Correlation analysis between mesenteric creeping fat index and inflammatory intestinal stricture in Crohn disease / 中华放射学杂志

Objective:To develop a mesenteric creeping fat index (MCFI) based on CT enterography (CTE) to characterize the degree of creeping fat wrapping around the inflamed gut in Crohn disease (CD), and to assess the relationship between MCFI and the inflammatory intestinal stricture.Methods:From December 2018 to July 2019, the patients with CD who underwent surgery in the First Affiliated Hospital of Sun Yat-Sen University were prospectively collected. The extent of perienteric mesenteric vessels wrapping around the gut was reconstructed to develop MCFI based on CTE images. The intestinal stricture index was obtained by calculating the ratio of the maximal upstream luminal diameter divided by the minimum luminal diameter apparent within the stricturing region. Using region-by-region correlation between CTE and surgical specimen, creeping fat score in intestinal specimen was obtained by assessing the extent of creeping fat wrapping around the resected bowel segment, and HE staining was performed on the bowel specimen corresponding to creeping fat to obtain the pathological inflammatory score. The Spearman correlation analysis was used to evaluate the correlation between MCFI, creeping fat score in intestinal specimen, and inflammatory score, intestinal stricture index. The ROC curve analysis was used to assess the accuracy of MCFI in distinguishing moderate-severe and mild inflammatory bowel walls.Results:Totally 30 CD patients were enrolled. The creeping fat score in intestinal specimen positively correlated with pathological inflammatory score ( r s=0.403, P=0.027) and with intestinal stricture index ( r s=0.642, P<0.001). MCFI positively correlated with creeping fat score in intestinal specimen ( r s=0.840, P<0.001), with pathological inflammatory score ( r s=0.497, P=0.005), and with intestinal stricture index ( r s=0.599, P<0.001). ROC analysis showed that the area under the curve of MCFI for differentiating moderate-severely from mildly inflammatory bowel walls was 0.718 (95%CI 0.522-0.913). Using MCFI≥4 as a cutoff value, the sensitivity and specificity were 81.8% and 47.4%, respectively. Conclusions:There was a correlation between creeping fat and inflammatory intestinal strictures in CD. MCFI can non-invasively depict the degree of creeping fat wrapping around the gut and assess the inflammatory intestinal stricture.

The correlation between intravoxel incoherent motion diffusion weighted MRI and intestinal inflammation and fibrosis in Crohn disease / 中华放射学杂志

Objective To determine the correlation between intravoxel incoherent motion (IVIM) parameters and both histologic inflammatory and fibrotic grades of Crohn disease (CD) in adults. Methods Prospectively, 17 patients (77 lesions) with a clinical and pathological diagnosis of CD in the first affiliated hospital of sun yat-sen university from July 2015 to June 2016 underwent MRE 15 days before surgery. All patients underwent T2WI, IVIM and enhanced MRI and calculated IVIM parameters include diffusion-related coefficient (D), perfusion-related coefficient (D*) and perfusion-related fraction (f). Histological intestinal inflammation and fibrosis was scored using the surgical histopathology as reference standard and further divided into mild-moderate (score 1 to 2) and severe (score 3 to 4) groups. Intestinal microvessel density (MVD) were also analyzed. Differences in IVIM parameters among different histological inflammation and fibrosis grades were assessed with the Kruskal-Wallis test. The Wilcoxon test was used for assessing differences in f between mild-moderate and severe fibrosis. The bivariate correlations between IVIM parameters and histological inflammation and fibrosis grades were analyzed using partial correlation . The bivariate correlations between IVIM parameters and MVD were analyzed using Spearman rank correlation. The areas under the receiver operating characteristics curves (AUROC) were analyzed to evaluate the efficacy for distinguishing severe from mild-moderate fibrosis. Results Of 77 surgical specimens, there were 41 mild-moderate and 36 severe inflammatory bowel segments, along with 22 mild-moderate and 55 severe fibrotic bowel segments. Positive correlation was shown between histologic inflammatory and fibrotic scores (r=0.592, P<0.01). MVD (42.7 ± 39.9)/HP presented weak positive correlation with histologic inflammatory scores (r=0.332, P=0.003) while no correlation with histologic fibrotic scores (r=0.129, P=0.262) was presented. Neither the D nor the D* values significantly correlated with histologic inflammation or fibrosis (P>0.05) while the f value significantly correlated with both histologic inflammation and fibrosis (P<0.05). Significant correlation was present between the f value and histologic inflammatory and fibrotic scores, respectively (r=-0.280, -0.520;P<0.05). There was significant difference in the f value between mild-moderate and severe fibrosis(Z=-5.255,P<0.01). The AUROC for the f value to distinguish between patients with mild-moderate fibrosis and severe fibrosis were 0.885. Using a threshold fractional perfusion of 0.33, the sensitivity and specificity values were 95.5％ and 81.8％, respectively. No correlation between f, D and D*value with histologic fibrotic scores (r=0.129, P=0.262) was presented. Conclusion The f value derived from IVIM could help to evaluate the severity of intestinal inflammation and fibrosis CD in adults.

