Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose

Abstract Objectives: To highlight the prevalence of respiratory epithelial adenomatoid hamartomas in the olfactory cleft of patients with nasal polyposis. To demonstrate characteristics indicative of hamartoma on the CT scans of paranasal sinuses during surgery and in histopathological exams. Methods: Cross-sectional study carried out in Hospital das Clínicas da UFMG and Núcleo de Otorrino BH. We performed 114 nasal endoscopic surgeries for polyposis, between February 2015 and November 2019. We assessed the olfactory cleft width in all preoperative CT scans. Upon seeing an indication of hamartoma on the CT scan, we took a tissue sample from the olfactory cleft during the surgery and sent for histopathological exam. We referred the samples to a pathologist experienced in the anatomopathological diagnosis of respiratory epithelial adenomatoid hamartomas. Results: Of the 114 patients with polyposis, 54 (47.4%) had olfactory cleft enlargement and, 100% of them had tissue with a dense and hardened polypoid aspect, with a slight cerebri-form appearance in this region during the surgery. Histology confirmed a respiratory epithelial adenomatoid hamartoma. Conclusion: This observation suggests that the presence of hamartomas in polyposis is common, but underdiagnosed. Level of evidence: Step 3 (Level 3).

Diagnostic value of CT for benign and malignant liver nodules in patients with liver cirrhosis / 中国基层医药

Objective To analyze the diagnostic value of CT for benign and malignant liver nodules in patients with cirrhosis. Methods From April 2015 to April 2018,135 cases of liver cirrhosis with solitary liver nodules in Shanxi Coal Central Hospital were selected,and all patients received the upper abdominal CT examination. The CT manifestations and diagnostic accuracy of the lesions were observed,and positive for hepatocellular carcinoma and negative for other benign nodules. The diagnostic efficacy of CT was analyzed. Results The CT scan of benign and malignant nodules of liver in the background of liver cirrhosis all showed a slight or low density focus,dynamic enhanced scan,the characteristics of hepatocellular carcinoma were obviously strengthened in the arterial phase,the portal phase was relatively low density,the delayed phase of the capsule was strengthened. The focal nodular hyperplasia was characterized by the enhancement of the middle heart scar in the delay period; the angioma was special. The characteristics of the hepatic adenoma were obvious enhancement of the arterial phase,the slow clearance of the portal phase and the delay period,and the enhancement of the liver parenchyma in the stages of the regenerative nodules of the liver cirrhosis. The accuracy of CT in the diagnosis of benign and malignant liver nodules under the background of liver cirrhosis was 90. 4% (122/135),of which the accuracy of diagnosis of hemangioma was the highest[100. 0% (30/30)],and the lowest rate for the diagnosis of regenerative nodules of liver cirrhosis was 81. 1% (30/37). The sensitivity,specificity,positive predictive value, negative predictive value and accuracy of CT for the diagnosis of benign and malignant liver nodules under the background of liver cirrhosis were 92. 1% ,89. 7% ,77. 8% ,96. 7% and 90. 4% ,respectively. Conclusion In the diagnosis of benign and malignant nodules under the background of liver cirrhosis,spiral CT has high diagnostic effect. Dynamic enhanced scan can accurately differentiate most of the lesions.

AnapplicationofMDCTtissuesegmentationtechnologyonthequantitativeevaluation andthevolumedegreedivisionofthepleuraleffusion / 实用放射学杂志

