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Objective To observe the value of MRI in evaluation on the morphology and function of iliococcygeal muscles in fertile and nulliparous women.Methods Totally 50 healthy fertile women (fertile group,further divided into cesarean section subgroup and spontaneous delivery subgroup according to the mode of delivery) and 17 nulliparous healthy women (nulliparous group) underwent MR scanning in both natural and increased abdominal pressure state.Iliococcygeus thickness (ICT),coronal iliococcygeal angle (cICA) and sagittal iliococcygeal angle (sICA) of different states were measured and compared between the groups.Results In the natural state,the right and bilateral average sICA in the fertile group were larger than those in nulliparous group (both P＜0.05),while no statistical difference of ICT,right,left and bilateral average cICA and left sICA were found between two groups (all P＞0.05);the bilateral average sICA in spontaneous delivery subgroup was larger than that in cesarean section subgroup (P＜0.05).In increased abdominal pressure state,left,right sICA and bilateral average sICA in fertile group were larger than those in nulliparous group (all P＜0.05),while there was no statistical difference of ICT and cICA between two groups (all P＞0.05);no statistical difference of ICT,cICA nor sICA was found between spontaneous delivery subgroup and cesarean section subgroup (all P＞0.05).Conclusion MRI can accurately evaluate morphological and functional changes of iliococcygeal muscle in females.
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Objective To evaluate the application of exponential apparent diffusion coefficient (eADC)value in differentiating benign from malignant thyroid nodules.Methods Routine MR sequences and axial diffusion weighted imaging (DWI)sequences with different b-values(0, 300,500,800 s/mm2)were performed in 46 patients with 51 histopathologically confirmed thyroid nodules,including 35 malignant nodules and 1 6 benign nodules.The eADC values of each thyroid nodules’solid component with different b-values were measured and assessed by independent samples t test.Receiver operating characteristic (ROC)curves were drawn and used to determine the diagnostic threshold and assess the screen test.Results The eADC values of the malignant nodules were higher than that of benign nodules (P<0.05)in all of the three different b-values.The eADC values of the malignant nodules and the benign nodules were 0.618±0.080 and 0.492±0.071 (b=300 s/mm2),0.520±0.104 and 0.371±0.077 (b=500 s/mm2)and 0.407±0.114 and 0.286±0.097 (b=800 s/mm2)respectively. According to the ROC curve,the area under the curve(AUC)was 0.883,0.890 and 0.824 when the b-value was set as 300,500 and 800 s/mm2respectively.When the b-value was set as 500 s/mm2and the diagnostic threshold was 0.454,the sensitivity,specificity, positive predictive value,negative predictive value and Youden index were 74.3%,93.8%,96.3%,60.9% and 0.68,respectively.Conclusion The eADC value is helpful in differentiating benign from malignant thyroid nodules,and the best result can be obtained by using DWI with b-value of 500 s/mm2.
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Objective To analyze CT findings of nasal NK/T-cell lymphoma.Methods The CT findings of 11 nasal NK/T-cell lymphomas, 134 nasal polyps and 24 nasal inverted papillomas were analyzed retrospectively.Fisher exact test was used to compare the differences of the three nasal lesions.Results Compared with the nasal polyps, nasal NK/T-cell lymphoma had a higher occurrence in the unilateral nasal cavity, more presented as nodular mass or mold growth,and more easily to invade nasal vestibule,nasal ala,nasal mucosal,nasopharyngeal wall and causebone destruction.Compared with the inverted papilloma,nasal NK/T-cell lymphoma had a higher incidence of tumor invasion to nasal vestibule, nasal ala, nasopharyngeal cavity, nasal mucosal.Conclusion Nasal NK/T-cell lymphoma is a homogenous tumor and often occurres in the unilateral nasal cavity, which creeps along the lateral wall of the nasal cavity, and causes the damage of nasal mucosal and surrounding soft tissue and slight destruction of bone in the early satge.