Changes in diameter of superior mesenteric vein and gastrocolic trunk in patients with cecum-ascending colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the difference of the diameters of superior mesenteric vein (SMV) and gastrocolic trunk (GCT) between patients with cecum-ascending colon cancer and normal individuals, and to assess the diagnostic value of the diameters of SMV and GCT in cecum-ascending colon cancer.</p><p><b>METHODS</b>Preoperative imaging data of 60 patients with primary cecum-ascending colon cancer confirmed by postoperative pathology at the First Affiliated Hospital of Sun Yat-sen University from June 2014 to December 2016 were retrospectively analyzed. The diameters of SMV and GCT were measured on preoperative CT images. SMV was measured at about 2 cm below the junction of SMV and splenic vein. GCT was measured at 1 cm near the proximal junction of right colon vein, right gastroepiploic vein and anterior pancreaticoduodenal vein. Another 60 people receiving pelvic CT examination without organ illness were collected as control. The diameter differences of SMV and GCT between cancer group and control group were compared. The diagnostic value of the diameters of SMV and GCT in cecum-ascending colon cancer was evaluated by receiver operating characteristic (ROC) curves.</p><p><b>RESULTS</b>Among 60 cases of cecum-ascending colon cancer, 36 were males and 24 were females with median age of 48 years (range 28-84); 13 were cecum cancer, 47 were ascending colon cancer; 11 had no lymph node and liver metastasis, 40 had lymph node metastasis, 9 had liver metastasis (all with lymph node metastasis). Compared to control group, the diameters of SMV and GCT in cancer group were significantly longer [SMV:(11.2±1.3) mm vs. (9.5±1.7) mm, t=6.04, P<0.001; GCT:(5.5±0.9) mm vs. (3.5±1.0) mm, t=11.51, P<0.001]. However, there were no statistically significant differences in diameters of SMV and GCT among hepatic metastasis, lymph node metastasis and no metastasis cancer groups (all P>0.05). The ROC curve analysis showed that the area under the curve of SMV diameter was 0.777, and the optimal cut-off point was 10.5 mm in the diagnosis of cecum-ascending colon cancer, with the sensitivity and specificity of 95.0%(57/60) and 46.7%(28/60) respectively. The area under the curve of GCT diameter was 0.923, and the optimal cut-off point was 4.5 mm in the diagnosis of cecum-ascending colon cancer, with sensitivity and specificity of 88.3%(53/60) and 85.0%(51/60) respectively.</p><p><b>CONCLUSION</b>The dilation of the SMV and GCT may be used as warning factors for cecum-ascending colon cancer, especially the diameter of GCT.</p>

The diagnostic value of magnetization transfer MRI for bowel inflammation and fibrosis in Crohn disease / 中华放射学杂志

