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Objective To explore the diagnostic value of contrast-enhanced ultrasound (CEUS) in detecting small liver metastasis (SLM) from breast cancer. Methods A total of 92 cases diagnosed as breast cancer by surgical pathology and suspected SLM by conventional ultrasonography were included in this study. CEUS was used to check liver lesion in patients. The biopsy operation was used as the gold standard. The coincidence rate of benign and malignant pathology was used to compare the consistency between CEUS and biopsy pathology. Results In 92 cases suspected liver metastases of breast cancer by routine ultrasound, there were 54 cases were diagnosed as benign by pathology, and all 92 cases were diagnosed as benign by CEUS. Thirty-eight cases were diagnosed as metastasis by pathology, in which 36 cases were correctly diagnosed by CEUS. The sensitivity of CEUS for the diagnosis of liver metastases of breast cancer was 94.74%(36/38), specificity was 100%(54/54), positive predictive value (PPV) was 100%(36/36) and negative predictive value (NPV) was 96.43%(54/56). Conclusion CEUS has a higher diagnostic value in SLM of breast cancer, and has clinical practical value.
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<p><b>OBJECTIVE</b>To evaluate the feasibility, safety, clinical, and angiographic follow-up of only overlapping stents therapy for intracranial vertebral artery dissection aneurysms (VADA).</p><p><b>METHODS</b>Eight consecutive patients (6 men, 2 women; mean age 46.8 years ranging from 34 to 62 years) with intracranial VADA admitted to Department of Neurology, Chinese People's Liberation Army General Hospital from June 2008 to June 2014 were retrospectively reviewed. All patients were diagnosed intracranial VADA by MRI or digital subtraction angiography (DSA). All patients were treated by only overlapping stents therapy under general anesthesia. In the endovascular treatment process 2 to 3 Solitaire, Neuroform or Wingspan self-expandable stents were overlapping implanted in the segment of the aneurysms. All patients received routine antiplatelet therapy before and after endovascular treatment.</p><p><b>RESULTS</b>The operative procedures were succeeded in all patients. Eight patients were implanted 18 stents (2 patients, 3 stents; 6 patients, 2 stents). The stents were located accurately and implanted smoothly, none perioperative complications occurred. All patients lived and worked normally and had no recurrent symptoms on follow-up of 6 to 48 months. All patients performed DSA reexamination on follow-up. The aneurysm blocked in 2 patients, the size lessened in 2 patients, and the size had no change in 3 patients.</p><p><b>CONCLUSIONS</b>Only overlapping stents therapy for treating intracranial VADA is feasible and has good operation safety. Preliminary follow-up results show that it can reduce the probability of thrombosis or hemorrhage and can improve the patients' life quality.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Intracranial Aneurysm , General Surgery , Retrospective Studies , Stents , Treatment Outcome , Vertebral Artery Dissection , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the feasibility,safety and follow-up results of multiple stents parallel placement and reconstruction technique for treating giant vertebrobasilar dissecting aneurysms.</p><p><b>METHODS</b>Five consecutive patients with giant fusiform vertebrobasilar dissecting aneurysms in Department of Neurology,Chinese People's Liberation Army General Hospital were retrospectively reviewed from April 2011 to October 2013. All patients were diagnosed vertebrobasilar dissecting aneurysms by MRI and digital subtraction angiography (DSA), the aneurysm size ranged 8.2-15.0 mm. All patients were treated by multiple stents parallel placement and reconstruction technique under general anesthesia. In the endovascular treatment process, 2-3 Solitaire or Neuroform self-expandable stents were parallel implanted in the maximum extension segment of the aneurysms to reconstruct the cavity of the aneurysm and solved the problem that the diameter of the intracranial stent is less than the diameter of the aneurysms. Multiple stents parallel placement can keep the stents stable in the cavity. The parallel stent can close the dissection as well as strengthen the aneurysm walls to alleviate the vessel pulsative compression of the brain stem. Furthermore, one of the parallel stents was selected for the main blood flow channel. Based on the main channel, telescope technique was used to completely covering the dissection. It can not only prevent the progress of dissection to normal regions, but also be helpful for blood flow channel reconstruction to reduce the hemodynamic disorders. All Patients received routine antiplatelet therapy before and after endovascular treatment.