ABSTRACT
Objective To analyze the factors related to the occurrence of complications in performing CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle. Methods CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle was carried out in a total of 58 patients. The postoperative complications were recorded, and the related factors causing complication were analyzed. Results Successful puncturing was achieved in all patients with a technical success rate of 100%. Postoperative complications included pulmonary hemorrhage (n=11,19.0%), a little amount of bleeding in needle tract (n=7,12.1%), hemoptysis (n=3,5.2%), hemothorax (n=1,1.7%), and pneumothorax (n=10,17.2%). Chi-square test showed that the occurrence of pulmonary hemorrhage bore a close relationship to the lesion’s diameter, the distance between the lesion and the chest wall, the lesion’s location and times of puncturing (P<0.05). The occurrence of pneumothorax was closely correlated with the age, the distance between the lesion and the chest wall, the presence of perifocal emphysema, the lesion’s location and times of puncturing (P<0.05). Univariate analysis indicated that the postoperative complications were liable to occur in the patients whose imaging examination showed perifocal emphysema and lung hilar lesion, and who had more than two independent risk factors (P<0.05). Conclusion CT-guided percutaneous lung biopsy with 18 G-Bard Magnum needle is an accurate and safe technique with relatively higher positive diagnosis rate, but this technique should be carefully used in patients who has perifocal emphysema, or lung hilar lesion, or more than two independent risk factors.(J Intervent Radiol, 2015, 24:792-796)
ABSTRACT
Objective To explore the value of fascial tail sign at MR images in the detection of nodular fasciitis (NF). Methods A retrospective analysis of MR images was performed in 19 patients with pathologically proven NF of the soft tissue and 53 patients with a variety of other fibrous-predominant tumors. MR manifestations of all cases were reviewed by two experienced musculoskeletal radiologists using a single blind method. The presence of fascial tail on MR images were evaluated. ROC was used to assess the value of fascial tail sign in the detection of NF. Sensitivity, specificity, Youden index and area under ROC curve were calculated. The association between the presence of fascial tail sign on MRI and pathological classification of NF was analyzed by Pearson chi-square test for independence . Results Fascial tail was present in 17 cases (89.5%) of the study group and in 6 cases (11.3%) of the control group, respectively, yielding a sensitivity of 89.5%, a specificity of 88.7%, a Youden index of 0.782 and an area under ROC curve of 0.891. The fascial tail sign was significantly associated with NF (c2=39.294,P<0.05,r=0.594). Conclusions Fascial tail sign at MRI is a moderately specific and sensitive for the diagnosis of NF relative to fibrous-predominant tumors. It can be used in differentiate between NF and aggressive soft tissue tumors.
ABSTRACT
Objective To investigate the MRI features of pleomorphic xanthoastrocytoma (PXA).Methods 1 5 pathologically confirmed PXA cases were analyzed retrospectively.Clinical history and imaging features including location,size,shape,signal intensi-ty,enhancement and surrounding changes of those lesions were analyzed.Results All 1 5 cases were supratentorial and solitary le-sions,of which 9 lesions located in temporal lobe(60%).14 lesions contacted with the leptomeninges,and 1 lesion contacted with lat-eral ventricle wall.All lesions were solid-cystic,with different proportion of solid/cystic components.8 large lesions were predomi-nantly cystic(53.3%),3 small lesions were predominantly solid(20%),and 4 lesions had roughly equal cystic and solid proportions (26.7%).Solid components showed iso-intense or mild hypo-intense on T1 WI,iso-intense or mild hyper-intense on T2 WI,and signif-icant enhancement with contrast.Cyst fluid showed slightly hyper-intense in some cases.Cyst wall or septa enhancement was seen in 7 cases,and leptomeningeal enhancement was seen in 8 cases.Conclusion The MRI features of PXA are the characteristic of suprat-entorial solid-cystic lesions commonly seen in temporal lobe and contacting with leptomeninges.The typical features include “cyst with mural nodule”and “multiple cysts with irregular eccentric nodule”with significant enhancement of solid component and some cyst wall.MRI features of PXA is valuable in diagnosis and differential diagnosis of PXA.