Objective To assess the diagnostic value of magnetization transfer MRI (MTI) for bowel inflammation and fibrosis in humans with Crohn disease (CD). Methods From July 2014 through April 2017, 31 patients with a confirmed diagnosis of CD were prospectively recruited from the First Affiliated Hospital of Sun Yat Sen University. They were scheduled for elective surgery due to bowel obstruction and other complications, and underwent preoperative MR enterography (MRE) and MTI within 15 days of surgery. All cases had available intestinal specimens identified on MRE and resected bowel segments for region by region matching. All patients underwent breath hold conventional MRE and MTI examinations, and then the magnetization transfer ratios (MTRs) of pathological bowel segments were measured. Using region by region correlation between MTI and surgical specimen, the bowel segments were resected to stain with HE for evaluating bowel inflammation, Masson for bowel fibrosis, and typeⅠcollagen staining for the deposition of typeⅠcollagen within the bowel walls. The histologic sections from the most severe areas were scored as 0 (normal), 1 (mild), 2 (moderate) and 3 (severe). The correlations between MTR and histologic scores were analyzed by using Spearman rank correlation or partial correlation. The differences in MTR among different grades of bowel fibrosis were analyzed by one way ANOVA. The efficacy of MTR for predicting bowel fibrosis was evaluated by receiver operating characteristic curves analysis. The difference in MTRs between purely inflammatory bowel walls and mixed fibrotic and inflammatory bowel walls was analyzed by Student s t test. Results Sixty two resected bowel specimens from 31 patients including 9 purely inflammatory bowel walls and 53 mixed fibrotic and inflammatory bowel walls were obtained in this study. There were significant differences in MTR among non fibrotic [(21.45 ± 2.65)%], mildly [(30.88 ± 6.14)%], moderately [(35.14 ± 4.31)%] and severely [(35.14 ± 4.31)%] fibrotic walls (F=38.397,P<0.01). MTRs strongly correlated with fibrosis scores (r=0.681, P<0.01). High accuracy of MTRs was shown (curve under area=0.905, P<0.01) for differentiating moderately severely fibrotic from non fibrotic and mildly fibrotic bowel walls. Using MTR of 31.50% as a cutoff value, the sensitivity and specificity were 93.6% and 80.0%, respectively. The MTRs of purely inflammatory bowel walls [(21.45 ± 2.65)%] were significantly higher than that of mixed fibrotic and inflammatory [(36.28±5.21)%] bowel walls (t=-13.052,P<0.01). MTRs correlated with the scores of type Ⅰ collagen (r=0.325, P=0.044) but did not correlate with inflammation scores (r=-0.024, P=0.857). Conclusions MTI enables quantitative evaluation of bowel fibrosis in patients with CD and can be used to differentiate purely inflammatory CD from mixed fibrotic and inflammatory CD.

Correlation between the Diameter of Superior Rectal Vein and Inferior Mesenteric Vein and the Lymph Node Metastasis of Rectal Carcinoma / 中山大学学报(医学科学版)

[Objective] To measure the diameter of the superior rectal vein (SRV) & theinferior mesenteric vein (IMV) by CT and analyze their relationship with lymphatic metastasis of rectal carcinoma.And to discuss the feasibility of utilizing SRV to prcdict lymph node metastasis of rectal cancer.[Methods] The CT imaging and pathological data of 105 rectal carcinoma patients were analyzed retrospectively.We measured and compared the diameter of every patient's SRV & IMV by CT in the presence and absence of microvascular tumor thrombus,signet ring cell,lymph node metastasis and distant metastasis.The accuracy of predicting lymph node metastasis for rectal carcinoma by the diameter of SRV were evaluated by ROC curve.[Results] There were statistical differences in the diameters of SRV and IMV between rectal cancer group with lymph node metastasis (D =4.34 mm,D =5.00 mm) and without (D =3.56 mm,D =4.81 mm;P ＜ 0.001,P =0.023).The differences were significant in the diameter of SRV between rectal cancer group with microvascular tumor thrombus or signet ring cell and without (P =0.019,P =0.044).However,the diameter of IMV showed no statistical difference between rectal cancer group with microvascular tumor thrombus or signet ring cell and without (P =0.605,P =0.663).And there was no statistical difference in the diameter of SRV or IMV between rectal cancer patients with distant metastasis and without (P ＞ 0.05).Regarding 3.75 mm as the cut-off value for the diameter of SRV to predict lymph node metastasis for rectal cancer patients,the sensitivity was 90.9％ and the specificity was 82.0％.Regarding 4.65 mm as the cut-off value for the diameter of IMV to predict lymph node metastasis for rectal cancer patients,the sensitivity was 87.3％ and the specificity was 38％.[Conclusions] It is completely feasible to utilize the diameter of SRV measured by CT to predict lymph node metastasis of rectal carcinoma with high sensitivity,accuracy,and relatively high specificity.

