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The early detection and qualitative diagnosis of salivary gland tumors are very important, which is helpful for clinical intervention and treatment in time to delay or stop the progression of the disease. At present, the multi-parameter quantitative analysis of dual-energy CT, such as virtual monochromatic image (VMI), base material image, spectrum curve and effective atomic number have been gradually applied to evaluate salivary gland tumors, providing many quantitative indexes for the characterization, staging and classification of salivary gland diseases. This article reviews the research progress of various post-processing parameters of dual-energy CT in the evaluation of salivary gland tumors.
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Objective To investigate the correlation between the angle and distribution of non-calcified plaque of left main coronary bifurcation and its hydrodynamic theory. Methods Retrospective analysis of 55 patients suspected of coronary heart disease who had undergone coronary computed tomographic angiography from January 2014 to June 2016.Angle,quadrant distribution,distance from bifurcation reference plane,minimal lumen area and extravascular elastic membrane cross section area of left main coronary bifurcation were measured. Then we calculated the plaque burden. The left main coronary bifurcation lesions were divided into plaque group and non-plaque group.Student's t test was used to compare the two groups.The left main coronary bifurcation lesions were divided into≥70°group and<70° group, Chi-square test and Fisher exact test were used to compared the two groups. Pearson correlation analysis was used to analyse the bifurcation angle and plaque distance. The data of non-plaque group was imported into the MIMICS,3-MATIC and abaqus CFD software to establish the hydrodynamic model,which was used to analyze the changes of pressure and velocity at different angles.Results Plaque group has 25 patients whose average value of the bifurcation angle was(55.95±14.77)°;non-plaque group has 30 patients whose average value of the bifurcation angle was(55.95±14.77)°.Angle difference was statistically significant between plaque and non-plaque group(t=2.893,P=0.006);Plaque difference was statistically significant between≥70°and<70°groups.The distance was negatively correlated with bifurcation angle(r=-0.773,P<0.001). Following the increase of bifurcation angle, the vascular wall area of high pressure and low speed region growed The green region of low-wall pressure with irregular distribution appeared in the lateral wall of the vessel that opposite to the red region of the bifurcation,and this region had lager gradient variability of wall pressure. Conclusion With the increase of coronary bifurcation angle, the possibility of plaque formation increases, the distance from plaque to bifurcation increases,the plaques tend to appear in the lateral wall of the blood vessels.
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Objective To analyze the CT manifestations of gastrointestinal stromal tumors(GIST),and compared with the pathological results,in order to improve the value of CT in clinical diagnosis of GIST.Methods 256 slice spiral CT manifestations of 35 cases with GIST confirmed by surgery and pathology were analyzed retrospectively.Results 30 cases with GIST tumors were located in the stomach,duodenum in 2 cases,ileum in 2 cases,1 case with multiple tumors (located in mesentery,retinal).The tumor size ranged from 1.0 to 11.2 cm.11 cases of lumps showed soft tissue mass,24 cases showed uneven density with cystic and necrosis,including 10 cases with ulceration in surface.There were 5 cases with hemorrhage,2 cases with scattered calcification.After enhancement scan,11 cases of tumors were homogeneous enhancement and 24 cases showed uneven enhancement.The solid composition was shown more rich blood supply,especially in the venous phase.There were 9 cases out of the digestive tract,22 cases in the digestive tract,4 cases were mixed growth.There were 35 cases with CD117 positive expression by immunohistochemistry,34 cases with CD34 positive expression.After postoperative pathological risk assessment,there were 21 cases with low risk malignant tumor,moderate malignant tumor in 7 cases,highly malignant tumor in 7 cases.Conclusion 256 layers spiral CT scan can accurately offer the morphology of gastrointestinal stromal tumor,location,size and internal structure,and evaluate the risk level of tumor,it is helpful for clinical preoperative treatment,and determination of the prognosis.
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Objective To investigate the clinical correlative factors and CT pulmonary angiography (CTPA) characteristics of secondary changes of chest in different types of acute pulmonary embolism. Methods One hundred and fifty-two cases with acute pulmonary embolism diagnosed by CTPA between January 2015 and October 2016 were retrospectively analyzed.They were divided into central(70 cases)and peripheral (82 cases) groups according to the embolization site. The clinical characteristics (including gender, age, risk stratification, etc.), laboratory findings (including D-dimer, etc.) and secondary imaging findings(including enlargement of the main pulmonary artery and enlargement of right heart,etc.)of the two groups were recorded. The parameters including patient age, body mass index, length of hospital stay and laboratory findings between the two groups were compared using independent sample t test or Mann-Whitney U test. The other variables including the clinical characteristics such as gender, smoking history, etc. and secondary imaging findings between the two groups were analyzed by χ2 test and Fisher exact test.Results The high,moderate and low-risk patients were 7,33,30 cases,respectively in the central group,and 2,16, 64 cases, respectively in the peripheral group. The percentages of moderate and high-risk patients in the central group were higher than peripheral group,the difference of risk stratification between the two groups was statistically significant(P<0.001).In the choice of clinical treatment,there were 5 cases of thrombolytic therapy in the central group and 0 cases in the peripheral group, and the difference was statistically significant (P= 0.019). The other differences of clinical characteristics such as gender and age were not statistically significant(P>0.05).The cardiac troponin I was 0.03(0.01,0.11)μg/L in the central group and 0.01 (0,0.04) μg/L in the peripheral group, and the difference was statistically significant (Z=-2.799, P=0.005).The other laboratory findings such as D-dimer were not statistically significant between the two groups (P>0.05). Among the various secondary changes of the chest on CTPA, the cases of enlargement of the main pulmonary artery,enlargement of right heart,pulmonary infarction,mosaic perfusion were 47,41, 23, 24 cases, respectively in the central group, and 20, 11, 11, 15 cases, respectively in the peripheral group.The percentages of these signs were higher in the central group than peripheral group,the differences were statistically significant (χ2= 28.002,34.214,8.221,5.064, P<0.05). Conclusions Central acute pulmonary embolism is more dangerous and more likely to cause a series of secondary changes.Determining the type of embolism has certain value for clinical doctors to judge the prognosis and choose the treatment.
