patients with lung cancer or metastatic lung cancer. Contrast?enhanced CBCT scans were acquired during the first three?dimensional conformal radiotherapy. The normal esophageal wall was contoured on 3DCT images, the end?exhalation phase of 4DCT images ( 4DCT50 ) , the maximum intensity projection of 4DCT images (4DCTMIP),and CBCT images. The wall thickness was measured on each segment and the average thickness of esophageal wall was obtained. Comparison of the thickness of a fixed segment of esophageal wall between different CT images was made by paired t test. Comparison of thickness on the same type of CT images between different segments of esophageal wall was made by one?way analysis of variance. Results For the thoracic and intra?abdominal segments,there was no significant difference in the thickness of esophageal wall between 3DCT and 4DCT50 images ( P= 0?056?0?550 );however, the thickness of esophageal wall was significantly smaller on 3DCT images than on 4DCTMIP or CBCT images (P=0?000?0?004).For the upper and middle thoracic segments,the thickness of esophageal wall was significantly larger on CBCT images than on 4DCTMIP images ( P= 0?008, P= 0?001 ) . On 3DCT, 4DCT50 , and 4DCTMIP images, the thickness of esophageal wall was significantly larger in the lower thoracic segment than in the upper or middle thoracic segments ( P=0.008~0?041);the intra?abdominal segment had a significantly larger thickness of esophageal wall than the thoracic segments ( all P=0?000 ) . There was no significant difference in wall thickness on CBCT images between three thoracic segments ( P=0.088~0?945) . Conclusions A uniform criterion can be adopted to judge the normal thickness of esophageal wall in gross tumor volume ( GTV ) delineation on 3DCT and 4DCT50 images for thoracic esophageal cancer. However,caution should be taken when 5 mm is used as a criterion for normal thickness of esophageal wall in GTV delineation on 4DCTMIP and CBCT images.
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OBJECTIVE:To explore the general rules and characteristics of ADR/ADE induced by Glycerol fructose injection and provide reference for clinical ration drug use. METHODS:284 cases of ADR/ADE induced by Glycerol fructose injection from Jan. 2004 to Oct. 2014 in Drug ADR Monitoring Center of Henan Province were statistically analyzed and comparatively analyzed with the drug instructions in 11 domestic drug manufacturing enterprises. RESULTS:ADR/ADE induced by Glycerol fructose injec-tion was related to gender,mainly adult male,and ADR/ADE might occurred within 30 min;main clinical manifestations were skin and its appendages damages,medication site damage and systemic damage. There were larger differences among the notes de-scription in the package inserts from 11 drug manufact urers. CONCLUSIONS:The clinic should strengthen the monitoring of ADR/ADE induced by Glycerol fructose injection,try to avoid or reduce the incidence of ADR,improve the drug instructions and ensure medication safety.
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<p><b>OBJECTIVE</b>The aim of this study was to retrospectively investigate the multi-detector computed tomography (MDCT) features of preinvasive lesions and minimally invasive adenocarcinoma (MIA) appearing as ground-glass nodules (GGNs), and to analyze their significance in differential diagnosis.</p><p><b>METHODS</b>The pathological data and MDCT images of 111 GGNs in 93 patients were reviewed and analyzed retrospectively, to identify the differentiating CT features between preinvasive lesions and MIA and to evaluate their differentiating accuracy.</p><p><b>RESULTS</b>In the 93 patients included in the study, there were 27 cases with preinvasive lesions (38 GGNs) and 66 cases with MIA (73 GGNs). No statistically significant difference was observed in terms of the gender, age and number of lesions between the two groups. There were significant differences (P<0.05) in the size of lesion, size of solid portion, content of solid portion, and morphological characteristics of the lesion edge between preinvasive lesions and MIA. ROC curve analysis showed that the optimal cut-off value of lesion size for differentiating preinvasive lesions from MIA was 13.0 mm (sensitivity, 83.0%; specificity, 80.0%), and that of solid portion size was 2.0 mm (sensitivity, 90.0%; specificity, 97.0%) and that of solid proportion was 12.0% (sensitivity, 88.0%; specificity, 97.0%). The analysis of CT morphological features showed that there were significant differences in the terms of lesion nature (pGGO, mGGO), presence or absence of lobulated sign and spiculated sign (P<0.05) between preinvasive lesions and MIA, but there were no significant differences in terms of the lesion edge, the presence or absence of vacuole sign, bubble lucency and pleural retraction (P>0.05).</p><p><b>CONCLUSIONS</b>Preinvasive lesions can be accurately distinguished from MIA by the size of lesion, size of solid portion,solid proportion and morphological characteristics of the lesion edge. The size of lesion, size of solid portion, content of solid proportion and morphological characteristics of the lesion edge are of significance in the differential diagnosis of preinvasive lesions and minimally invasive adenocarcinoma of the lung.</p>