Multi-detector Spiral CT Manifestations of Pediatric Sacrococcygeal Tumors / 中山大学学报(医学科学版)

[Objective] To evaluate the diagnostic values of multi-detector spiral computed tomography (MDCT) in pediatric sacrococcygeal tumors (SCT) and to improve the diagnostic ability.[Methods] 54 children (22 male and 32 female,age between 1 day and 16 years old) with pathologically confirmed SCT were involved in our study.All of them received 64-row spiral Computed Tomography before surgery,CT characteristics and clinical data were retrospectively analyzed.[Results] Pediatric SCT are more common in female children under four years old,with the germ cell tumors most common,followed by neurogenic tumors.Among the 54 SCT,39cases were malignant and 15 were benign (malignant∶ benign =2.60∶1).In CT image findings,37 cases (68％) were mainly solid mass,with 31 cases confirmed malignant by pathology.8 cases (15％) were mainly cystic,with all of them confirmed benign by pathology.9 cases (17％) were cystic-solid or with obvious necrosis in solid mass,with 8 cases confirmed malignant by pathology.[Conclusion] Malignant pediatric SCT are more common than benign SCT.Most malignant SCT are mainly solid mass or cystic-solid or with obvious necrosis in solid mass,and most benign tumors are mainly cystic.Combined with clinical data,MDCT can help to correctly diagnose SCT before surgery.

Diagnostic value of magnetized transfer imaging and diffusion-weighted imaging in the evaluation of bowel wall in Crohn disease / 中华放射学杂志

Objective To explore the diagnostic value of magnetization transfer imaging (MTI) and DWI for detecting intestinal wall property of crohn's disease (CD). Methods Forty four patients with CD were prospectively enrolled in the study, and MR enterography (MRE), MTI and DWI were performed. According to MRE findings, patients were divided into three subgroups:acute inflammatory group, chronic fibrotic group and combined inflammatory with fibrotic group. Intestinal wall T2WI signal, magnetization transmisson rate (MTR) and ADC value were measured on MRE, MRI and DWI imagings, respectively. The differences of MTR and ADC among the three groups were analyzed by one-way ANOVA;the differences of T2WI scores were analysed by Kruskal Wallis;the differences of MTR and ADC values between normal and pathological intestinal wall were analyzed by paired t test;ROC curve were used to evaluate the CD fibrosis and inflammation diagnostic efficiency of MTI ana DWI based on MRE signs. Results Among the 44 cases, 11 cases were in the acute inflammatory group, 18 cases were in the chronic fibrotic group and other 15 cases were in the combination group. The T2WI score, MTR and ADC among the three groups showed significant differences (all P<0.01).The mean MTR and ADC of pathological intestinal wall of the 44 cases were (40.77±6.05)%and (1.04±0.18)× 10-3mm2/s, and the adjacent normal bowel were (21.75±4.17)%and (1.97 ± 0.23) × 10- 3mm2/s, respectively. Moreover, the difference of the above values showed significant differences (t=19.12,-21.80 respectively, all P<0.01). There was a negative correlation between MTR and T2WI score (r=-0.71,P<0.01). While ADC value was positively correlated with T2WI score (r=0.80, P<0.01). Using ROC curve analysis to differentiate the CD fibrosis from acute inflammation, the area under the curve (AUC) of MTR and ADC were 0.97 and 0.96 ,respectively. Conclusions Both MTI and DWI can be used to assess the properties of intestinal wall, which has the same diagnostic efficacy to identify the acute inflammation and fibrosis.

Visceral abdominal adiposity tissue volume quantification using noninvasive MRI in prediction of type 2 diabetes / 中国医学影像技术

