CT features of primary hepatic fibrosarcoma / 中华消化外科杂志

Objective:To investigate the computed tomography (CT) features of primary hepatic fibrosarcoma (PHF).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 8 patients with PHF who were admitted to 2 medical centers from January 2010 to December 2019, including 3 cases of Yueqing People's Hospital of Zhejiang and 5 cases of Wenzhou People's Hospital of Zhejiang were collected. There were 5 males and 3 females, aged 50 years(range, 39?60 years). All patients underwent abdominal CT plain and enhanced examination, and surgical procedures were selected based on patients' will and individual situations. Surgical tumor specimens were given pathological examination and immunohistochemical staining. Observation indicators: (1) imaging features of CT examination; (2) treatment and pathological examinations; (3) follow-up. Follow-up was performed by outpatient examination or hospitalization to detect survival of patients and tumor recurrence up to December 2020. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Imaging features of CT examination: 8 patients received preoperative CT examinations, 3 cases of which were diagnosed as malignancies, 3 cases were diagnosed as hepatic space-occupying lesions, 2 cases were diagnosed as intrahepatic cholangiocarcinoma. ① Tumor location and general status: 8 patients had single tumor, of which 6 cases had tumor located in the right lobe of the liver and 2 cases had tumor located in the left lobe of the liver. The tumor was in oval shape in 5 patients and in circular in 3 patients. The maximum diameter of tumor in 8 patients was 9.3 cm(range, 4.0?15.0 cm). There were 1 case with tumor maximum diameter ≤5.0 cm, 4 cases with tumor maximum diameter as 5.1?10.0 cm, 3 cases with tumor maximum diameter >10.0 cm. ② CT plain scan showed uniform low density in 2 cases and uneven low density in 6 cases and the CT value of 8 cases was 40 HU(range, 29?43 HU). The tumor showed expansive growth with clear boundary in 6 cases, and invasive growth with unclear boundary in 2 cases. Five cases had intratumoral necrosis and cystic transformation, 2 cases had intratumoral strip hemorrhage, and 1 case of intratumoral calcification. There was 1 case with hilar lymph node metastasis. ③ Enhanced CT scan showed 8 cases with uneven enhancement in arterial phase, 8 cases with uneven tumor density in portal vein phase, 8 cases with intratumoral enhancement slowly withdrew in delayed phase and the density lower than liver parenchyma. (2) Treatment and pathological examinations: ① 8 patients under-went surgical resection, without intrahepatic or hilar metastasis. ② The results of postoperative pathological examination showed 2 cases with grade Ⅰ tumor differentiation (low potential malignancy), 5 cases with grade Ⅱ and Ⅲ tumor differentiation (moderate potential malignancy), 1 case with grade Ⅳ tumor differentiation (high potential malignancy). ③ Immuno-histochemical staining showed that 8 cases were positive for vimentin, CD10, p53 and negative for smooth muscle actin, keratin19, epithelial membrane antigen, endotheliocyte 34. All 8 patients were diagnosed as PHF. (3) Follow-up: all 8 patients were followed up for 7 to 128 months, with a median follow-up time of 53 months. The overall survival time of 8 patients was 15 to 122 months, and the median overall survival time was 45 months. One patient died of tumor recurrence and distant metastasis at 17 months after surgery, and the survival time of 7 patients was >28 months.Conclusions:CT plain scan of PHF showed uneven low-density masses. After enhancement, the arterial phase shows the tumor ring or peripheral nodular uneven enhancement, the intratumoral strip-shaped enhanced blood vessels. The portal vein phase shows the tumor-like small patches or grid-like continuous enhancement. The delayed phase is characterized by the slow withdrawal of intratumoral enhancement.

Imaging findings of primary peripheral primitive neuroectodermal tumors of bone / 中国医师进修杂志

investigate the clinical and imaging features of primary peripheral primitive neuroectodermal tumors (pPNETs) of bone. Methods Clinical and X-ray, CT and MRI findings of 6 cases of primary bone pPNETs in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang, Yueqing People′s Hospital of Zhejiang, and Wenzhou People′s Hospital of Zhejiang were retrospectively analyzed. Results There were 4 males and 2 females, aged from 2 to 38 years, with an average age of (18.5 ± 12.0) years old. Local pain was found in all cases, including 4 cases with mass, with an average survival of (22.2 ± 16.9) months. Iliac bone tumor was found in 2 cases, sacrum in 2 cases, scapula in 1 case and femur in 1 case. Digital radiography(DR) examination was performed in 4 cases:4 cases showed osteolytic destruction, including 1 case with mild swelling changes, 1 case with laminar periosteal reaction and radial bone needle, and 3 cases with soft tissue mass. CT examination was done in 4 cases, and there were 4 cases of osteolytic destruction accompanied by soft tissue mass without periosteal reaction. Among them, 1 case had irregular sclerosis at the edge of bone destruction and 2 cases had fine calcification in soft tissue mass. MRI examination in 4 cases:there were 3 cases with equal signal on T1WI and 1 case with moderate to high signal on T1WI, 3 cases with inhomogeneous medium and high signal on T2WI and STIR, and 1 case with homogeneous high signal on T1WI, and 4 cases with soft tissue masses and peritumoral edema. Conclusions Bone pPNETs is characterized by osteolytic destruction with soft tissue masses, periosteal reaction with or w ithout periosteal reaction, and intratumor al calcification. Im aging exam ination is helpful to under stand the extent of lesions, formulation of therapeutic measures and evaluation of therapeutic effect.

