Characteristics and clinical pathologic analysis of computed tomography, magnetic resonance imaging in the lymphoma of head and neck / 白血病·淋巴瘤

Objective To explore the imaging and clinical pathological features of extranoda and intranoda lymphoma in head and neck characterized by computed tomography (CT) and magnetic resonance imaging (MRI).Methods 46 malignant lymphoma patients were confirmed by surgery and pathology.The CT and MR images data were reviewed and analyzed in comparison with surgical and pathological results.Diagnostic value of the CT and MRI findings were analyzed. Results The subjects enrolled in this study including 38 cases of non-Hodgkin lymphoma(NHL)and 8 cases of Hodgkin Lymphoma(HL).The pathological sites of extranodal lymphomas (45.65 ％,21/46) included nasal (10 cases),Waldeyer ring (7 cases),throat (2 cases),Thyroid(1 case) and parotid (1 case).The lymph nodes metastases in the neck were observed in 13 cases of Extranodal lymphomas.Intranodal lymphoma in neck (54.35 ％,25/46) involved all district lymph nodes especially Ⅱ-Ⅳ districts. According to the Ann Arbor staging,14 cases were Ⅰ staging, 19 cases Ⅱ staging,none Ⅲ staging,Ⅳ staging 13 cases.According tumor form,21 cases were multinodulars,12 cases mass type, 11 cases diffuse swelling type, 2 cases ulcer or necrotic type. Conclusion CT and MR images might indicate the location, morphology, surrounding tissue and lymph nodes metastases of malignant lymphoma in head and neck.Great value in clinical diagnosis and treatment is observed.

Overnight Preliminary Interpretations of CT and MR Images by Radiology Residents in ER: How Accurate Are They?

PURPOSE: At many institutes in Korea, preliminary interpretations of after-hours CT and MR images are performed by radiology residents, with the attending radiologist's reviewing the interpretations the next day. The purpose of this study was to assess the rate of discrepancy between residents' interpretations and the final interpretations performed by attending radiologists. METHODS: We reviewed the interpretations of 1381 CT and 404 MRI scans that were obtained at the emergency department of our institute over three months. Any discrepancies between the preliminary and final interpretations were categorized as either major or minor discrepancies with a major discrepancy defined as one resulting in a change in diagnosis and treatment plans. We conducted patient follow-up via a retrospective review of the medical records to evaluate the clinical outcomes of the discrepancies. RESULTS: The rate of major discrepancies was 2.5%, and the rate of minor discrepancies was 11.4%. Major discrepancies led to a change in diagnosis or patient treatment plans, but did not lead to any increase in patient morbidity. CONCLUSION: The discrepancy rate at our institution was relatively insignificant, and patient care at the emergency department was not adversely affected by having radiology residents interpret CT and MRI scans after-hours and the attending radiologist review the interpretations the next morning. Still, further efforts are needed in order to reduce the frequency of major discrepancies.

The Diagnostic Value of Radionuclide Imaging in Hepatic Adenoma / 中国现代普通外科进展

Objective:To evaluate the accuracy and ch aracteristics of combined use of 99Tcm-sulfur colloid (SC)and 9 9Tcm-diethyliminodiacetic acid (EHIDA)imaging on the diagnosis of hepat ic adenoma (HA). Methods:8 patients with HA were involved in this study.All of them were studied by nuclear medicine (NM)with dual-radiopharmaceuticals.The 99 Tcm-SC imaging was perfomed first ,then the 99Tcm-EHIDA im aging two days later,and the ratios between lesions and normal liver tissue(L/N) were calculated in terms of different counts within the same size regions of int erest (ROI) in different phases(30min,1h and 2h respectively).Some of the cases were also analysed by CT and/or MRI within one week before the operations. Results:All of the cases were submitted to surgical treatment and c onfirmed diagnosis of HA by pathology. For HA, scintigrahy presented a accuracy of 100%(8/8),which was higher than that of CT and MRI comparatively.For 99 Tcm-EHIDA imaging,there were significant differences in L/N ratios among different phases(30min,1h and 2h). Conclusion:The results show that radionuclide imaging proved to be a safe,invasive and effcetive method on the diagnosis and differential diagnosis of HA,especially ,when CT and/or MRI findings are not typical.