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Objective To investigate the diagnostic significance of basophil activation test (B A T) in ana-phylaxis to non-ionic contrast media through testing the content of CD 63, m ast cell-carboxypeptidase A 3 (M C-CPA 3), and term inal com plem ent com plex SC5b-9 of the individuals by testing their levels in the norm al im m une group and the anaphylaxis groups to β-lactam drugs and non-ionic contrast media. Methods The CD 63 expression of basophilic granulocyte in blood w as detected by flow cytom etry. The levels of M C-CPA 3 in blood serum and SC5b-9 in blood plasm a w ere detected by ELISA . Results The CD 63 expression of basophilic granulocyte in blood, the levels of M C-CPA 3 and SC5b-9 of anaphylaxis to non-ionic contrast media and β-lactam drugs w ere significantly higher than that in norm al im m une group (P<0.05). Conclusion There is activation of basophilic granulocytes, m ast cells and com plem ent system in anaphylaxis to non-ionic contrast media. B A Tcan be used to diagnose the anaphylaxis to non-ionic contrast media.
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Objective To assess the volume of epicardial adipose tissue(EAT) and intrathoracic adipose tissue(IAT) and the correlation of EAT,IAT and the EAT/IAT ratio with the severity of coronary artery atherosclerosis in patients with metabolic syndrome(MS) and coronary heart disease(CHD).Methods Ninty-seven MS subjects without coronary atherosclerosis and one hundred and eighteen MS subjects with CHD were enrolled in this study.The volumes of EAT,PAT and IAT were measured using axial data from base to apex traced manually with a dedicated semiautomatic software program-volume.Results (1)Compared with MS subjects without coronary atherosclerosis,MS subjects with CHD had significantly increased age[(60.6± 1 1.4)years vs.(57.9 ± 8.7) years,P=0.001],positive family history of cardiovascular disease(29.7％ vs.21.6％,P=0.03),EAT[(98.3±41.4) cm3 vs.(82.2±39.7) cm3,P=0.001],IAT [(171.3±64.1) cm3 vs.(156.2±48.1) cm3,P=0.001] and HbA1c[(7.1 ± 1.8)％ vs.(6.6±2.3)％,P=0.02],but siginificantly reduced total cholesterol[TC,(4.9 ± 1.2)mmol/L vs.(5.4 ± 1.0) mmol/L,P=0.003],low-density lipoprotein cholesterol[LDL-C,(3.0±1.1) mmol/L vs.(3.6±1.0) mmol/L,P=0.03] and high-density lipoprotein cholesterol[HDL-C,(1.0 ± 0.4) mmol/L vs.(1.1 ± 0.3) mmol/L,P=0.04].(2) In MS subjects without coronary atherosclerosis,the volumes of EAT,pericardial adipose tissue(PAT) and IAT were associated with gender,body mass index(BMI),waist circumference(WC),diabetes mellitus and hyperlipidemia(all P＜0.05); however,in MS subjects with CHD,the volumes of EAT,PAT and IAT were associated with BMI and WC (both P＜0.05).(3) The volumes of EAT and IAT were correlated with calcification grades(r values were 0.45 and 0.50,P values were 0.017 and 0.013,respectively) and Gensini score(r values were 0.476 and 0.563,P values were 0.015 and 0.017,respectively) instead of coronary artery calcifacation score(CACS).Moreover,the EAT/IAT ratio was negatively correlated with CACS(r=-0.321,P=0.028).Conclusions Compared with MS subjects without coronary atherosclerosis,MS subjects with CHD have significantly increased EAT and IAT volumes.In our subjects,the volumes of EAT,PAT and IAT were associated with BMI and WC.Only in MS subjects with CHD,the volumes of EAT and IAT were correlated with caleification and Gensini score.
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<p><b>OBJECTIVE</b>To investigate the molecular genetic basis of samples with ABO typing discrepancy and provide the guidline for identification and clinical transfusion for these samples.</p><p><b>METHODS</b>Six cases with similar serological characteristics were collected. Serological method, PCR-SSP and direct sequencing of ABO gene were used to explore the underlying mechanism. Condition of clinical transfusion of patients was also reviewed.</p><p><b>RESULTS</b>Three conditions were related with the ABO blood type discrepancy, which included weaken antigen (2 cases), weakened antibody (3 cases) and ABO subtype (1 case). The satisfactory effect of transfusion was achieved in all patients with the principle of the same blood type or the compatible crossmatch.</p><p><b>CONCLUSION</b>Heterogeneity has existed with the ABO group. Indivianals with same reaction pattern may result in different mechanisms.</p>