Objective To investigate the feasibility of utilizing visceral abdominal adiposity tissue (VAT) volume quantification using MRI to predict type 2 diabetes mellitus (T2DM).Methods Forty-eight subjects including 15 T2DM (T2DM group),17 impaired glucose tolerance (IGT,IGT group) and 16 normal glucose tolerance (NGT,NGT group) were enrolled in this study.All subjects underwent upper abdominal iterative decomposition of water and fat with echo asymmetry and least square estimation-image quantification (IDEAL-IQ) MRI scanning.VAT volume of the second and third lumber vertebral body ranges (VATV L2,VATV L3),sum of VATV L2 and L3 (total VATV),hepatic and pancreatic fat were measured in fat fraction mapping of T1WI IDAEL-IQ sequence on post-processing workstation.The accuracy of predicting T2DM using VAT was evaluated by Logistic regression equation via ROC curve.Results The mean of VATV L2,VATV L3 and total VATV in T2DM group were significantly higher than those of IGT group and NGT group (P＜0.05),while there were no significant difference of these metrics between IGT group and NGT group (P＞0.05).Taking 460.34 ml as the cut-off value for VATV L2 to predict T2DM,sensitivity was 73.33％,specificity was 75.76％ and accuracy was 75.00％,respectively.Taking 429.46 ml as the cut-off value for VATV L3 to predict T2DM,sensitivity was 86.67％,specificity was 72.73％ and accuracy was 77.08％,respectively.Taking 887.83 ml as the cut-off value for total VATV to predict T2DM,the sensitivity,specificity and accuracy were 86.67％,72.73％ and 77.08％,respectively.Only VATV L3 was enrolled by Logistic regression equation (P=0.01,OR=1.01),and the sensitivity,specificity and total accuracy of prediction for T2DM were 80.00 ％,88.20 ％,and 84.40 ％,respectively.Conelnsion It is feasible to utilize VAT volume quantification with MRI to predict T2DM.VATV L3 is a better predictor.

Diagnostic Value of MR Enterography and Diffusion Weighted Imaging in Crohn Disease / 中山大学学报(医学科学版)

[Objective] To analyze the image findings of MR enterography (MRE) and diffusion weighted imaging (DWI) in Crohn disease (CD) and to discuss the diagnostic value of MRI for evaluating the activity of CD.[Methods] 26 patients proved by clinical,imaging and pathological data were enrolled in this study.The intra-/extra-intestinal image features of CD were retrospectively analyzed,and the intestinal lesions were evaluated by MRE+DWI scoring system.The differences in image features of active and inactive CD were compared.[Results] 26 bowel segments were evaluated and included active (n =20) and inactive CD (n =6).The intestinal performance of CD included wall thickening,T2WI hyperintensity and hyperenhancement.The pathological changes of active CD were more serious when comparing with that of inactive CD.DWI showed hyperintensity in the affected bowel wall.ADC of active C D [(0.9 ± 0.2) × 10-3 mm2/s] was significantly lower than that of inactive CD [(1.5 ± 0.4)× 10-3 mm2/s] (P ＜ 0.001).Extra-enteric performance of active CD included comb sign,lymphadenectasis of mesentery,mesenteric exudation,fistula and abdominal abscess.[Conclusion] MRE combined with DWI can accurately assess CD activity and diagnose extra-enteric complications.

Application Research of T2*Mapping in Evaluating Inflammatory Activity in Crohn Disease / 中山大学学报(医学科学版)

[Objective]To explore the efficacy of T2* mapping for evaluating inflammatory activity in the patients with Crohn disease(CD).[Methods]A total of 98 CD patients underwent MR enterographywith T2*WI. T2* values were measured by put-ting regions of interest on the thickening bowel wall on T2*mapping. The activity of bowel segment was scored by magnetic resonance index of activity(MaRIA),to analyze the relationship between T2*values with CD activity.[Results]A total of 160 bowel segments were evaluated and includedinactive(MaRIA<7,n=26),mild(7≤MaRIA<11,n=23),and moderately-severe(MaRIA≥11, n = 111)active lesions. The differences in T2* values amongthese three groups were significant(all P < 0.05). T2* values of 160 bowel segments correlatedclosely withMaRIA(r=0.743,P<0.05). High accuracy of T2*values was shown for differentiating inac-tive from active CD(AUC=0.877)anddifferentiating inactive-mild from moderate-severe CD(AUC=0.848). The threshold T2*value of 20 ms allowed differentiation of mild from moderate-severe CD with74.5%sensitivity and 84%specificity.[Conclusions]T2*values, as thequantitative indexof T2*mapping,correlate well with CD activity and showsatisfiedefficacy for diagnosing inflammatoryactivity.