Objective Toexploreasimpleandaccuratemethodfordeterminingthequantitativeevaluationandthevolumedegree divisionofpleuraleffusionbyMDCTtissuesegmentationtechnology.Methods Thevolumeofwaterinjectedintothreecontainersof differentshapeswasmeasuredby MDCTtissuesegmentationtechnique,andwerefurthercomparedwiththevolumeoftheactual waterinjection.Byusingthesamemethod,theliquidvolumeofpleuraleffusionbeforeandafterpumpingfrompatientswasmeasured andthedifferencebetweentheanteriorandtheposteriorwascalculated.Thenthedifferencebeforeandafterthepumpingwascomparedwiththe actualvolumeofclinicalfluidpumping.Atthesametime,thespecificmethodtodeterminethedegreedivisionofpleuraleffusionwas established.Results Forcontainersofdifferentshapes,theresultfromtheCTscanningliquidmeasurementwasthesameasactualwater injection,andhadahighcorrelation.Thedifferencebetweenbeforeandafterfluidextractionandclinicalactualfluidextractionwas linearcorrelated(positivecorrelation,r=0.986,P<0.001).Accordingtothemethodfordegreedivisionofadulthemothorax,MDCT tissuesegmentationtechnologydividedthevolumeofpleuraleffusionbeforethepumpingintosmall,mediumandlargeamounts.There were44caseswithsmallpleuraleffusion,11caseswithmoderatepleuraleffusionand7caseswithlargepleuraleffusion.Conclusion The volumeofpleuraleffusion measuredby MDCTtissuesegmentationtechnologycanreflecttheactualvolumeofpleuraleffusionin clinictoacertainextent,and MDCTtissuesegmentationtechnologycanbeusedtodividethevolumedegreeofpleuraleffusion.

Applicationvalueofanewgenerationmodel-basediterativereconstructioninchestCTscan / 实用放射学杂志

Objective ToinvestigatetheimpactofCTimagequalityforfilteringbackprojection(FBP),conventionalmodel-based iterativereconstruction(MBIRC)andnewgeneration model-basediterativereconstruction (MBIRN)onchest.Methods Thirtypatientswith chestCTscanwerecollected.FBP,MBIRCandMBIRN wereusedtoreconstructtheimage.Objectivequality[standarddeviation(SD) valueoftheROI,SNR],thenoisereductionrateandSNRimprovementrateofMBIRCand MBIRN withrespecttoFBP werecom-paredacrossthethreeimages.Atthesametime,tworadiologistsusedtheblind methodtoevaluatetheintrapulmonarystructurein thelungalgorithm FBP,MBIRC,MBIRN,andthemediastinalstructure (5-pointsystem)inthestandardalgorithmsFBP,MBIRC, MBIRN.Results ComparedwithFBP,theimagemusclenoisesofMBIRCand MBIRN were76.71% and86.06%lowerthanFBP,respectively, andthefatnoiseswere66.91% and78.18%lowerthanFBP,respectively.Thedifferencewasstatisticallysignificant(P<0.05).The imageSNRofMBIRCandMBIRN were74.12% and84.97% higherthanthatoftheFBPgroup,respectively.ThefatSNRwere65.63% and 76.02% higherthanthatoftheFBPgroup (P<0.05).Thethreealgorithmsshowedstatisticallysignificantdifferencesinsubjective noise,intrapulmonaryvascular,bronchialresolution,mediastinalbloodvessels,andlymphnodes.MBIRN hadthelowestsubjective noise,andthehighestSNR,mediastinalstructure,andintrapulmonaryvesselsandbronchi.Conclusion Comparedwith MBIRC and FBPwithnormaldosechestCTscan,MBIRN cansignificantlyreducethenoiseofchestCTscanimages,improveSNR,and more clearlyshowthedetailsofthescanrangeandlesionedgefeatures.

CTfeaturesofganglioneuroblastoma / 实用放射学杂志

Objective ToimprovethediagnosticaccuracybyassessingtheCTfeaturesofganglioneuroblastoma(GNB).Methods 38patientswithGNBconfirmedbypathologicalresultsandunderwentplainandcontrast-enhancedCTscanwereanalyzedretrospectively. Results GNBoftenoccurredinchildren.Allthecasesappearedassolitarylesion,7werelocatedinthemediastinum,12intheadrenal,15inthe retroperitoneal,3inthethoraxcavityand1inthepelviccavity.PlainCTshowed36lesionswithheterogeneouslowdensitywithnecrosisand cysticdegeneration,and28caseswithcalcifications,2withhomogeneouslowdensity.Thesolidlessionofallcasesshowedprogressive enhancement(4casesshowedslightprogressivecontrastenhancement,11casesshowed moderateenhancement,23casesshowed markedlyenhancement).Peripheralvesselsweredisplacedbytumorin19casesandembeddedbytumorin13cases.13casesshowed thepresenceofsmallvesselsin/aroundthetumorarrangedinclumpsorinline.Conclusion ThespecificCTfindingsofheterogeneouslowdensity withnecrosis,calcifications,peripheralvesselsdisplaced,moderatetomarkedlyprogressiveenhancement,mightbeusefulforthediagnosisofGNB.