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Humans , Adenocarcinoma , Diagnostic Imaging , Pathology , Diagnosis, Differential , Lung Neoplasms , Diagnostic Imaging , Pathology , Multidetector Computed Tomography , Neoplasm Invasiveness , ROC Curve , Retrospective Studies , Sensitivity and SpecificityABSTRACT
Objective To assess the clinical value of multi-slice helical CT perfusion on the post-operative follow-up of glioma.Methods CT perfusion image was applied to 32 patients with glioma after operation.Various perfusion parameters,include cerebral blood volume(CBV),permeability surface(PS),relative cerebral blood volume(rCBV)and relative permeability surface(rPS)were measured on recurrent area,nonrecurrent area and normal cerebral area respectively.SPSS 12.0 statistical software was used.Independent t test was used to compare the differences.Results In the recurrent group(16 cases),the value of CBV in creased in 12 cases and was normal in the other 4 cases.The value of PS increased in all the cases of recurrent group.The value of rCBV exceeded 2.6 in 10 cases,among which the biggest value of rCBV was 4.01.The mean value of rCBV was 2.67 and the mean value of rPS was 6.32;In the non-recurrent group(16 cases),the value of CBV was nearly normal in 7 cases,increased in 2 cases and decreased in the remaining 7 cases.The value of PS was nearly normal in 11 case,decreased in 3 cases and increased in the remaining 2 cases.The values of rCBV were all less than 2.6 and the biggest value of rCBV was 2.14.The mean value of rCBV was 0.99 and the mean value of rPS was 1.42.The statistic significance was obtained for all the parameters when compared the recurrent group with the non-recurrent group(P＜0.01)and with the normal cerebral area(P＜0.01).When compared the non-recurrent group with the normal cerebral area,none of the parameters had statistic significance(P＞0.05);The statistic significance was obtained for rCBV and rPS when compared the recurrent group with the non-recurrent group(P＜0.01).Conclusion CT perfusion image is valuable in determining glioma recurrence after operation.
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Objective To characterize the CT features of primary mediastinal seninoma. Methods CT scans of 10 cases with pathologically proved primary mediastinal seminoma were retrospectively reviewed.Results 9 of the 10 cases with the maximal dimension of 6. 5 ～ 18.2 cm( mean = 12. 3 cm) were located in the anterior mediastinum and 1 tumor was located in the middle mediastinum. All of the 10 tumors were solid masses and none of cavity, loculus, fat, calcification or fluid was detected. Areas of low density in the center of tumors were seen in 9 cases. Tumors encircling macrovascular or pericardium were seen in 7 cases. Chest wall invasion was detected in 2 cases. Enlarged lymph nodes in supraclavicular or mediastinum were identified in 4 cases. Lung diseases were found in 5 cases. Bilateral pulmonary metastasis was seen in 1 case. Pleural effusions were detected in 4 cases. Pericardial effusions were evident in 5 cases. Conclusion Most of the primary mediastinal seminomas are solid and large mass without calcification or fat. The tumors are usually located in the anterior mediastinum and areas of low density are usually seen in the center of tumors. Some tumors involve in adjacent structures. Seminoma has some features on CT.
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OBJECTIVE:To investigate the form, advantage, limitation, influence factor and effect of spontaneous reporting system of ADR monitoring. METHODS: Based on domestic and foreign literatures and information, the importance of spontaneous reporting system of ADR monitoring was evaluated with the method of literature analysis according to the condition of China. RESULTS&CONCLUSION: Spontaneous reporting system of ADR monitoring is the foundation of drug risk management and is the most rapid, powerful and economic administration method of early warning for drug safety monitoring.
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OBJECTIVE:To investigate the regularity and characteristics of ADR induced by Mailuoning injection,and to provide reference for rational use of drugs.METHODS:In retrospective study,ADR/ADE cases of Mailuoning injection reported in Henan province from 2004 to 2009 were analyzed statistically.RESULTS:Main clinical manifestations were lesion of skin and its appendents(24.95%),respiratory system injury(23.81%) and nervous system injury(15.38%).The clinical manifestations of serious ADR/ADE were allergic shock,dyspnea and choking etc.CONCLUSION:Clinical rational use of drugs should be improved to avoid serious ADR and guarantee the safety of drug use.