Comparative study on computed tomography features of gastrointestinal schwannomas and gastrointestinal stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the CT image of gastrointestinal schwannomas (GIS) and gastrointestinal stromal tumors(GIST), and to find the CT features to be helpful for differentiation of GIS from GIST.</p><p><b>METHODS</b>Clinical and iconography data of 15 GIS patients and 50 GIST patients who underwent stomach CT scan with postoperatively confirmed histopathology between January 2000 and July 2014 in our department were collected retrospectively. CT findings of these two tumors were compared. Then the ROC curve was drawn based on the significant CT findings and area under the curve (AUC) was calculated to assess the sensibility and specificity for the differential diagnosis of GIS and GIST.</p><p><b>RESULT</b>CT findings, such as the tumor size, shape, cystic change, perilesional lymph nodes, vessel seeding, enhancement pattern and degree, absolute and standardized CT value were significantly different between GIS and GIST(all P<0.05). Among the CT findings, tumor size, cystic change, perilesional lymph nodes, enhancement pattern and arterial phase standardized CT value (Sa) were better differential than others (all AUC>0.7). Tumor size showed the highest sensibility(90%), and cystic change and Sa showed the highest specificity(87%).</p><p><b>CONCLUSIONS</b>GIS seems to show a homogeneous tumor more frequently, presenting light and moderate enhancement pattern and obvious enhancement of perilesional lymph nodes, while GIST seems to reveal malignant features, such as abundant blood supply, larger volume, frequent necrosis and cystic change. Cystic change and Sa value possess the better differential ability in diagnosis of these two tumors.</p>

Short-term and long-term efficacy analysis of acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture at acupoints near ears for nervous tinnitus / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy differences between acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture (EA) at acupoints near ear and simple EA for the treatment of nervous tinnitus.</p><p><b>METHODS</b>Sixty-three patients were randomly divided into an observation group (31 cases) and a control group (32 cases). The observation group was treated with acupoint catgut embedding at C4-C7 Jiaji (EXB 2) points on the affected side combined with EA at acupoints near ears, including Ermen (TE 21). Tinggong (SI 19), Tinghui (GB 2), etc.; the control group was treated with EA at regular acupoints near ears alone. The EA treatment was given five times per week, and the acupoint catgut embedding was given once every two weeks. All the treatment was given for 6 weeks. The Tinnitus severity score (TSS)was applied to assess the severity of tinnitus before the treatment, 2 weeks, 4 weeks and 6 weeks into treatment and one month after treat ment. Also the efficacy of two groups was compared.</p><p><b>RESULTS</b>After the treatment, the severity of tinnitus was both improved in two groups at each time point (all P<0.05). which was more significant in the observation group (P<0.05, P<0.01). The cured and markedly effective rate was 77.4% (24/31) in the observation group, which was superior to 50.0% (16/32) in the control group (P<0.05).</p><p><b>CONCLUSION</b>The short-term and long-term efficacy of acupoint catgut embedding at cervical Jiaji (EX-B 2) points combined with electroacupuncture are both superior to those of simple electroacupuncture for treatment of nervous tinnitus.</p>

Correlation of ¹⁸F-FDG PET-CT maximum standard uptake value and T/N ratio with the prognosis of postoperative colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the correlation of primary colorectal cancer (CRC) lesions' maximum standardized uptake value (SUVmax) and tumor to normal tissue SUVmax ratio (T/N ratio) detected by ¹⁸F-deoxyglucose positron emission computed tomography (¹⁸F-FDG PET-CT) imaging with the postoperative prognosis.</p><p><b>METHODS</b>Clinicopathological data of 92 CRC patients who underwent curative resection after the PET-CT examination and received ¹⁸F-FDG PET-CT examination from January 2009 to December 2013 in the First Affiliated Hospital of Sun Yat-sen University were reviewed retrospectively. The correlation of SUVmax and T/N ratio in primary lesions with clinicopathological factors was analyzed. The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were investigated by using ROC curve analysis. Association of clinicopathological factors and prognosis was examined and the Cox proportional hazard regression model was used in the multivariate analysis.</p><p><b>RESULTS</b>Primary SUVmax was associated with tumor TNM staging, location, differentiation degree and the maximum tumor diameter, while T/N ratio was only associated with pathological type (all P<0.05). The optimal cutoff point of disease-free survival time of SUVmax, T/N ratio and the maximum tumor diameter were 12.2 (sensitivity 67.6%, specificity 63.6% ), 6.9 (sensitivity 51.4%, specificity 74.5%) and 4.3 cm (sensitivity 56.8%, specificity 80.0%) respectively. Univariate analysis showed that age, TNM staging, tumor location, differentiation degree, the maximum tumor diameter, T/N ratio and CA125 level were significant predictors of survival. Multivariate analysis demonstrated that TNM staging (P=0.000, OR=3.98, 95% CI:2.12-7.45), tumor location (P=0.009, OR=0.43, 95% CI:0.23-0.81), tumor differentiation degree (P=0.001, OR=7.52, 95% CI:2.12-25.9) and T/N ratio (P=0.008, OR=2.92, 95% CI:1.33-6.411) were independent predictors of survival. However, SUVmax was not independent predictor of disease-free survival.</p><p><b>CONCLUSION</b>For postoperative prognosis of colorectal cancer patients, T/N ratio is more valuable than the of primary tumor SUVmax.</p>