ThevalueofGd-EOB-DTPA-enhanced MRIindiagnosisofhepatocellularcarcinoma / 实用放射学杂志

Objective ToexplorethediagnosticvalueofenhancedCTandGd-EOB-DTPA-enhanced MRIinthedetectionofhepatocellular carcinoma (HCC).Methods 41patientswith52HCCsunderwentenhancedCTandGd-EOB-DTPA-enhancedMRIrespectively.The imagingmanifestationswereanalyzed,andthelesionsweregrouped.Theimagingdiagnositicresultswerecomparedwiththepathologicalresults, andtheefficacyofthetwomodalitieswasevaluatedusingtheaccuracyindex.Results Ofthetotal52HCCs,42lesionswereidentifiedexactlyby enhancedCT,and51byGd-EOB-DTPA-enhancedMRI.Foralllesions,includingsmalllesions(≤2cm),theaccuracyratioofGd-EOB-DTPA-enhancedMRIwashigherthanthatofenhancedCT withastatisticallysignificantdifference(P<0.05),however,therewasnosignificant differenceforthelesionsbiggerthan2cm (P>0.05).Conclusion EnhancedCTislimitedindiagnosisoftheHCCssmallerthanor equalto2cm.ThediagnosticefficacyofGd-EOB-DTPA-enhanced MRIishigherthanthatofenhancedCT,anditcansignificantly improvethediagnosisofsmallHCC.

CTcharacteristicsoftracheobronchialtuberculosiswithdifferentpathologicaltypes / 实用放射学杂志

Objective ToexploretheCTcharacteristicsoftracheobronchialtuberculosis(TBTB)withdifferentpathologicaltypes. Methods CTdataof80patientsdiagnosedasTBTBbybronchoscopywereanalyzedretrospectively.Results CTcharacteristicsofTBTBwere follows:(1)Directsignsweredetectedin127cases.Therewere47cases(37.0%)withbronchialwallthickening,57cases(44.9%) withbronchiostenosisand23cases(18.1%)withbronchialocclusion.ForactiveTBTB,therewereonly2caseswithbronchialwall thickeningand1casewithbronchiostenosisin9casesintypeⅠ,40cases(31.5%)withbronchialwallthickeningandbronchiostenosisintypeⅡ, 41cases(32.3%)withallthreedirectsignsintypeⅢ.AmongstableTBTB,22cases (17.3%)withbronchialwallthickeningand bronchiostenosisintypeⅣ;TherewerefewcasesintypeⅤ,butallwithbronchialocclusion.(2)Indirectsign:54cases(45.4%)with bronchialdisseminated,13cases(10.9%)withdestroyedlung,25cases(21.0%)withcavities,27cases(22.7%)withmediastinallymphnodes enlargementamongthe119cases.BronchialdisseminatedlesionsinactiveTBTBweresignificantlymorethandestroyedlungandcavitylesions (P<0.01).Conclusion DifferentpathologicaltypesofTBTBhavedifferentCTcharacteristics.ActiveTBTBischaracterizedbydirectsignsand oftenaccompaniedwithindirectsignssuchasbronchialdissemination.

InfarctionofthearteryofPercheron:5casesandliteraturereview / 实用放射学杂志

Objective Toanalyzetheimagingcharacteristicsandearlydiagnosticvalueofpatientswithinfarctionofthearteryof Percheron(AOP).Methods Theclinicaldataandimagingfeaturesof5patientswithAOPinfarctionwereanalyzedretrospectively, andrelevantliteratures werereviewed.Results Allof5patientspresented withdisturbanceofconsciousness.MRIof5patients showedsymmetricalhighsignalonDWIinthebilateralparamedianthalami,and1patientwithanteriorthalamiclesionand1patient withmidbrainlesionshowed "V"sign.Inaddition,MRAshowedlocalizedstenosisoftheP1segmentoftheposteriorcerebralartery in2patients.Conclusion TheclinicalpresentationsofpatientswithAOPinfarctionarevariable.Thesymmetricalhighsignalinthe bilateralparamedianthalamionDWIishelpfulforearlydiagnosisandclinicaltreatmentofAOPinfarction.