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Objective To evaluate the accuracy of MSCT in the pre-operative N-staging and diagnosis of metastatic lymph nodes in each group of gastric cancer.Methods Pathological and CT data of 91 patients with gastric cancer proved by surgery and pathology were analyzed retrospectively.Three-phase dynamic enhancements were performed before surgery in a unified way of hypotonic oral water,N-stage and grouping of lymph nodes of the preoperative CT imaging were evaluated by using the established diagnostic criteria and then compared with the results of surgery and pathology,the accuracy of staging and grouping was analyzed by using Kappa test.Results The accuracy of MSCT diagnosing the N-staging as a whole was 86.3%.The accuracy for N0,N1,N2 and N3 was 83.5%,89.0%,83.5% and 89.0%,respectively.The sensitivity was 86.5%,83.3%,50% and 47.4%,respectively.The specificity was 79.5%,89.4%,89.6% and 100.0%, respectively.The sensitivity for N0 was statistically different from that for N2, N0 and N3(P≤0.007).The detected accuracy for the group of left side of the cardium (No.2), periphery of the splenic hilum (No.10), posterior of the pancreastic head (No.13) were higher than other groups on MSCT with the accuracyof 100%.The sensitivity for the group of No.2,periphery of the coeliac trunk(No.9),No.10,and No.13 was 100%.The specificity for the group of No.2,No.10,and No.13 was 98.9%.Conclusion Relatively high accuracy in the preoperative N-staging and diagnosis of metastatic lymph nodes in each group of gastric cancer can be obtained by MSCT, which provide reliable information for preoperative assessment and intraoperative lymph node dissections.
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Objective To evaluate the diagnostic value of MSCT in small bowel obstruction and related complications caused by diverticulitis.Methods Clinical data and CT findings of 13 patients with diverticulitis and related complications were reviewed.The imaging findings of diverticulitis were calculated and compared with those in other 20 cases without intestinal obstruction.Results Among the 1 3 cases with diverticulitis,8 occurred in the j ej unum and other 5 in ileum.CT revealed the diverticulitis in all patients as a predominantly cylindrical expansion in communication with the adjacent small bowel.CT showed intraluminal intestinal contents and little air bubbles in 3 cases with simple diverticulitis,thickening of the appendix lumen in 2 cases with perforated diverticulitis, and annular high-density in lumen in 2 cases with diverticulitis and bezoar.CT also showed diverticulitis with volvulus in 6 cases as mesenteric swirling.The average thickness of diverticula were (3.06±0.31)mm,and the average volume of diverticula were (98.98±38.59)cm3 , exhibting statistically significant differences between diverticulitis and control groups (P value were 0.000 and 0.000).Conclusion MSCT is helpful for the diagnosis of small bowel obstruction and related complications caused by diverticulitis.
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<p><b>OBJECTIVE</b>To evaluate the role of 2-deoxy-D-glucose (2-DG) modified supermagnetic iron oxide nanoparticles (SPIO) (γ-Fe2O3@DMSA-DG NPs) in tumor detection as a magnetic resonance imaging (MRI) contrast agent.</p><p><b>METHODS</b>γ-Fe2O3@DMSA-DG NPs was prepared. The degree of A549 cells targeted absorption of γ-Fe2O3@DMSA-DG NPs was detected by Prussian blue staining, colorimetric assay, T2W and multi-echo sequence MRI. γ-Fe2O3@DMSA NPs was used as a control agent, and free D-glucose as a competitive inhibitor. Human lung adenocarcinoma A549 xenograft tumor was prepared in nude mice. Sterile aqueous suspension of γ-Fe2O3@DMSA NPs or γ-Fe2O3@DMSA-DG NPs was injected into the tail vein of nude mice. Before and 6, 12, 24, 48 h after injection, MRI imaging of the mice was performed. T2 signal intensity of the tumor, brain, liver and thigh skeletal muscles, and T2 values of the tumors were measured.</p><p><b>RESULTS</b>The average diameter of the particles was about 10 nm, and there were no significant differences between the diameters of γ-Fe2O3@DMSA NPs and γ- Fe2O3@DMSA-DG NPs. The IR spectra showed the C-N retractable vibration peak at γ-Fe2O3@DMSA-DG NPs surface, indicating that 2-DG was conjugated to the γ-Fe2O3@DMSA NPs. The Prussian blue staining, colorimetric assay, MRI T2 signal intensity and T2 values revealed that γ-Fe2O3@DMSA-DG NPs were significantly more absorbed by A549 cells at growth peak than γ-Fe2O3@DMSA NPs, and the absorption of γ-Fe2O3@DMSA-DG NP was inhibited by free D-glucose. The results of in vivo examination showed that before and at 6, 12, 24, 48 h after injection of γ-Fe2O3@DMSA-DG