The Investigation of venous blood cell reference interval for 3-14 years old healthy children in Nanhai district of Foshan city / 国际检验医学杂志

Objective To establish the reference interval of 3-14 years old children in Nanhai district of Foshan city .Methods 2 032 cases of 3-14 years old healthy children were detected and analyzed using MINDRAY BC-5800 automatic blood cell analy-zer .The levels of WBC ,RBC ,Hb ,PLT ,Hct ,MCV ,MCH ,MCHC ,RDW were analyzed .Results The levels of WBC ,RBC ,Hb , PLT ,Hct ,MCV ,MCH ,MCHC ,RDW in 2 031 cases were non normal distribution .The levels of Hb ,Hct had no statistical signifi-cance between male children and female children (P>0 .05);The levels of WBC ,RBC ,PLT ,MCV ,MCH ,MCHC ,RDW had statis-tical significance between male children and female children (P<0 .05) .Conclusion It is very important to establish the reference interval of 3-14 years old children in Nanhai district of Foshan city .

Multi-slice Computed Tomography Enteroclysis in Evaluation of Active Ulcerative Colitis / 中国医学影像学杂志

Purpose To summarize the characteristics of computed tomography enteroclysis (CTE) in active ulcerative colitis (UC), and to explore the value of multi-slice CTE in the evaluation of UC. Materials and Methods Thirty-five patients with active UC confirmed by clinical manifestation, colonoscopy and pathology underwent CTE examination in the study. According to the modiifed Mayo-score, the patients were divided into mild group, moderate group and severe group, and the CTE manifestations were compared among the three groups. Results Among 35 patients, 6 patients were in the mild group, 13 in the moderate group, and 16 in the severe group. Submucosal bubbles had signiifcant differences between mild and moderate groups (P0.05). Conclusion Multi-slice CTE can provide image features of bowel wall, intestinal tube and structures outside intestine in the evaluation of UC, thus it is useful in the diagnosis of active UC as well as in its clinical grading.

Analysis of semen quality of 1 865 outpatients in male infertile clinic in Foshan city / 国际检验医学杂志

Objective To analyze the semen quality in the outpatients from 3 male infertile clinics of Foshan city.Methods The semen from 1 865 outpatients with male infertility was detected and analyzed routinely by the CASA technology in strict accordance with the WHO operation technical specifications.The outpatients were divided into the normal group,mild,moderate and severe as-thenospermia groups according to the sperm vitality.Results There were 524 (28.1%)cases of abnormal sperm concentration,826 (44.3%)cases of abnormal sperm viability,985 (52.8%)cases of abnormal sperm motility,713 cases (38.2%)of teratosperm and 652 (35.0%)cases of leukocytospermia in all outpatients;the motion parameters were decreased along with the decrease of activity in each group,in which,the 6 indicators of VSL,VAP,VCL,LIN,STR and WOB were significantly lower than those in the normal activity group with statistical differences(P <0.05),furthermore,the sperm vitality had staitstcally significant differences among the mild,moderate and severe asthenospermia groups (P <0.05).Conclusion In the routine parameter indicators,the sort order of the percentage of abnormal results in turn were sperm motility、sperm viability、sperm deformity rate、semen WBC、sperm concentra-tion、semen liquefaction time、semen pH.With reduced sperm motility,the sperm motion parameters of VSL,VCL,VAP,LIN,STR and WOB were decreased,the results of each group were significantly lowered (P <0.05).