ClinicalstudyofnonGpresseddirectmethodinCTimagingoflowerextremityvein / 实用放射学杂志

Objective Toinvestigatetheeffectofpressureandnon-pressureonthedirectimagingoflowerlimbdeepveinswith CTvenography(CTV).Methods 100patients(50malesand50females,aged30－80yearsold,mean (63.5±13.5yearsold)with suspectedlowerextremityvenousdiseasesfrom September2015to October2018 wereretrospectivelyanalyzed.50patientswere scannedafterpressingtheankle(controlgroup),andtheother50werescannedwithoutpressingtheankle(experimentalgroup).Results Therewerenosignificantdifferencesbetweenthecontrolandexperimentalgroupsintheauxiliaryveinscore (t＝－0.20,P＝0.82), femoralveinscore(t＝－0.1,P＝0.91),andtotaliliacveinscore(t＝－0.03,P＝0.97).Conclusion CTV withoutpressingtheankle demonstratescomparableefficacytodirectimagingoflowerlimbdeepveins,withgoodimagequality,reducedcomplicationsandeasy toapply,sothatitshouldbewidelyusedinclinicalpractice.

CTdiagnosisofinfantilehepatichemangioendothelioma / 实用放射学杂志

Objective ToexploretheCTcharacteristic manifestationsoftheinfantilehepatichemangioendothelioma (IHHE). Methods 10cases(5malesand5females)withIHHE (agerangefromonly1dayto8months,withthemeanageof53days)were collected.Theclinicalmanifestationsincludedabdominalmassesin5cases,vomitingin2andjaundicein1.Therewasababygirlwith congenitalcholedochalcyst.Allpatientsunderwenttheplainandcontrast-enhancedscans.Results CTshowedlocalandsingleintrahepatic massin6cases(including2casesinrighthepaticlobe,2casesinquadratelobeand2casesinleftlobe),2－3massesinliverin2,and diffusenodulesin2.PlainCTshowedallmasseswithlowdensityorlow-equalhybriddensity.Themarginswereclearin4cases,and unclearin6cases,withspottedcalcificationin2cases.TheenhancedCTshowedall10caseswithrosette-likemarginalenhancement, and6caseswithgradualwash-inindelayedphase.Threepatientsreceivedinterventionaltreatmentswithintrahepaticarterialembolization, andthenthediffuselesionsintwopatientssignificantlyreducedafter20monthsand33monthsrespectively,whilethesinglelesionin 1casealsosignificantlyshrankafter6monthsoftreatment.Conclusion CTisaneffectivemethodforthediagnosisofinfantilehepatic vascularendothelioma.Marginalring-enhancementisthecharacteristicmanifestationofIHHE,anditdoesnotinvadeadjacentliver parenchymaandbloodvessels,whichcanbedistinguishedfromotherliveroccupyinglessions.

CTand MRIfindingsofovariancysticlesions / 实用放射学杂志

Objective ToimprovetherecognitionofovariancysticlesionsbyanalyzingCTand MRIappearances.Methods A retrospectivereviewofCTand MRIimagesof67caseswithpathologicallyprovenofovariancysticlesionswasperformed.Among which,58casescarriedoutplainCTscan,52casesunderwentenhancedCTscan,12casesunderwentplainMRIscan,and7casesunderwent enhancedMRIscan.Results 20caseswereovariancystadenomas,14caseswerecystadenocarcinomas,8caseswereteratomas(1case wasmalignant),5caseswerestrumaovarii,15caseswerecysts,3casesweremetastases,and2caseswereovariantuberculosis.The CTand MRIcharacteristicsofthecysticlesions,inculdingsize,shape,thicknessofcystwall,wallnodule,densityorsignalintensity andenhancementfeatureswerevaluableindifferentialdiagnosisofovariancysticlesions.Conclusion CTand MRIappearancesofovarian cysticlesionshavesomecharacteristics,includingcysticwallandseptaofcystadenocarcinomasirregularthickened,papillaryprotuberance andascites.Teratomasoftencontainfatandcalcification.Strumaovariipresentsmultilocularcystic-solidmass,withthesolidportions markedenhancement.Metastatictumorshaveahistoryofprimarygastrointestinalneoplasmsandperitonealeffusion.

