Comparison of CT features of severe and non-severe coronavirus disease 2019 at admission / 中华全科医师杂志

Forty-one patients with COVID-19 (22 males and 19 females with the age of 24~94 years) from February to March 2020 were enrolled in the study, including 15 severe or critically ill cases (severe group) and 26 moderate cases (non-severe group). The CT findings of intrapulmonary lesions at admission were evaluated and compared between severe and non-severe groups. There were significant difference between severe and non-severe groups in the aspects of the presence or absence of pure ground-glass opacity (GGO) (χ 2=10.791), GGO with focal consolidation (χ 2=5.512), sheet consolidation (χ 2=27.359), crazy paving sign (χ 2=8.343), thickening of the bronchial wall (χ 2=14.473), air bronchogram sign (χ 2=4.977), and pleural effusion (χ 2=6.561), all P<0.05. Multivariate logistic regression analysis showed that range of lesion involvement was a relevant factor for severe cases( OR=0.029,95 %CI:0.001-0.647, P=0.026). The study indicates that CT features are diverse in COVID-19 patients; there is lack of pure GGO, but more GGO with focal consolidation. The appearance of sheet consolidation and crazy paving sign and wide-range of lesion involvement and pleural effusion in CT findings may be indications for severe COVID-19.

DifferentialdiagnosticvalueofMSCTforadvancedgastriccancerandgastriclymphoma / 实用放射学杂志

Objective ToinvestigatetheapplicationvalueofMSCTinthedifferentialdiagnosisofadvancedgastriccancerand gastriclymphoma.Methods AretrospectiveanalysisofCTimagingdatawascarriedoutin48patientswithadvancedgastriccancer and16patientswithgastriclymphoma,confirmedbypathology.ThedifferencesofCT manifestations,includingtumorsiteinthe stomach,gastricwallchanges,gastricmucosachanges,changesofgastriccavity,densityandtheenhancementpatterns,adjacentadiposetissue changes,otherorganinvolvementandlymphnodemetastasis,wereanalyzed.Results Foradvancedgastriccancer,thetumorswere locatedinthegastricantrumin21casesandinmultiplesitesin11cases.Forgastriclymphoma,thetumorswerelocatedinthegastric bodyin2casesandinmultiplesitesin10cases.Foradvancedgastriccancer,gastricmucosaldisruptionwasfoundin33cases,stenosisofthe gastriclumenin27cases,andinhomogeneousenhancementin36cases.Forgastriclymphoma,gastricmucosaldisruptionwasfound in2cases,stenosisofthegastriclumenin3cases,andinhomogeneousenhancementin2cases.Foradvancedgastriccancer,morethan twogroupsoflymphnodesaroundthestomachwereinvolvedin23cases,andretroperitoneallymphadenopathybelowthelevelofrenalhilumin 9cases.Forgastriclymphoma,morethantwogroupsoflymphnodesaroundthestomachwereinvolvedin8cases,andretroperitoneal lymphadenopathybelowthelevelofrenalhilumin4cases.TherewerestatisticallysignificantdifferencesinCTmanifestationsmentionedabove, notinotherCT manifestationsbetweenthetwogroups.Conclusion MSCTcanwelldemonstratethethicknessofthediseasedgastricwall,the lesion’sdensity,siteandextent,theinvolvementofadjacentorgans,andboththeabdominalandretroperitoneallymphadenopathy. MSCTfindingsofadvancedgastriccancerandgastriclymphomahavecertaindifferenceandtheirowncharacteristics,providingCT evidencesforthedifferentialdiagnosiswhichishelpfulforthediagnosisandtreatment.