Imaging findings of primary peripheral primitive neuroectodermal tumors of bone / 中国医师进修杂志

Objective@#To investigate the clinical and imaging features of primary peripheral primitive neuroectodermal tumors (pPNETs) of bone.@*Methods@#Clinical and X-ray, CT and MRI findings of 6 cases of primary bone pPNETs in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang, Yueqing People′s Hospital of Zhejiang, and Wenzhou People′s Hospital of Zhejiang were retrospectively analyzed.@*Results@#There were 4 males and 2 females, aged from 2 to 38 years, with an average age of (18.5 ± 12.0) years old. Local pain was found in all cases, including 4 cases with mass, with an average survival of (22.2 ± 16.9) months. Iliac bone tumor was found in 2 cases, sacrum in 2 cases, scapula in 1 case and femur in 1 case. Digital radiography(DR) examination was performed in 4 cases:4 cases showed osteolytic destruction, including 1 case with mild swelling changes, 1 case with laminar periosteal reaction and radial bone needle, and 3 cases with soft tissue mass. CT examination was done in 4 cases, and there were 4 cases of osteolytic destruction accompanied by soft tissue mass without periosteal reaction. Among them, 1 case had irregular sclerosis at the edge of bone destruction and 2 cases had fine calcification in soft tissue mass. MRI examination in 4 cases:there were 3 cases with equal signal on T1WI and 1 case with moderate to high signal on T1WI, 3 cases with inhomogeneous medium and high signal on T2WI and STIR, and 1 case with homogeneous high signal on T1WI, and 4 cases with soft tissue masses and peritumoral edema.@*Conclusions@#Bone pPNETs is characterized by osteolytic destruction with soft tissue masses, periosteal reaction with or without periosteal reaction, and intratumoral calcification. Imaging examination is helpful to understand the extent of lesions, formulation of therapeutic measures and evaluation of therapeutic effect.

Application of wrist MRI combined anti-cyclic citrullinated peptide antibody detection in the diagnosis of early rheumatoid arthritis / 中国医师杂志

Objective To study the clinical value of wrist magnetic resonance imaging (MRI) combined anti-cyclic citrullinated peptide antibody detection in the diagnosis of early rheumatoid arthritis (RA).Methods Forty five patients with early RA were selected as RA group,45 cases of patients without rheumatoid arthritis as non-RA group,and 43 cases of people with normal examination as control group.All subjects were given wrist MRI and anti-cyclic citrullinated peptide (CCP) antibody with the enzyme linked immunosorbent assay (ELISA).At the same time,clinical symptoms,physical signs,MRI manifestations,and laboratory indicators were collected.All results were statistically analyzed.Results Positive rate of MRI lesions and serum anti-CCP antibody in RA group were significantly higher than non-RA group and control group (P ＜0.05).The sensitivity and specificity of MRI (or anti-CCP antibody) for early RA were 88.88％ and 82.22％ (or 68.88％ and 91.11％).The sensitivity (64.44％) of MRI combined with anti-CCP antibody was decreased compared to individual; however,the specificity (100％) of MRI combined with anti-CCP antibody was increased.The correlation of MRI synovial scores and anti-CCP antibody levels was positively correlated (rs =0.612,P ＜ 0.05).MRI abnormal signs and joint disease activity score (DAS28) were positively correlated (rs =0.521,P ＜ 0.05).Anti-CCP antibody levels and DAS28 were positively correlated (rs =0.541,P ＜ 0.05).Conclusions MRI examination and combined with anti-CCP antibody detection is helpful to improve the diagnosis of early RA,and it provides a detection basis for dynamic assessment of RA condition changes.

CT findings and pathology comparative analysis of ectopic pheochromocytoma in the abdomen / 中华内分泌外科杂志