CTimagingfeaturesanddifferentialdiagnosisofhilarcholangiocarcinomawithdifferentgrossclassification / 实用放射学杂志

Objective TodiscusstheCTimagingfeaturesanddifferentialdiagnosisofhilarcholangiocarcinomawithdifferent grossclassifications.Methods 83casesofperihilardiseasesconfirmedbyhistopathologywereanalyzedretrospectivelybytworadiologists. CTimagingfeaturesandenhancementpatternsinhilarcholangiocarcinomawithdifferentgrossclassificationsandotherperihilarbenign diseaseswerecomparedtoseeiftherewasasignificantdifference.Results Ofall,15caseswithintraductalgrowinghilarcholangiocarcinoma, theaxialdiametersweresignificantlylargerthanperihilarbenigndiseases,andallofthem werewash-inandwash-outpatternof enhancement.38caseswereperiductalinfiltratinghilarcholangiocarcinomawithsignificantlyshorterlongitudinallength,mostlywith biliarystricture,bileductthicknessandsoftrattandistantbiliarydilatation.Mostofthem werewash-inandwash-outpatternof enhancement.30casesweremass-forminglesions.Hilarmass-forminglesionsweremostlyhilarcholangiocarcinoma,andtheenhancement patternswerepersistentandprogressiveenhancements.Conclusion Differentgrossclassificationsofhilarcholangiocarcinomahave differentCTfeatures,includingthesize,morphology,indirectsignsandenhancementpatterns,whichcanbeusedtodistinguishwith thehilarbenignlesions.

TheCTfindingsandpathologicalfeaturesofgastricneuroendocrineneoplasm / 实用放射学杂志

Objective ToinvestigatethevalueofenhancedCTindifferentiatinggastricneuroendocrinetumors (NET)from gastric neuroendocrinecarcinomas(NEC).Methods 34patientswithpathologicallyprovenneuroendocrineneoplasms (NEN)underwent abdomenenhancedCT.Theage,genderandCTfeaturesofthetumorswereanalyzedretrospectively.TheCTfeaturesincludedtumor location,shape,size,homogeneityofdensity,welldefinedserosalsurface,CTvalueofplainandenhancedCT,enhancementpattern, and metastasesoflymphnode.TheevaluatedparameterswerecomparedbetweengastricNETandgastricNECby t testand Fisher exacttest.Results AsignificantdifferenceingenderwasfoundbetweengastricNETandgastricNEC (P＜0.05),however,nosignificant differenceinagewasfound(P＞0.05).Thereweresignificantdifferencesintumorsize,shape,welldefinedserosalsurface,enhancement degreeandenhancementpatterninarterialphasebetweengastricNETandgastricNEC(P＜0.05),however,nosignificantdifferencesin otherparameterswerefound(P＞0.05).Conclusion TheNETofthestomachhascertaincharacteristicsofcontrast-enhancedCT. Theshape,size,welldefinedserosalsurface,degreeofenhancementandenhancementpatterninthearterialphasearevaluablein differentiatinggastricNETfromgastricNEC.