NPs, the mean T2 signal intensities of the tumors were (326.00 ± 16.26)s, (276.40 ± 5.13)s, (268.40 ± 30.58)s, (240.40 ± 25.93)s, (262.20 ± 30.04)s, respectively, and the T2 values of the tumors were (735.80 ± 20.93) ms, (645.80 ± 69.58) ms, (615.00 ± 124.61) ms, (570.60 ± 67.78) ms, and (537.80 ± 105.29) ms, respectively. However, before and at 6, 12, 24, 48 h after injection of γ-Fe2O3@DMSA NPs, the mean T2 signal intensities of the tumors were (335.60 ± 4.93)s, (290.80 ± 5.93)s, (273.40 ± 15.08)s, (327.40 ± 16.65)s, and (313.20 ± 20.45)s, respectively, and T2 values were (686.00 ± 21.44)ms, (617.80 ± 69.93)ms, (645.20 ± 85.89)ms, (669.40 ± 13.72)ms, and (608.80 ± 61.90)ms, respectively. The T2 signal intensity and T2 value of the tumors were not declined generally after injection. The liver T2 signal intensity was decreased after injection of both γ-Fe2O3@DMSA-DG NPs and γ-Fe2O3@DMSA NPs, and T2 signal intensity of the brain and muscle did not show significant changes.</p><p><b>CONCLUSIONS</b>γ-Fe2O3@DMSA-DG NPs has an ability to target glucose receptors overexpressed in tumors, and may serve as a MRI contrast agent for tumor detection.</p>
Subject(s)
Animals , Humans , Mice , Adenocarcinoma , Diagnosis , Metabolism , Pathology , Cell Line, Tumor , Colorimetry , Contrast Media , Chemistry , Pharmacokinetics , Deoxyglucose , Chemistry , Pharmacokinetics , Ferric Compounds , Chemistry , Pharmacokinetics , Image Enhancement , Lung Neoplasms , Diagnosis , Metabolism , Pathology , Magnetic Resonance Imaging , Magnetite Nanoparticles , Mice, Inbred BALB C , Mice, Nude , Neoplasm Transplantation , Particle SizeABSTRACT
Objective To evaluate the role of 64-slice spiral CT with diphase dynamic scanning in predicting the T staging of gas-tric carcinoma in different locations and assessing the sensitivity of metastasis of lymph nodes.Methods 185 patients with gastric carcinoma proved by pathology underwent diphase 64-slice CT scan and performed a TNM staging according to UICC classification. The results were compared with surgical pathological findings.Results The detection sensitivity for earlier stage gastric carcinoma was 92.0% and 99.4% for the advanced stage gastric carcinoma,While the overall accuracy rates of T and N staging were 85.4%, 69.2% respectively.Compared with the pathologic findings,the accuracy rate of CT scan for T1,T2,T3,T4 staging was 72.0%, 69.6%,90.8% and 83.3% respectively.The differences were statistically significant between T1 and T3,T2 and T3.The accuracy rate of T staging was 86.0%,84.8% respectively when the lesions were located in cardia and in antrum and this difference was not statistically significant.When the lesions were located in the body of the stomach,the differences were also not statistically signifi-cant with the accuracy rate of T staging was 89.5%,86.4% ,87.2% respectively for the lateral wall of the lesser curvature,the posterior wall of the lesser curvature and both the lesser curvature and larger curvature involved.As for the N staging,The accuracy rate of N0,N1,N2,N3 was 54.3%,87.5%,68.1% and 53.6%.The differences were significant statistically between N0 and N1, N1 and N3.Conclusion There was a high accuracy in the preoperative TNM staging of the gastric carcinoma with 64-slice spiral CT. The accuracy rate of T staging of the gastric carcinoma is not relative to the lesion’s location.
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ObjectiveTo estimate the applications of ADC value and rADC value in the diagnosis of nodular lesions of breasts.Methods Fifty-two cases with 66 nodular lesions of breasts confirmed by histopathology underwent diffusion-weighted magnetic resonance imaging.Three b values (0,800 and 1000 s/mm2) were applied.The mean ADC values of the breast nodules,the ADC values of ipsilateral breast( rADC1 )and ADC values of contralateral breast (rADC2 )were respectively measured.The independent-samples t-test and chi-square test were used for statistical analyses.ResultsOf the 52 patients,there were 18 patients with infiltrating ductal carcinoma and 34 patients with fibroadenoma.50 patients with 64 lesions were examined by DWI.( 1 ) at b = 800 s/mm2,the mean ADC values of malignant nodules [ ( 1.01 ±0.09) × 10-3 mm2/s],rADC800-1 (0.52 ±0.07)and rADC800-2 (0.51 ±0.06) were lower than that of the benign nodules [ ADC value = ( 1.54 ± 0.28 ) × 10 -3 mm2/s,t = 8.217,P ＜ 0.01 ; rADC800-1 =0.77 ±0.15,t =9.339,P＜0.01 ; rADC800-2 =0.76 ±0.14,t = 10.394,P ＜0.01 ].The one-side upper limits of 95％ medical reference value of mean values of infiltrating ductal carcinoma were adopted as the threshold point to distinguish the malignant from the benign.The threshold value of breast malignant nodule ADC,the rADC800-1 and rADC800-2 were respectively 1.05 × 10-3 mm2/s,0.55 and 0.53.The sensitivities of the three methods were 75.0％,65.0％ and 60.0％ ; the specificities were 100.0％,95.7％ and 97.8％ ;the positive predictive values were respectively 100.0％,86.7％ and 92.3％ ; the negative predictive values were 90.2％,86.3％ and 84.9％; the diagnosis accordance rates were respectively 92.4％,86.4％ and 86.4％.