Diagnostic value of contrast-enhanced CT scans in identifying lung adenocarcinomas manifesting as ground glass nodules / 中华肿瘤杂志

Objective@#To investigate the value of contrast-enhanced CT scans in differential diagnosis of atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimal invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) in patients who manifested as ground glass nodules (GGNs) or mixed GGNs (mGGNs) in unenhanced CT imaging.@*Methods@#The unenhanced and enhanced CT images of 194 patients with GGNs in the lung were retrospectively analyzed, including 64 cases with pre-invasive lesions, 80 cases with MIA, and 50 cases with IAC. The prediction of pathological types was based on maximal diameters and the solid portions of the lesions displayed on unenhanced and enhanced CT images, and then compared with pathological diagnosis.@*Results@#In 64 patients with pre-invasive lesions, the CT value increased in 59 cases after contrast-enhanced administration, whereas the solid portions increased in 5 cases. In the 80 patients with MIA, solid portions increased in 50 cases and the CT value increased in 30 cases after contrast administration. In 50 cases with IAC, almost all of them showed increased solid portions, whereas only 2 cases showed an increase of CT values. In the pre-invasive group and the MIA group, the increase of CT values after contrast administration was (45.88±15.97) HU and (66.47±44.54) HU, respectively, showing statistically significant difference (P=0.001). The increase of solid portions in the MIA group and IAC group was (1.55±0.73) mm and (1.88±0.75) mm, respectively, also showing significant difference (P=0.032).@*Conclusion@#Contrast-enhanced CT scans were more useful than unenhanced CT scans for the diagnosis of lung adenocarcinomas manifesting as GGNs .

CT diagnosis of post-traumatic intrapulmonary hematoma / 实用放射学杂志

Objective To evaluate CT findings and dynamic changes of post-traumatic intrapulmonary hematoma.Methods CT data of 43 patients with traumatic intrapulmonary hematomas were analyzed retrospectively.Results A total of 52 lesions were found in 43 patients with intrapulmonary hematomas.The majority of hematomas were located in the peripheral lung fields close to the pleura,single or multiple in number.CT showed nodular,mass,fusiform,ribbon and irregular shadows with uniform and high density in lung.There are two types of evolution: (1) The hematomas gradually reduced in size and finally disappeared;(2)The hematomas evolved into gas-liquid cyst cavity or gas cyst cavity, and then was absorbed gradually.Conclusion CT examination is helpful in the early diagnosis of post-traumatic intrapulmonary hematomas, and can monitor the morphology changes over time.

The Functions of the Middle Ears of Children with Adenoid Hypertrophy / 听力学及言语疾病杂志

Objective To explore the influence of adenoid hypertrophy on the state of the middle ear in children.Methods Two hundred and seventy two adenoid hypertrophy patients,aged from 2 to 12 years old,were examined with otoscopy,tympanometry and temporal bone computered tomography before adenoidectomy.The average age of the patients was 6.3 years old.These patients were divided into two groups:Group A contained 94 normal hearing patients(188 ears),Group B 178 patients(356 ears) containing of hearing loss.Results Out of the temporal bone computed tomography (CT) revealed that 209 patients(396 ears) had middle ear effusions in(72.79%,396/544ears),and 37 patients(65/188 ears,34.57%) hydrotympanum in Group A and 172 patients(331/356 ears,92.98%) in Group B.All the 396 ears effusion were confirmed by operation.Three hundred seventy three ears effusion were confirmed by the CT and operation in the two groups,377 ears with B type tympanogram(373/377,98.94%),93.85%(61/65 ears) in Group A,100%(312/312 ears) in Group B,respectively.The positive predictive value for middle ear effusion of the B-type tympanogram was higher in Group B than in Group A(P＜0.01).Fourteen ears with peak pressure ＜-200 daPa revealed hydrotyrnpanum and 23 ears with normal acoustic stapedius reflex revealed no fluid by CT and operation in 73 ears with C-type tympanogram.CT also revealed two patients suffered from large vestibular aqueduct syndrome and one with cochlear malformation in Group B.Conclusion Type B tracing tympanogram has a high positive predictive value for middle ear effusion in adenoid hypertrophy children.Type C tympanogram could not exclude effusion when the peak pressure is＜-200 daPa.CT is the best tool for identifying hydrotympanum.

Santorinicele without Pancreas Divisum: Diagnosis with Multi-Detector Row CT and MR Cholangiopancreatography

A santorinicele is a cystic dilatation of the dorsal pancreatic duct at the minor papilla, and has been reported in patients with pancreas divisum and pancreatitis. Santorinicele without pancreas divisum is extremely rare, with only one case being previously reported. We present here a case of santorinicele that was observed as a cystic dilatation of the distal dorsal pancreatic duct at MCDT, and had communication between the ventral and dorsal pancreatic ducts. Additionally, MRCP and ERCP firmly confirmed the presence of a santorinicele.

The comparative study of nuclein hypoxia imaging,tumoraffin imaging and CT in the diagnosis of lung neoplasms / 中国医师杂志

Objective To investigate the value of ~(99m)Tc-HL91 hypoxia imaging,~(99m)Tc-MIBI tumoraffin and computered tomography(CT) in the diagnosis of lung cancer.Methods The ~(99m)Tc-HL91 hypoxia imaging,~(99m)Tc-MIBI tumoraffin and CT were performed in 50 patients with lung neoplasm confirmed by pathology.Results There was not significant difference in the sensitivity of three imaging examination methods.The specificity of ~(99m)Tc-HL91 hypoxia imaging was obviously higher than that of ~(99m)Tc-MIBI tumoraffin and CT.The accuracy of ~(99m)Tc-HL91 hypoxia imaging was higher than that of ~(99m)Tc-MIBI tumoraffin,and had not significance difference with that of CT.The sensitivity,specificity and accuracy of the combination of three imaging examination methods in the diagnosis of lung cancer were 96.9%,100% and 98%,respectively.Conclusion The ~(99m)Tc-HL91 hypoxia imaging is valuable in diagnosing lung cancer and the diagnostic accuracy may be further improved with the combination of ~(99m)Tc-MIBI tumoraffin and CT.

Ground-Glass Attenuation in Usual Interstitial Pneumonia: Histologic Correlation and Serial Changes onThin-Section CT

PURPOSE: To achieve pathologic correlation in areas of ground-glass attenuation (GGA) in usual interstitialpneumonia(UIP) and, using serial thin-section CT, to observe changes in those lesions. MATERIALS AND METHODS:CT-pathologic correlation was performed at 20 sites of GGA in 18 patients with UIP. Two chest radiologistsassessed serial CT scans, focusing particularly on areas of GGA where open lung biopsy had been performed.Pathologic score of inflammation vs. fibrosis was recorded by two independent lung pathologists. RESULTS: Oninitial CT, GGA appeared as an isolated manifestation at one site, mixed with irregular lines at six, and mixedwith both irregular lines and bronchiectasis/bronchiolectasis at thirteen. Pathologically, those areascorresponded respectively to areas of active inflammation, dominant inflammation, and dominant fibrosis. Theextent of GGA seen on follow-up CT decreased when it was an isolated finding (n=1), and at four of six sites (67%)where it was associated with irregular lines. At the remaining two sites, GGA persisted. GGA, when combined withirregular lines and bronchiectasis/bronchiolectasis, persisted (n=6) or progressed (n=7). CONCLUSION: GGA in UIP,when it appears combined with irregular lines and bronchiectasis/bronchiolectasis, pathologically denotes areas offibrosis and does not improve with treatment. Isolated areas of GGA or GGA associated with irregular lines appearto be inflammatory and improve with treatment.