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Objective:To compare the predictive value of contrast-enhanced ultrasound(CEUS) Liver Imaging Reporting and Date System(LI-RADS) version 2017 with magnetic resonance imaging(MRI) LI-RADS version 2018 applied alone or in combination for focal liver lesions in high-risk patients.Methods:From January 2018 to October 2021, the clinical and imaging datas of 212 patients with 300 nodules underwent CEUS and contrast-enhanced MRI(CEMRI) within 4 weeks in Ruijin Hospital and its Wuxi branch were retrospectively analyzed. Each nodule was categorized according to the CEUS LI-RADS v2017 and CT/MRI LI-RADS v2018. Inter-modalities agreement was assessed with Cohen′s Kappa. The diagnostic performances of the two classification criteria applied alone and in combination for the predictive value of malignant risk of focal liver lesions were compared using histopathology or follow-up as gold standard.Results:The inter-modalities agreement of CEUS LI-RADS v2017 and MRI LI-RADS v2018 was moderate (Kappa=0.441). The specificity of CEUS LR-5, MRI LR-5 and CEUS LR-5+ MRI LR-5 in the diagnosis of HCC was 93.66%, 95.07% and 88.73% ( P>0.05), respectively, positive predictive values of them were 93.13%, 93.81% and 89.81%( P>0.05), respectively. The sensitivity of CEUS LR-M, MRI LR-M and CEUS LR-M+ MRI LR-M in the diagnosis of non-HCC malignancy was 85.71%, 82.86% and 100%, respectively. CEUS LR-M+ MRI LR-M had higher sensitivity than MRI LR-M( P=0.033), whereas no difference was found between CEUS LR-M+ MRI LR-M and CEUS LR-M( P=0.063). Conclusions:The inter-modalities agreement of the LI-RADS category between CEUS and MRI is moderate. The specificity and positive predictive values of HCC in LR-5 of the CEUS and MRI LI-RADS are comparable. In addition, the sensitivity of non-HCC malignancy in LR-M of the CEUS and MRI LI-RADS are comparable. The combined application of CEUS and MRI LR-M can improve the diagnostic sensitivity of non-HCC malignancy.
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Clinical data of 5 patients with pancreatic and liver lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the Department of Gastroenterology of Beijing Friendship Hospital from February to May 2020 were analyzed retrospectively. Pancreatic lesions were located in the head of pancreas in 3 cases, the neck of pancreas in 1 case and the body of pancreas in 1 case, with the maximum diameter of 3.2-4.6 cm. The histological and cytologic results of pancreas were all positive in 5 patients after 2-4 needles of aspiration. Three patients had single lesion in left lobe of liver, 1 had multiple lesions in left lobe of liver, and 1 had multiple lesions in left and right lobe of liver. The maximum diameter of liver lesions were 0.4-1.2 cm. After 1-3 needles of aspiration, the histological and (or) cytologic results of liver were positive in 4 of 5 patients, only 1 patient's cytologic result was negative. No associated complications were recorded. EUS-FNA for pancreatic and liver lesions is safe and effective.
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Objective To evaluate and explore the diagnostic value of focal liver lesion ( FLL) ( ≤2 cm) undetectable on conventional ultrasound by image fusion with contrast-enhanced ultrasound(CEUS) . Methods A total of 50 patients with 65 lesions( ≤2 cm) were enrolled . All lesions were undetectable on conventional ultrasound but showed clearly in CT/MRI images . Ultrasound-CT/MRI image fusion with CEUS was performed ,and the nodule detection rate and enhancement perfusion mode were analyzed . Results All the 50 patients were matched successfully ,56 lesions (86 .2% ) were detected by image fusion combined with CEUS ,among which 27 lesions (41 .5% ) were significantly different from surrounding parenchyma on conventional ultrasound , 54 lesions ( 83 .1% ) showed different enhancement from the surrounding parenchyma on CEUS . There were 46 lesions that were eventually diagnosed by surgical pathology or clinical comprehensive diagnosis . The diagnostic accuracy of image fusion with CEUS was 91 .3% (42/46) . According to different groups of MRI matching sequences ,the detection rates of T 2 sequence group and enhanced sequence group were 87 .5% (28/32) and 91 .3% (21/23) ,respectively ,there was no statistically significant difference between the two groups ( P ＝0 .686) . Conclusions CT/MRI image fusion combined with CEUS has high detection rate and diagnosis accuracy for small FLL undetectable on conventional ultrasound .