( 2 ) at b = 1000 s/mm2,the mean ADC values of malignant nodules [ ( 0.93 ± 0.08 ) ×10-3 mm2/s],rADC1000-1 (0.53 ±0.09) and rADC1000-2 (0.52 ±0.07) were also lower than that of the benign nodules[ ADC value= (1.45 ±0.28) ×10-3 mm2/s,t=11.844,P＜0.01; rADC1000-1 =0.75 ±0.16,t=5.820,P ＜ 0.01 ; rADC1000-2 = 0.74 ± 0.15,t = 8.082,P ＜ 0.01 ].The threshold value points breast malignant nodule ADC,the rADC1000-1 and rADC1000-2 were respectively 0.97 × 10-3 mm2/s,0.58,0.55.The sensitivities were all 70.0％ ; the specificities were respectively 100.0％,95.7％ and 93.5％ ;the positive predictive values were 100.0％,87.5％ and 82.4％ ; the negative predictive values were 88.5％,88.0％ and 87.8％ ; the diagnosis accordance rates were 90.9％,87.9％ and 86.5％ respectively.There were no significant differences in specificities and the diagnosis accordance rates ( x2 = 1.232,2.263 ; P =0.942,0.812 ).Conclusions ADC value and rADC value are both important parameters of MRI in differentiating benign and malignant breast diseases.The study indicated that ADC value ( at b =800 s/mm2) was the most valuable parameter.
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Objective To classify the accessory fissures and assess the frequency of accessory fissures of the lung by 64-slice spiral CT (MSCT). Methods Of 2664 patients, 847 patients were included in this study excluding the patients with pulmonary parenchymal distortion, pleural disease or lobectomy. Allvolume raw data with a slice thickness of 0.6 mm were reformatted in sagittal and coronal orientations with 3 mm thickness and the accessory fissures were assessed. Results A total of 177 accessory fissures in 144 patients (17.0%) were detected. Most of the accessory fissures were incomplete except 10 fissures on the right lung (8.2%) and 2 fissures on the left lung (3.6%) were complete. The most common fissurewas the superior accessory fissure on the right low lobe (n = 112,13.2%) ,followed by the left minor fissure (n= 51,6.0%), the right inferior accessory fissure( n = 6,0. 7% ), the left superior accessory fissure ( n =4, 0.5%), the azygos fissure (n = 3,0.4%) and the accessory fissure on the right upper and middle lobe(n = 1,0.1%). Conclusion 64-slice CT is an efficient method to observe and classify the accessory fissures of the lung with MPR technique and can provide reliable and useful imaging information for the clinician.
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e thickness and axial MPR images with 7 mm reformatted slice thickness is the optimal protocal.
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Objective To investigate the dynamic CT features of peripheral lung cancer (PLC) and pulmonary inflammatory pseudotumor(IPT).Methods 23 patients with PLC and 6 patients with IPT were undergone plain and dynamic enhanced CT scans (beginning at 30 s after the onset of injection,serial scan were obtained at 30 s intervals within 180 s) before surgery or administration of antibiotic.Results The average CT values of plain CT,CT enhanced attenuation at 30 s and 90 s were significantly different between PLC and IPT.There were no significant decline following peak enhancement in IPT but PLC within 180 s.Conclusion The comprehensive analysis of plain CT value,enhanced CT value at 30 s,and the decreasing rate after 90 s of administration of contrast material may be useful in differential diagnosis between PLC and IPT.
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Objective To study the relationship between expression of p16 and tumor angiogenesis as well as value of CT enhancement in peripheral lung cancer. Methods twenty-three patients with peripheral lung cancer were examed with dynamic CT scan before surgery.The MVD、protein expression of VEGF and p16 were measured immunohistochemically on speciments of resected tumors.Results There were negative correlation tendency between expressions of p16 and VEGF,but the difference were no significant.During the course of delaying 30 s from injecting contrast dose,the relating coefficient was the highest between enhanced CT value and MVD,P=0.9364.The mean value of MVD and CT enhancement in the course of delaying 30 s in p16 negative expression group were higher than that in the group of p16 positive expression with no significant.Conclusion p16 negative expression may improve angiogenesis in peripheral lung cancer.