A study on diagnostic value of serum human epididymis protein 4 detection for ovarian cancer / 国际检验医学杂志

Objective To investigate the diagnostic value of serum human epididymis protein 4 (HE4 ) for ovarian cancer . Methods Electrochemiluminescence immunoassay was employed to detect the serum HE 4 of 91 patients with ovarian cancer (ovari-an cancer group) ,69 patients with benign ovarian disease(benign group) and 60 healthy people(control group) .Area under the curve(AUC ) of receiver operator characteristic (ROC ) curve for HE4 was calculated .Results Serum HE4 level [(146 .81 ± 81 .29)pmol/L] of patients in ovarian cancer group was significantly higher than those in control group [(43 .16 ± 25 .64) pmol/L] and benign group[(59 .86 ± 39 .87) pmol/L](P<0 .01) .Set serum HE4≥140 pmol/L as positive cutoff value ,the diagnostic sensi-tivity of serum HE4 detection for ovarian cancer was 82 .4% (75/91) ,specificity 89 .9% (62/69) and diagnostic efficiency 85 .6% . Serum HE4 levels of patients with serous adenocarcinoma ,endometrial adenocarcinoma or other ovarian cancer were markedly high-er than that with mucinous adenocarcinoma (P<0 .01) .Serum HE4 levels of patients with stage Ⅲ ,Ⅳ ovarian cancer were obvious-ly higher than those with Ⅰ ,Ⅱ stage(P<0 .01) .Conclusion HE4 detection has clinical value for the auxiliary diagnosis of ovarian cancer .

CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

Application value of MDCT with vessel probe for isolated superior mesenteric artery dissection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the value of MDCT with vessel probe(VP) in the diagnosis and treatment of isolated superior mesenteric artery dissection (ISMAD).</p><p><b>METHODS</b>Clinical and imaging data of 15 patients with ISMAD admitted to the First Affiliated Hospital of Sun Yat-Sen University from June 2008 to May 2013 were retrospectively reviewed. Relationship among radiograpic features, clinical symptoms and therapeutic options of ISMAD was examined based on the imaging of 64-MDCT with VP.</p><p><b>RESULTS</b>The dissection crevasse of all the 15 patients located in anterior arterial wall, and the distance was(24.3±9.7) mm from the origin of SMA. Meanwhile dissection crevasse of 73.3%(11/15) patients located in the zone within 1 cm of proximal end and 1 cm of distal end of the proximal SMA curvature. There were significant differences between patients without abdominal pain(8 cases) and those with abdominal pain(7 cases) in dissection length, minor diameter ratio of true lumen to false lumen, major diameter ratio of true lumen to false lumen(all P<0.01). According to classification of Yun, there were 5 patients of typeI( and 3 type II(a, whose conservative treatment were successful. In other 7 patients of type II(b, 3 patients received successful conservative treatment, and 4 patients had symptom remission after turning to interventional treatment or surgery.</p><p><b>CONCLUSIONS</b>64-MDCT with VP can clearly depict the image manifestation of ISMAD, which provides evidence for the diagnosis and therapeutic options of ISMAD.</p>

Comprehensive application of CT and PET/CT in diagnosing colorectal mucinous and non-mucinous adenocarcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the value of comprehensive application of CT and PET/CT in differential diagnosing mucinous and non-mucinous colorectal adenocarcinoma.</p><p><b>METHODS</b>CT and PET/CT image data of 37 patients with mucinous adenocarcinoma and 50 patients with non-mucinous adenocarcinoma confirmed by pathology in our hospital from January 2010 to December 2012 were analyzed retrospectively. Differences of image were compared between two methods.</p><p><b>RESULTS</b>On CT, lesion density of pre-contrast, pro-contrast phase and enhancement degree were significantly lower in mucinous adenocarcinoma than those in non-mucinous adenocarcinoma(all P<0.01). Enhancement degree of hypointense area, hypointense area proportion of total lesion, and lymphatic or distant metastasis ratio were significantly higher in mucinous adenocarcinoma than those in non-mucinous adenocarcinoma(all P<0.05). On PET/CT, maximal SUV value of mucinous adenocarcinoma was significantly lower as compared to non-mucinous adenocarcinoma[(8.64±4.34) Bq/L vs. (12.38±5.96) Bq/L, P=0.015].</p><p><b>CONCLUSIONS</b>CT combined with PET/CT provides better valuable information in differential diagnosing between mucinous and non-mucinous colorectal adenocarcinoma and clinical practice.</p>