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Hepatic space-occupying lesions refer to the lesions which are located in the abnormal echo area or density area of the liver parenchyma, have the appearance of nodule or mass, occupy a certain space, and may cause pressure, displacement, or invasion of adjacent liver tissue and vessels, as determined by imaging examination. Hepatic space-occupying lesions have various causes, as well as similarities and differences in clinical manifestations. An understanding of the etiology and clinical manifestations of hepatic space-occupying lesions helps with their diagnosis and differential diagnosis and the development of targeted therapeutic regimens to improve prognosis. This article introduces related issues, in order to help clinical physicians to expand their thoughts in diagnosis and treatment.
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Clinical efficacy of liver lesion with the treatment of reduced glutathione and ademetionine was analyzed retrospectively. 83 patients were randomly divided into two groups based on the application of preventive hepatopro-tective drug. Control group was treated with reduced glutathione intravenous drip infusion once a day ( n =40 ) , while treatment group with reduced glutathione and ademetionine(Transmetil) once a day(n=43). After 12 days, the clinical efficacy of treatment group was better than that of control group. Total response rate was 95. 35% for treatment group, much better than that of control group(80. 00%). There was significant difference between two groups ( P<0.05 ) . Reduced glutathione and ademetionine are more effective in the treatment of chemotherapeutics-induced liver lesion than only with reduced glutathione.
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An overview of the epidemiological, biological, and clinical studies of Taenia and taeniasis in Taiwan for the past century is presented. The phenomenal observations that led to the discovery of Taenia asiatica as a new species, which differ from Taenia solium and Taenia saginata, are described. Parasitological surveys of the aborigines in Taiwan revealed a high prevalence of taeniasis, which might be due to the culture of eating raw liver of hunted wild boars. Chemotherapeutic deworming trials involving many patients with taeniasis were discussed. Praziquantel was found to be very effective, but sometimes complete worms could not be recovered from the feces after treatment, probably due to the dissolution of the proglottids. Atabrine, despite some side effects, can still be used, in properly controlled dosages, as the drug of choice for human T. asiatica infection if we need to recover the expelled worms for morphological examinations. Research results on the infection of T. asiatica eggs from Taiwan aborigines in experimental animals were also noted. Since the pig serve as the natural intermediate host of T. asiatica and the predilection site is the liver, a differential comparison of other parasitic pathogens that might cause apparently similar lesions is also presented.
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Animals , Humans , Anthelmintics/therapeutic use , Biomedical Research/history , History, 20th Century , History, 21st Century , Taenia/classification , Taeniasis/drug therapy , Taiwan/epidemiologyABSTRACT
Objective To investigate the movement,and the factors that influence such movement of liver lesions and to provide a reference for determination of internal target volume (ITV) during stereotactic radiotherapy. Methods We implanted 1 -2 gold markers into or near the liver tumors of 42 liver primary or metastasis cases percutaneously under B-ultrasound or computer tomography (CT) guidance. The marked motion of liver lesions in x ( right-left), y (superior-inferior) and z (anterior-posterior) directions was measured via X-ray simulator system. Based on the statistical analysis of the detected movements, we investigated the relevant influencing factors of liver lesions with bivariate correlation analysis. Results Data showed that mean motion amplitudes of liver lesions were 0.27 ± 0. 11 cm (0. 1 -0. 5cm) in x direction,0.38 ±0. 19 cm (0. 1 -0. 8cm) in y direction and 1.19 ±0. 27 cm (0. 5 - 1.9cm) in z direction. Motion amplitude was not correlated with the height, weight or age of the patients nor with the location or size of the tumor. Conclusions Motion of liver lesions was mainly influenced by the respiratory and has maximal amplitude in the z direction. Therefore,the motion in the z direction should be given a priority consideration while determining the ITV.
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Objective To investigate the diagnostic value of a double action MR contrast agent——gadobenate dimeglumine (Gd-BOPTA) for focal liver lesion and biliary system disease.Methods Articles about Gd-BOPTA in CNKI and PubMed for the past few years were searched and the value of Gd-BOPTA in the diagnosis of focal liver lesion and biliary system disease was summarized.Results For focal liver lesion,Gd-BOPTA not only can reveal blood supply of the lesion,but also reveal the hepatocellular functional status in the lesion.For biliary system,biliary excretion of Gd-BOPTA can be used to evaluate the anatomic structure of bile duct,function of gallbladder and biliary system disease.Conclusions Gd-BOPTA has an important value in the diagnosis of focal liver lesion and biliary system disease.Gd-BOPTA may have wider applications in the future.