</p><p><b>RESULTS</b>The operative procedures were succeeded in all patients. Five patients were implanted 18 stents (3 stents in 3 patients; 4 stents in 1 patient; 5 stents in 1 patient; parallel 3 stents in 2 patients; parallel 2 stents in 3 patients). The signs and symptoms of brain stem and posterior group of cranial nerves improved significantly. All patients lived and worked normally and had no recurrent symptoms on follow-up of 6-24 months. All patients performed DSA reexamination at 6-12 months postoperation. The aneurysm size lessened in 2 patients and had no change in 3 patients.</p><p><b>CONCLUSIONS</b>Multiple stents parallel placement and reconstruction technique for treating giant fusiform vertebrobasilar dissecting aneurysms is feasible and have good operation safety. It may control the dilatation of the aneurysm and reduce the probability of thrombosis or hemorrhage. It can improve the patients' clinical symptoms and quality of life in short term follow-up. The long term result need for further follow-up.</p>
Subject(s)
Humans , Aortic Dissection , General Surgery , Intracranial Aneurysm , General Surgery , Quality of Life , Retrospective Studies , Stents , Treatment OutcomeABSTRACT
Objective To evaluate the value of positive 99Tcm-MIBI tumor imaging for thyroid cancer diagnosis. Methods Fifty four suspected thyroid cancer patients underwent 99Tcm-O4 and 99Tcm-MIBI combined imaging procedure. The imaging data were confirmed by pathological findings. Results All the 54 cases had single throid nodules, and 25 of which were pathologically malignant. Fifty two cases of nodules were detected by the 99Tcm O4 thyroid static imaging, including 2 hot nodules,4 warm nodules, 10 cool nodules and 36 cold nodules;2 cases were negative by the imaging. Of the 25 malignant thyroid nodules, 16 nodules were visible by 99Tcm-MIBI uptake and were cold nodules;29 exhibited benign thyroid nodules,of which 15 could be seen by 99Tcm-MIBI uptake,including 1 warm nodules,2 cool nodules and 12 cold nodules. The sensitivity, specificity of the combined imaging of 99Tcm O4 and 99Tcm-MIBI were 64. 00% ( 16/25 ) and 48. 28% (14/29). No significant difference was found for the positivity between benign nodules and malignancy nodules by 99Tcm-MIBI tumor imaging ( χ2 = 0. 83, P ＞ 0. 05 ). Conclusion 99Tcm-MIBI tumor imaging is not specific for the diagnosis of thyroid malignancy.
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OBJECTIVE: To investigate the effects of Wenyang Huoxue Recipe (WRHXR), a compound traditional Chinese herbal medicine for warming yang and promoting blood flow, on the expression of angiopoietin mRNA in rats with chronic aristolochic acid nephropathy induced by Caulis Aristolochia Manshuriensis (CAM) decoction, and to explore the protection mechanism of WYHXR against kidney damage. METHODS: Twenty-eight male SD rats were randomly divided into normal control group, CAM group and WYHXR-treated group. Rats in the normal control group (n=8) and CAM group (n=10) were intragastrically administered with normal saline 10 ml/(kg.d) or CAM decoction 10 ml/(kg.d) respectively. Rats in the WYHXR-treated group (n=10) were intragastrically administered with WYHXR 30 g/(kg.d) and CAM decoction 10 ml/(kg.d). The expressions of Ang-l and Ang-2 mRNAs were detected by real-time reverse transcription polymerase chain reaction (RT-PCR) after 20-week treatment. RESULTS: Compared with the normal control group, the expression of Ang-l mRNA was significantly decreased, and the expression of Ang-2 mRNA was significantly increased in the CAM group (P0.05). Renal pathology showed that renal damage in WYHXR-treated group was significantly reduced as compared with the CAM group. CONCLUSION: WYHXR can up-regulate the expression of Ang-l mRNA, which may be its action mechanism in protecting the kidneys.