TheMSCTandpathologicalfeaturesofsarcomatoidhepatocellularcarcinoma / 实用放射学杂志

Objective ToexploretheMSCTandpathologicalfeaturesofsarcomatoidhepatocellularcarcinoma(SHC)inorderto improvetheaccuracyofpreoperativediagnosis.Methods TheMSCT,clinicalandpathologicaldataofall25caseswithpathologically provenSHCwerereviewedretrospectively.Results (1)TheaveragediameterofSHCwas(64.70±40.15)mm.OnplainCT,thelesions showedround-likehypodensityby89.3% (25/28).Thelesionsshowedcompletelycysticdegenerationby14.3%(4/28),unclear boundaryby85.7% (24/28),andheterogeneousdensityby78.6% (22/28),mainlyrepresentingcysticlowdensity.(2)Oncontrast-enhanced CT,thelesionsshowedheterogeneousenhancementby85.7% (24/28).The marginsandinternalsolidsegmentsofthelesions showedirregularmildtomoderateenhancementonarterialphase,andobviousenhancementonportalanddelayedphasesby28.6%(8/28).57.1% (16/28)ofthelesionsshowedobviousenhancementonarterialphase,andwash-outonportalanddelayedphases.The cysticwallandseptumofthecysticlesions (14.3%,4/28)weremildto moderateenhancementonarterialphase,andobvious enhancementonportalanddelayedphases.32.1% (9/28)ofthelesionsshowedhepaticarterybloodsupply,and17.9% (5/28)ofthe lesionshadpseudocapsulesign.(3)ImmunohistochemistryshowedthatVimentinand CD34 werepositiveexpression,meanwhile CK19,HepatocyteandEMA werepartlypositive.Conclusion SHChascertaincharacteristicssignsatMSCT.Lesionsshowhypo-density masseswithlargevolumeandunclearboundaryintheliverparenchyma,andinhomogeneouslymildtomoderateenhancement.Thediagnosis shouldbeconsideredespeciallywhenthelesionhaslargecysticnecrosis.

Consistencyanalysisofpreoperativeultrasoundand MSCTindiagnosing microvascularinvasioninhepatocellularcarcinoma / 实用放射学杂志

Objective Toinvestigatetheconsistencyofultrasoundand MSCTindiagnosing microvascularinvasion (MVI)in hepatocellularcarcinoma,andtocomparethediagnosticefficiencyofbothtwomethods.Methods TheultrasoundandMSCTdataof 82patientswithhepatocellularcarcinomawerecollected.Accordingtothepostoperativepathologicalresults,theconsistencyanddiagnostic efficiencyofultrasoundandMSCTindiagnosingMVIinhepatocellularcarcinomawerecompared.Results Accordingtothepostoperative pathologicalfindingsof82patients,30caseswerepositiveofMVI,while52caseswerenegative.ThepreoperativeMSCTandultrasound examinations had a strong consistency (Cohen’s Kappa＝0.829 ,P＜0.001 ).The sensitivity ,specificity and accuracy of preoperative ultrasoundinpredictingtheMVIinhepatocellularcarcinomawere76.67% (23/30),67.31% (35/52)and70.73% (58/82),respectively. Thesensitivity,specificityandaccuracyofpreoperativeMSCTinpredictinghepatocellularcarcinomaMVIwere83.33% (25/30),73.08%(38/52)and75.61% (63/82),respectively.Conclusion Preoperativeultrasoundand MSCThavegoodconsistencyandhighdiagnostic efficiencyindiagnosing MVIinhepatocellularcarcinoma.

MSCTpostGprocessingtechniqueforthediagnosisoffishboneinesophagus andforanalyzingthefactorsrelatedtothecomplicationofperforation / 实用放射学杂志

Objective ToinvestigatethevalueofMSCTandpost-processingtechniquesforthepresentationoffishboneinesophagus, andtoexploretherelatedfactorsofcomplicationsafterfishboneincarceration.Methods TheclinicaldataandMSCTdataof81cases ofesophagealfishforeignbodiestreatedbyendoscopyorsurgerywereanalyzed,including46 malesand35females;moreoverttest andχ2testwereusedforintergrouptesting.Results (1)Therewerenosignificantdifferencesinthemaleandfemalepatients’age, distributionoffishboneincarceration,theperiodofbetweenmedicaltreatmentandfishbonepuncturingintotheesophagus,thelength ofthepuncturedfishbone,theincarcerationmethod,andtheperforationcomplications(P＞0.05).Thedistancebetweenthefishbone andtheincisorinthemalepatientswasfarlongerthanthatinthefemalepatients,andthedifferencewasstatisticallysignificant(P＝0.011).Therewere54cases(66.7%)inthehorizontalincarcerationand27cases(33.3%)inthelongitudinalincarceration.(2)9patients (11.1%)hadesophagealperforation.Theoccurrenceofesophagealperforationcomplicationwasnotrelatedtotheageofthepatient, thedistancefromthetopofthefishbonetotheincisor,andthelengthofthefishbone(P＞0.05);theincarcerationtimewaspositively correlatedtotheperforationcomplications(r＝0.258,P＝0.02).Horizontalincarcerationoffishbonewasmoreeasilyperforatedthan longitudinalincarceration (P＝0.000).(3)Alltheforeignbodiesoffishbonesshowedbone-likehighdensityonCT.Theforeign bodiesoffishbonesweremostlyembeddedintheupperesophagus.Thedistancebetweenthetopofthefishboneandtheincisorwas about(19.38±4.08)cm.Allcaseshadswellingandthickeningoftheesophagealwall.Conclusion Thefishbonehorizontalincarceration, andlongertimestayintheesophagusaremorelikelyhappentoperforationcomplications.MSCTandpost-processingtechniquesprovidea basisforthequalitativediagnosisoffishbones,displayingthelocation,incarceration,andperforationcomplicationsofthefishbones intheesophagus.

