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Objective ToinvestigatethefeasibilityofpredictingtheKi-67expressionusing MRandclinicalfeaturesofbreast cancer.Methods 52patientswith56invasivebreastcarcinomawereretrospectivelyinvestigated.Eachsubjectunderwentpresurgical breastMRI,whichincludeddynamiccontrastenhancementandDWI(b=0s/mm2,1000s/mm2).Clinicalcharacteristicsand MR findingswerecollected,includingage,ER ,PR ,HER2,tumorsize,location,number,spiculesign,lobulationsign,margin,TICandADCvalues. Ki-67expressionwasrecordedbyimmunohistochemicalstaining,whichwasdividedintohighexpression(≥20%)andlowexpression (<20%).Leastabsoluteshrinkageandselectionoperator(Lasso)wereperformedtoselectthefeaturesmostassociatedwithKi-67 expression.ThenomogramwasconstructedtopredictKi-67expression,aswellasAUCand95%confidenceinterval(CI)werecalculated.Results TICtypesandADCvaluesassociatedwithKi-67expressionwereidentifiedbyLassoregression.Thenomogram predictedthehigh andlow Ki-67expressionwithanAUCof0.827 (95% CI:0.713-0.940).TheKi-67expressionwasnegativelycorrelatedwiththe ADCvalues(r=-0.430,P=0.003).Ki-67expressionwassignificantlycorrelatedwithTICtype,andTICⅢwasmorelikelytohavehigher expressionofKi-67.Conclusion ThereisindividualandrespectivecorrelationbetweentheexpressionlevelofKi-67andTICtype, ADCvalue.TheexpressionlevelofKi-67canbepredictedtosomeextentbyADCvaluesandTICtypes.
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Objective To explore the technique and clinical effect of Fogarty catheter in treatment of acute limb arterial embol-ism.Methods Eight cases of acute limb arterial embolism treated by Fogarty catheter were analyzed retrospectively.The technique of thrombectomy,curative effect,complications,prognosis,and 6-24 months follow-up results were assessed to evaluate the safe-ty,effectiveness and operative skills.Results Seven cases were cured,and 1 case was efficacious.The endangium injury and vaso-spasm was occurred in 1 case,respectively.During follow-up from 6 to 24 months,6 cases recovered activity,1 case was hemiplegia because of cerebral infarction after 12 months,and 1 case died of respiratory function failure after 6 months.Conclusion Fogarty catheter is safe and effective in treatment of acute limb arterial embolism.
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Objective To discuss the safety and clinical effect of fine needle single-step centesis in percutaneous endoscopic nephrolithotomy for renal staghorn calculi. Methods Percutaneous endoscopic nephrolithotomy with fine needle single-step centesis was employed in 75 patients (single-step group) with renal staghorn calculi, and percutaneous endoscopic nephrolithotomy with two-step centesis was adopted in other 75 patients with renal staghorn calculi (two-step group). The clinical effect and the incidence of complications were compared between the two groups. Results The placement of drainage catheter was successfully accomplished in all 150 patients. In single-step group the operation time was 18-45 minutes with a mean of 36 minutes; the mean blood loss during the procedure was about 5 ml. After the treatment, massive bleeding occurred in 3 cases that needed blood transfusion, and residual stone was observed in 6 cases. In two-step group the operation time was 16-42 minutes with a mean of 34 minutes; the mean blood loss during the procedure was about 7 ml. After the treatment, massive bleeding occurred in 7 cases that needed blood transfusion; one of them had renal pseudoaneurysm and the bleeding was stopped after renal artery embolization treatment; and residual stone was observed in 7 cases. No procedure-related perirenal organ injury was seen in single-step group, while in two-step group pneumothorax (n=1) and injury of splenic flexure of colon (n=1)were found. Conclusion In performing percutaneous endoscopic nephrolithotomy, fine needle single-step centesis is more safe and effective than conventional two-step centesis.