The value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma / 中华普通外科杂志

Objective To explore the clinical value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma (PTC).Methods A total of 1 408 PTC patients who met the inclusion criteria and received initial thyroidectomy at our department from January 2006 to December 2011 were enrolled in this study.Results After a median follow-up time of 7.8 years,distant metastases developed in 46 patients.Patients with lateral neck lymph node metastasis ≥7,individual size of lateral neck lymph node metastasis ≥ 1.15 cm and the total number of cervical lymph node metastasis ≥9 were prone to higher risk of distant metastasis;the high risk group had a lower 10-year distant metastasisfree survival (78.7％ vs.98％,x2 =122.941,P ＜0.01) and a shorter distant metastasis-free survival time (99.2 M vs.122.5 M,x2 =122.941,P ＜ 0.01).Conclusions Lateral lymph node metastasis is an independent risk factor for distant metastasis in PTC patients.

Analysis on cases of fetus limb deformity using systematic continuous sequence approach during early and middle pregnancy / 中华医学超声杂志（电子版）

Objective To summarize prenatal two-dimensional ultrasound examination results of different types of fetal limb deformity,and emphasise on some rare deformity disease such as phocomelia and sirenomelia.To investigate the value of systematic continuous sequence approach in the examination of fetal limb during pregnancy periods.Methods Eighteen thousand seven hundred and eight cases of fetus were selected from September 2014 to August 2016 in the 105th Hospital of Chinese People's Liberation Army,which were screened by routine and systematic ultrasonography.The systematic continuous sequence approach was used to focus on examination of the fetal limb.All fetuses with abnormal limbs were followed up.The ultrasonographic images were compared with the results of pathological examination and X-ray examination to summarize the ultrasonographic features of fetal limb deformities.Results Seventy-six cases of fetal limb deformity were detected by prenatal ultrasotmd system in 18 708 cases.Three cases were detected at 11-13 + 6 weeks of gestation,18 at 14-19 + 6 weeks,38 at 20-27 + 6 weeks,17 at 28-35 + 6 weeks.Types of limb deformities are as fllowing,11 cases of abnormal number of fingers (adactylism,polydactyly,syndactyly),2 cases of cleft hand deformity,45 cases of foot varus,1 case of sirenomelia and 4 cases of short limbs.Thirty-seven cases of fetal limb deformity combined with other system malformations and 12 cases were with multiple system malformations.Karyotypes were abnormal in 11 cases,including 3 cases of trisomy 21,6 cases of trisomy 18 and 3 cases of trisomy 13.One case of prenatal ultrasound diagnosis of twins with sirenomelia.An autopsy of twin fetus indicated that there were epactal toes at the left foot.Prenatal ultrasonography.Conclusions The systematic continuous sequence approach in early and middle pregnancy play the advantages of each pregnancy examination.The fetal limb deformity can be detected early by combining application of systematic continuous sequence approach.

Pharmacokinetic parameters of dynamic contrast enhanced MRI in differential diagnosis of primary central nervous system lymphoma and glioblastoma / 中国医学影像技术

Objective To explore the difference of pharmacokinetic parameters derived from dynamic contrast enhanced (DCE) MRI between primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM).Methods Data of 17 patients with PCNSL and 21 patients with GBM were retrospectively analyzed.All patients underwent DCE MRI.The pharmacokinetic parameters (K,Kep,Ve) and the initial (60 s) area under the Gd concentration-time curve (iAUC) of peri-tumoral parenchymas (PT),enhancement tumors (ET) and contralateral normal parenchyma (NP) were obtained.The differences of various parameters were compared among different regions of PCNSL and GBM using one-way ANOVA.The differences of various parameters of PT,ET and NP were compared using independent samples t-test.Results There were statistical differences of K,Kep in ET,Kep in PT between PCNSL and GBM patients (all P＜0.05),as well as of K,Kep,Ve,iAUC in PCNSL and GBM patients between ET and PT (all P＜0.05).However,K and Kepof PT showed statistical differences compared with those of NP in GBM patients (both P＜0.05),so did Ktrans between PT and NP in PCSL patients (P＜0.05).Conclusion The pharmacokinetic parameters derived from DCE MRI based on extended Tofts Linear can promote differential diagnosis between PCNSL and GBM.