CT manifestationsandmisdiagnosisofatypicalpulmonaryhamartoma / 实用放射学杂志

Objective ToanalyzetheCTimagingfeaturesofatypicalpulmonaryhamartomas,soastounderstandthecausesof misdiagnosisandimprovetheaccuracyofdiagnosis.Methods 18caseswithatypicalpulmonaryhamartomasconfirmedbypathology inourhospitalwerecollectedretrospectively,including9 malesand9females.18caseswereexaminedbychestCTscans,among which,2caseswithplainscans,and16caseswithenhancedscans.TheresultsofCTimagingwereanalyzedbytwoassociatechief radiologistswithdoubleblindmethod,observingthelesionlocation,size,edge,border,density,enhancementfeatures,theremaining lungtissue,theageofonset,history,andclinicalmanifestations.Results Inall18cases,3caseswereendotracheallesion,ofwhich1 casewasinleftmainbronchus,theothertwowereinrightmiddleandupperbronchusrespectively,showingcalcificationdensityand subsequentatelectasis;15caseswereperipherallesions,including7casespresentingrightpulmonarynodulesand8casespresenting leftpulmonarynodules.Allperipheralcasesweresolitarypulmonarynoduleswithoutcalcificationandfatdensity.Thediameterof nodulesrangedfrom0.3cmto2.1cm.5casesshowedsmoothroundisolatednodulesand10casesshowedshallowlobulatednodules. In16casesofenhancedscan,1lesionshowedremarkableenhancement,6lesionsshowedslightlyenhancement,and9lesionsshowed nosignificantenhancement.Conclusion PulmonaryhamartomaislackofcharacteristicofCTimaging,whichisthemainreasonof misdiagnosis.Recognizingitsdiverseimageperformancesincludingshallowlobulation,roughedge,remarkableenhancementandetc. helpsusavoidmisdiagnosis.

DetectionofCTfeaturesofinterstitialpneumoniainAIDSpatientsandsignsfordifferentialdiagnosis / 实用放射学杂志

Objective TodetecttheCTfindingsofinterstitialpneumoniainacquiredimmunodeficiencysyndrome (AIDS)patients andtoanalyzedifferentialdiagnosisofdifferenttypesofinterstitialpneumonia.Methods Atotalof168 AIDSpatientswithinterstitial pneumoniabetweenOctober2016andJune2018 wereretrospectivelystudied.PulmonaryCTfindingsweredescribed.Results Among 168cases,44caseswerediagnosedaspneumocystiscariniipneumonia (PCP),40casesascytomegalovirus(CMV)pneumonia,and 84casesasPCPaccompaniedwithCMVpneumonia.Statisticallysignificantdifferenceswerefoundamong3groupsonsignsofpure groundglassopacity,accompaniedwithdistortedfibrousstripes,andaccompaniedwithconsolidationandmultiplecysts(P＜0.05). PuregroundglassopacitiesweremorelikelytobeseeninPCPpatients,whiledistortedfibrousstripeswerelesslikely,comparedto theothertwogroups.Militarynodules,consolidationandmultiplecystspresentedlessinpatientswithPCPcomparedtopatientswith PCPaccompaniedwithCMVpneumonia.ForPCPpatients,lesionsweremorelikelytobetotallyabsorbedaftertreatment,whilefor patientswithCMVpneumoniaandPCPaccompaniedwithCMVpneumonia,fibrousstripesandemphysema/airsacsweremorelikelyto present.Conclusion CTfindingsofinterstitialpneumoniavaryinAIDSpatients,however,signsofdistortedfibrousstripes,multiple cysts,remainingfibrousstripesandemphysema/airsacsaftertreatmentsuggestco-infectionofCMV.