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Objective To assess the clinical value of interventional treatment for bone and soft-tissue tumors. Methods Selective angiography, transcatheter intra-arterial chemotherapy and/or embolization were performed in 28 patients with pathologically-proved bone and soft-tissue tumors. After treatment the clinical response and pathological changes were observed, and the results were analyzed. Results After transcatheter intra-arterial chemotherapy and/or embolization, relieving or even disappearing of the pain was seen in 23 patients, subside of soft-tissue swelling together with regression of the tumor was seen in 19 patients. Twenty-two patients underwent surgical resection of the lesion one week afte.r interventional treatment. Pathologically, cellular degeneration, necrosis and various degrees of liquefaction were demonstrated on the tumor specimen, which were more obvious in patients treated with embolization. Limp-sparing resection was adopted in 66.7% of patients (10/15). Conclusion lnterventional therapy is an effective method for bone and soft-tissue tumors and it is worth popularizing this technique in clinical practice.
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Objective To suty DSA features of the splencin artery which provides blood supply to the tumor in the patients with hepatic carcinoma,to improve the clinical results of interventional therapy.Methods DSA was performed in 3 patients with hepatic carcinoma and the blood supply of tumors by splenic artery was found.The DSA features were analysed and the interventional embolization was carried out at the same time.Results After super-selective embolization of the splenic artery,obvious reduction of the tumor-feeding microvessels and marked shrinking of the lesion were observed in all cases.Conclusion Splenic artery as one of the supply arteria to the tumors in hepatic carcinoma is very important to familiarize that in transcatheter arterial chemoembolization for hepatic carcinoma.
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Objective To evaluate the interventional management in emergency splanchnic bleeding and the application value.Methods 27 patients with emergency splanchnic bleeding underwent the interventional management in our hospital from May of 2003 to January of 2006 were reviewed.The sites and causes of the splanchnic hemorrhage were verified through selective DSA,using different methods and materials for percutaneous transarterial embolization.Results No bleedings recurred in all 27 patients within 18 months after the treatment.3 patients of advanced hepatic carcinoma died in 6 months because of non-splanchnic bleeding etiology.Conclusions Selective angiography is a veracious way to detect the location and cause of emergency splanchnic hemorrhage.The choice of different selective arterial embolizations and embolic materials can effectively and promptly cease the bleeding with rescuing the patients.
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Objective To study CT findings and prognosis of hypoxic -ischemic encephalopathy in full term neonates .Methods Two hundred and sixty-eight cases of full-term neonates diagnosed clinically as hypoxic-ischemic enceohathy(HIE) were examined.Seventy-nine cases were observed by CT follow-up one or four times.Nineteen normal neonates with same age were selected as contral group.Results Two hundred and thirteen cases(79%)were abnormal on CT.The CT value of the low density area of brain white matter were lower than 18 HU in two hundred cases(94%).The low density area were enlarged in one hundred and ninty two cases(90%).Subarachnoid hemorrhage(SAH) were found in seven cases(3.3%) and intraventricular hemorrhage(IVH) in four cases(2%), and infarction in one case (0.5%).CT follow-up study of 51 cases were carried out around one year of age . 27 of them were abnormal on CT,mostly showing external hydrocephalus,minority of them with cerebral atrophy and softening .23 cases were studied by CT follow-up at or after two years old,3 of them had external hydrocephalus and 1 of them had cerebral softening.Conclusion CT findings of HIE mostly had :①brain edema showing lower density area of enlarged brain white matter;②brain hemorrhage mostly showing subarachnoid hemorrhage and intraventricular hemorrhage;③seldom brain infarction.Prognosis of HIE which was mild and moderate degree based on CT findings was better ,and severe degree was bad.
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Objective To evaluate the long-term curative effect of bronchial artery embolization on massive hemoptysis in patients with pulmonary tuberculosis. Methods Bronchial arterial embolization with PVA grain and silk segment was performed in 42 cases of patients with hemoptysis of secondary pulmonary tuberculosis. Of them, 27 cases were bilateral pulmonary tuberculosis and 15 lateralized. The bloody bronchial arteries were confirmed by bronchial arteriography, and the PVA grains or silk segments were injected slowly into the target vessels until hemorrhage stopped. Results After one time embolization, hemoptysis stopped immediately in 34 cases, 7 cases still had little hemoptysis,and one case of hemorrhage was unable to be controlled. The short-term efficacious rate was 97.6%,and no severe complications occurred. Followed up 6 months to 7 years after treatment,24 cases were clinical cure,7 cases obviously effective,5 cases effective,and 6 cases recurrent.The long-term effective rate is 85.7%. Conclusion Embolization of bronchial artery with PVA grain and silk segment was a safe and effective method for controlling hemoptysis of pulmonary tuberculosis, and its combination with anti-tuberculosis treatment could consolidate the curative effect.