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OBJECTIVE:To observe clinical efficacy of reduced glutathione in the treatment of chemotherapeutics-induced liver lesion in cancer patients.METHODS:85 patients with drug-induced liver lesion after chemotherapy were randomly divided into 2 groups.Treatment group were treated with reduced glutathione and diammonium glycyrrhizinate injection (n=43) and control group were treated with diammonium glycyrrhizinate (n=42).Clinical efficacies of 2 groups were compared.RESULTS:After 2 weeks,average value of several index in treatment group were lower than in control group,there were significant difference between 2 groups (P
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To explore the clinical value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant focal liver lesions (FLLs) with SonoVue, CEUS was used to examine 113 pa- tients with focal liver lesions (FLLs) in our hospital during July 2005 to December 2006. All the pa- tients underwent contrast-enhanced CT (CECT) or contrast-enhanced MRI(CEMRI). Except for pa- tients with focal fatty sparings (n=18) and with hemangiomas (n=8), all the patients were confirmed by operation or ultrasonic-guided liver puncture biopsy. A sulfur hexafluoride gas-based contrast agent was used with a MI of 0.15 to 0.17. Forty-eight cases of malignant FLLs, including 30 hepato- cellular carcinomas (HCCs), 2 cholangiocarcinomas and 16 metastatic tumors, were detected. Sev- enty-eight cases of benign FLLs, including 33 hemangiomas, 9 focal nodular hyperplasias (FNHs), 19 focal fatty sparings, 5 abscesses, 7 regenerative nodules and 2 inflammatory pseudo-tumor, were in- volved. The contrast pattern of benign and malignant FLLs was quite different. CEUS has higher specificity and sensitivity than conventional ultrasound in differentiating benign and malignant FLLs.
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PURPOSE: Decreased expression of beta-catenin has been known to be associated with tumor metastasis. However, the clinical relationship between the degree of expression and the prognosis in colorectal cancer (CRC) remains unclear. In this study, we evaluated the prognostic value of beta-catenin expression in CRC patients with liver metastasis. METHODS: Paraffin embedded blocks were obtained from 70 patients who underwent potentially curative resection for CRC with liver metastasis. Samples from normal colon mucosa, primary CRC and metastatic liver lesion were prepared in tissue microarrays and were stained by immunohistochemistry with monoclonal antibody against beta- catenin. The membranous beta-catenin expression was assessed and the beta-catenin expression difference between primary CRC and metastatic liver lesion was analysed in relation to overall survival as well as disease free survival rates. RESULTS: In beta-catenin expression, preserved expression (score >6) was observed in 42.0%, and 21.9% of primary CRC tumor samples and tumor samples from metastatic liver lesion respectively. The degree of beta-catenin expression in metastatic liver lesion was significantly lower than that in primary CRC (P=0.022). According to the difference of beta-catenin expression score between primary CRC and liver metastasis, patients were classified as group 'A' and 'B'. Group 'A' was defined as patients showing remarkably decreased expression of beta-catenin in metastatic liver lesion in that the difference of the score was three or more. Group 'B' was defined as patients showing maintained or increased beta-catenin expression in metastatic liver lesion in comparison to primary CRC, in that the difference of beta-catenin expression score was less than three. Overall survival rate and disease free survival rate were significantly better in group 'B' than group 'A' (P=0.02, P=0.002). CONCLUSIONS: Decreased expression of beta-catenin in metastatic liver lesion may be a poor prognostic marker in colorectal cancers with liver metastasis. A further large-scaled investigation is necessary to define the role of beta-catenin in CRC.
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Humans , beta Catenin , Colon , Colorectal Neoplasms , Disease-Free Survival , Immunohistochemistry , Liver , Mucous Membrane , Neoplasm Metastasis , Paraffin , Prognosis , Survival RateABSTRACT
A retrospective study on 17 patients with the hepatic fasciola hepatica infection with the positive serum diagnosis was carried out. The CT scanner and MRI were implemented to determine the position, evaluate the lesion and monitor the progress and specific signs of the disease. In the CT scanner image, the sound intensity in the fasciola hepatica located position was reduced, the lesion usually concentrated. In the MRI, in the phase of abscess, the sign intensity of lesion was low (higher than T1W and lower than T2W), moderate lesion occurred in septal an wall.