Objective To investigate the CT characteristics of ectopic pheochromocytoma in the abdomen.Methods The CT characteristics of 31 cases of ectopic pheochromocytoma in abdomen proved by surgery and pathology were retrospectively analyzed.The relationship between the density,cystic change,calcification,boundary,the enhancement degree and pathological types and tumor tissue components were studied.Results The tumors location was:9 cases in mesentery,8 cases adjacent to abdominal aorta(7 on the left and1 right),3 cases above the adrenal gland(2 on the right and 1 left),3 cases outside the renal hilum(1 on the right and 2 left),3 cases behind the inferior venacava,3 cases in hepatic hilum,and 2 cases in duodenal ampulla.Tumor size ranged from 2.7 cm ×2.5 cm to 18.0 cm × 11.0 cm(average 6.8 cm ×5.6 cm).CT plain scan:the CT value was 32-58 Hu for the substantial part(average 45 Hu),18 to 25 Hu for the cystic necrosis part (average 21.5 Hu).28 cases had clear boundary and tumor boundary in 3 cases was not clear.24 cases had equal density of the substantial part,7 cases had high density of the substantial part.21 had irregular low-density areas of necrosis in the mass center.8 cases had punctiform,patchy or linear calcification in the mass.Enhanced CT:CT value in arterial phase was 47-105 Hu of the substantial part(average 76 Hu),among which tortuous expansion within the enhanced vascular shadow of the tumor was found in 8 cases.CT value in venous phase was 45 to 90 Hu of the substantial part(average 65Hu),among which 7 cases had obviously decreased density in parenchymal enhancement part,19 cases slightly decreased,and 5 cases strengthened constantly.CT value in delayed phase was 42 to 70 Hu of the substantial part(average 56 Hu),among which 26 cases had less enhancement degree of the substantial part compared to that in the arterial and venous phase,and 5 cases had constant enhancement.Conclusions Ectopic pheochromocytoma in the abdomen has certain characteristic in CT.CT characteristics are correlated with pathologic types and tissue components.CT findings combined with clinical manifestation may suggest diagnosis.

Correlative study of subacromial space and acromial shoulder impingement syndrome / 中国基层医药

Objective To investigate the correlation between subacromial space and acromial shoulder impingement syndrome (SIS).Methods The clinical and imaging data of 40 patients with SIS were collected and retrospectively reviewed.The shape of acromion and tears of rotator cuff of all patients were classified.A cromion-Humerus (A-H) distance was measured.Results Among 40 patients,there were 9 cases of type Ⅰ,12 cases of type Ⅱ,19 cases of type Ⅲ.32 patients had subacromial space narrowing.7 cases had calcification in the supraspinatus tendon and 10 patients had acromioclavicular joint ostcoarthritis.There were 17 cases of type Ⅰ,15 cases of type Ⅱ,18 cases of type Ⅲ of tears of rotator cuff.6 patients had subacromial bursa thickening,5 patients had subacromial-deltoid sac fluid and 10 patients had the joint capsule fluid.2 patients had jointlabrum avulsion,3 patients had the supraspinatus muscle atrophy and 4 patients had Bankart Lesion.There was no significant difference was found in A-H distance measured with X-ray and MRI(P =0.137 0).There was positive correlation between the A-H distance and class of rotator cuff(r =0.545,P =0.000 1).Conclusion There exists some correlation between subacromial space and SIS.The diagnosis and class of SIS can be assessed according to narrowing range of subacromial space.

CT features of traumatic bone cyst / 中华放射学杂志

Objective To study the CT findings of traumatic bone cyst and to improve the knowledge of that disease.Methods CT features of 8 cases of traumatic bone cyst confirmed by clinical and pathology were reviewed retrospectively.There were 4 females and 4 males,from 26 to 76 years (the median age was 53 years old)of age.Three patients had traffic accidents,2 patients had trauma unrelated,1 patient had boulder crushing,1 had patient stick wounded and 1 patient had high jump wounding.The bone cyst occurred from 18 to 36 months after trauma(2 at 18 months,4 at 24 months,1 at 30 months and 1 case at 36 months).Results There were 6 fractures,1 joint dislocation and 1 frontal soft tissue hematoma in trauma.The cyst located in the ilium of 3 cases,in the calcaneus of 2 cases,in the frontal bone of 1 case,in the hooked bone of 1 case,in the lunate bone of 1 case.The cyst size was 2.0 cm × 2.6 cm to 3.0 cm × 6.0 cm (average 2.7 cm × 4.0 cm).8 cases all single capsule change,all clear boundaries.6 cystic destruction and 2 cystic expansion destruction of bone.Two see separated and 6 no divider of the cyst region.Five bone sclerosis and 3 no hardening of the cyst edge.Three sclerosis and Five no sclerosis of the adjacent bone.Four osteoporosis decalcification and 4 no osteoporosis decalcification of he adjacent bone.Conclusion The traumatic bone cyst is closely related to trauma,CT manifestations with certain characteristics,combined with a history of trauma can make a definite diagnosis.

Study on Pharmacokinetics of Escitalopram Oxalate Tablets in Human Body / 中国药房

OBJECTIVE:To study the pharmacokinetics of escitalopram oxalate tablets in human body.METHODS:Es-citalopram oxalate tablets were administered orally at a single dose of30mg to10healthy subjects respectively,the plasma concentration of escitalopram oxalate was determined by HPLC method,the pharmacokinetic parameter was fitted with3p97software.RESULTS:The concentration-time curve of escitalopram oxalate tablets was in line with the two-compartment model,the main pharmacokinetics parameters of escitalopram oxalate were as follows,the C max was(42.73?10.19)?g?L,t max was(2.90?0.32)h,t 1/2 was(35.34?7.78)h,AUC 0～132 was(1241.5?194.3)(?g?h)/L and the AUC 0～∞ was(1327.5?210.5)(?g?h)/L.CONCLUSION:The study on pharmacokinetics can be used as a reference in the clinical medication.