ABSTRACT
OBJECTIVE@#To evaluate signal intensity-time (SI-Time) curve and quantitative dynamic contrast-enhanced 3.0T magnetic resonance imaging in diagnosis and differentiating neoplasm of uterus. @*METHODS@#A total of 42 cases of uterine neoplasm (20 were malignant and 22 were benign) were evaluated in our study. All cases received dynamic contrast-enhanced scanning on 3.0T MRI. The raw data was processed by Siemens Tissue 4D software and the SI-Time curve was obtained and analyzed. Pharmacokinetic modeling of Tofts with a modeled vascular input function was used for calculating volume parameters: volume transfer constant (Ktrans), reverse volume transfer constant (Kep), the extravascular extracellular space volume per unit volume of tissue (Ve). The correlation of these parameters at each groups were investigated. The SI-Time curve and the data of perfusion parameters between the 2 groups were compared by T test. @*RESULTS@#Among 20 malignant tumors, 12 were cervical carcinoma and 8 were endometrial cancer. Among the benign tumors, 13 were leiomyomas, 3 were endometrial polyp, 3 were endometrial hyperplasia, and 3 were adenomyosis. 59.1% cases of benign tumors belong to Type I curve and 65% cases of malignant tumors belong to Type II curve. There was significant difference in SI-Time curve between benign and malignant tumors (P=0.011). If Type I curve was used as diagnostic criteria for benign tumors, and Type II and III curve were for malignant tumors, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value were 90.0%, 59.1%, 66.7%, and 86.7%, respectively. Ve was 0.477 ± 0.143 in malignant and 0.614 ± 0.146 in control group with significant difference (P=0.004). Ve was 0.477 ± 0.143 in malignant and 0.589 0.176 in benign group with significant difference (P=0.004). Ktrans was (0.178 ± 0.067) min⁻¹ in malignant and (0.263 ± 0.111) min⁻¹ in control group with significant difference (P=0.003). Ktrans was (0.182 ± 0.096) min⁻¹ in benign and (0.263 ± 0.111) min⁻¹ in control group with significant difference (P=0.011). @*CONCLUSION@#The type of SI-Time curve and perfusion parameters were important for differentiating benign and malignant uterine tumors in dynamic enhanced MRI. These parameters provide a supplement for conventional morphological MR diagnosis.
Subject(s)
Female , Humans , Contrast Media , Magnetic Resonance Imaging , Sensitivity and Specificity , Uterine Neoplasms , Diagnosis , Uterus , PathologyABSTRACT
Objective To investigate the differential diagnostic features of subtypes of renal cell carcinoma(RCC) using dynamic contrast-enhanced MRI(DCE-MRI).Methods The MRI appearances of 77 RCCs, including 55 clear cell RCCs(CCRCC),14 papillary RCCs(PRCC) and 8 chromophobe RCCs(CRCC), were retrospectively analyzed and compared with findings of pathology. DCE-MRI was conducted in each case after intravenous administration of contrast agent. Region of interest measurements (cortical, nephrographic and delayed Phases) of signals within tumor and uninvolved renal cortex were used to calculate percentage signal intensity change and tumor-to-cortex enhancement index, and the data was analyzed by AVONA and t test. Results On unenhanced and enhanced MRI, most CRCCs showed homogeneous signal(7/8). CCRCC and PRCC often show inhomogenous signal with necrosis(36/55, 7/14). Hemorrhage and cystic degeneration were often found in PRCC (9/14). On the cortical, nephrographic and delayed phase images, CCRCCs showed greater signal intensity change[(296.15±60.27)%, (236.33±58.31)% and (216.83±46.72)%,respectively than PRCCs (79.70±18.84)%, (122.81±27.35)% and (117.55±20.63)%, respectively], and CRCCs showed intermediate change [(119.56±40.76)%, (163.06±33.91)% and (179.72±32.89)%, respectively].A phenomenon of quick staining and quick fainting was observed in CCRCCs. Both of CRCCs and PRCCs showed delayed enhancement. The tumor-to-cortex enhancement index at the cortical, nephrographic and delayed phases was highest for CCRCCs (1.26±0.34, 0.92±0.23 and 0.76±0.14, respectively), lowest for PRCCs (0.33±0.12, 0.41±0.23 and 0.35±0.11, respectively), and intermediate for CRCCs (0.54±0.10, 0.62±0.15 and 0.69±0.12, respectively,P＜0.01). The degree of enhancement was significantly different among the 3 subtypes at the every contrast enhanced phase (F=940.931, 124.515 and 38.194, P＜0.01), so was the tumor-to-cortex enhancement index(F=798.625,78.308 and 73.699, P＜0.01). There was a good consistency between MR appearances of the 3 RCC subtypes and pathological characteristics. Conclusion DCE-MRI could distinctly show imaging features of CCRCC, PRCC and CRCC, which were related to their pathological characteristics, and these features were helpful in predicting a specific subtype of RCC.
ABSTRACT
Objective To investigate the radiographic body posture selection and improvement and it's application value.Methods We selected the uncommon postures optimal for radiographic diagnosis according to different body parts of compound injury patients,and offered the filming process and cautions of some improved postures in radiographic practice.Results Appropriate body posture,improved filming position and processes,optimized parameters of exposure,and the application of digital imaging devices could ensure the image quality of diagnosis.Conclusion Effective filming processes,improved body postures and variable digital devices should be selected in compound injury patients according to practical condition.