The clinical value of ultrasound diagnosis on papillary thyroid carcinoma coexisted with Hashimoto thyroiditis / 中国医师进修杂志

ObjectiveTo investigate the diagnostic value of ultrasound on patients with papillary thyroid carcinoma(PTC) coexisted with Hashimoto thyroiditis(HT).Methods The preoperative ultrasonography data of 2144 cases with PTC from January 2006 to December 2011 who treated with operation and diagnosed by pathology were analyzed retrospectively.Among them,265 cases coexisted with HT (PTC coexisted with HT group),1879 cases were not coexisted with HT (non-PTC coexisted with HT group).ResultsMost of the cancerous nodes in two groups exhibited in the ultrasonographic performance just like irregular shape,unclear boundary and so on (P ＞ 0.05).Most of the cancerous nodes in non-PTC coexisted with HT group exhibited hypoechoic nodules with microcalcifications,those in PTC coexisted with HT group exhibited various internal echoes with mainly microcalcifications,and the coarse calcification occupied a certain proportion(P＜ 0.01 ).The cancerous nodes in PTC coexisted with HT group were not rich in blood flow compared with non-PTC coexisted with HT group,but mostly exhibited blood disorders.When compared with non-PTC coexisted with HT group,the rate of ultrasound diagnosis in PTC coexisted with HT group was lower [ 52.8 ％( 140/265 ) vs.75.0 ％ (1409/1879),P ＜ 0.01 ],and the false positive rate in lymph node was higher [84.0％(487/580) vs.74.8％ (77/103)] (P ＜0.05).ConclusionsThe nodules are malignant when they appear as hypoechoic solid nodules,have unclear boundary and have microcalcifications should be highly suspected.The hyperechoic solid nodules or coarse calcification nodules should also be awared and taken further observation of the characteristics around the echoes and the internal blood flow,making comprehensive analysis to determine whether it could be malignant transformation and try best to reduce the misdiagnosis and missed diagnosis rates of this disease.

Application of magnetic resonance spectroscopy in diagnosing DNS / 中国基层医药

Objkctive To determine the potential ability of the area of each peak for the proton magnetic resonance spectroscopy(1 H-MRS) in the diagnosis of DNS(Delayed neuropsychological sequelae after carbon monoxide poisoning).Methods MRI and STEAM(stimulated-echo-acquisition mode)were performed in 38 DNS patients and 18 healthy volunteers.The area of the peak of each organic compound were obtained in each volume of interest.Results The data spectra abtained from patients shows NAA(881±76),Cho(2 352 ±86),β、γGlx(3 024 ± 187).Compared with the control group,theβ、γGlx ratio and Cho area increased,but the NAA ratio decreased.The area of NAA,Cho,β、γGlx between DNS and control group were compared,the results showed significant differences (P ＜0.05).In spectroscopy,the Lip evaluated peak in 0.9～1.40 ppm were detected.Conclusion 1H-MRS may do some contribution to the diagnosis of DNS.

CT Differential Diagnosis of Salivary Lesions / 实用放射学杂志

Objective To study CT diagnostic value of benign and malignant salivary gland lesions.Methods CT features in 36 cases with pathologically-proved salivary lesions were retrospectively analyzed.There were 19 cases with benign tumors,5 cases with chronic inflammation,1 case with tuberculosis and 11 cases with malignant tumors.Results Benign tumors were regular in 17 and well-defined in 16.All cases with chronic inflammation and 1 case with tuberculosis were regular but ill-defined.Benign lesions showed homogeneous or inhomogeneous density.Of all 11 malignant tumors,7 cases presented ill-defined margin with irregularity in shape,infiltration of adjacent subcutaneous fat tissue and disappearing of epiderm.Salivary glands enlarged and looked like "cast form" in malignant tumors.Most of the malignant tumors and benign tumors presented inhomogeneous density.Conclusion CT scan is of important value in the diagnosis of salivary diseases.