ThevalueofCTimagetextureanalysisinthedifferentialdiagnosisofbenignandmalignantparotidtumors / 实用放射学杂志

Objective ToinvestigatethevalueofCTimagetextureanalysisindifferentiatingbenignandmalignantparotidtumors inadults.Methods Thirty-threepatientswithparotidtumorswereretrospectivelyenrolledfromAugust2013toApril2018.Thehistological resultswereconfirmedthroughsurgeryorbiopsy,andtheyweredividedintothebenign(22cases)groupandthemalignant(11cases) groupaccordingly.AllpatientsunderwentCTscanswithcontrastenhancementbeforeanytreatment.ROIwasusedintextureanalysis forextractingfeaturesofthemaximumsliceofthetumorsinCTimages.Textureparametersbetweenbenignandmalignantgroups werecompared.ThestatisticallysignificantparameterswerethenanalyzedwithROC.Results CTtextureparametersshowedsignificant differencesbetweenthebenignandthemalignantgroups(P＜0.05),includingClusterShade,Sumentropy;GrayLevelNonUniformity, LargeAreaHighGrayLevelEmphasis,Contrast,ZoneEntropy,GrayLevelVariance,Sum Entropy;Entropy,IDMN,Sum Entropy, DifferenceEntropy,GrayLevelNonUniformityNormalized,andSmallAreaLowGrayLevelEmphasisthatoriginatedfromconventional, arterialandvenousphaseCTimagesrespectively.Sum Entropyfrom CTvenousphasewasconsideredasthebestdifferentiating parameter(AUC＝0.88,P＜0.05).WithSum Entropycutoffvalueof1.53,thesensitivityandspecificityindifferentiatingthebenign parotidtumorswere100%and72.70%respectively.Conclusion CTtextureanalysiscouldbeappliedclinicallyindifferentiatingbenign andmalignantparotidtumors.

CTand MRImanifestationsofcerebralpleomorphicxanthoastrocytoma / 实用放射学杂志

Objective ToinvestigatetheMRIandCTimagingcharacteristicsofcerebralpleomorphicxanthoastrocytoma(PXA). Methods CTandMRImanifestationsof5cerebralPXAcasesconfirmedbypathologywereanalyzedandcomparedwiththosecases reportedindocumentation.Results The meanageof5caseswas (27±18)years,andallthecasesrespectivelyhadsinglelesion whichwaslocatedinthecortexorsubcortex.In5cases,3leionsoccurredinthetemporallobe,while1lesioninthefrontallobeand1 lesioninthecerebellarvermis.Solid-cystictumorsin3casesandsolidtumorsin2cases(including1casewithpartialpiamaterinfiltrated) wereidentifiedbyCTandMRI.ThecysticpartoflesionwasshownaslowdensitywhilethesolidpartasmixeddensityonplainCT scan,including1casewithscatteredpoint-stripecalcification.Thesolid-cysticcapsuleandthesolidpartoflesionweredemonstrated asuniform markedenhancementonenhancedCTscan.ThesolidareaoftumorwasshownasslightlyhypointenseonT1WI,slightly hyperintenseonT2WI,markedenhancement,andequisignalorhyperintenseonDWIimage.Thesolid-cysticcapsulewallwasenhanced in3cases,whilethecysticpartwasnotenhanced.ThemildtomoderateedemaaroundthetumorwasdetectedinalltumorsbyCT and MRI.Conclusion PXAoccursmostfrequentlyinthetemporallobeofadolescents.TypicalcharacteristicsofCTandMRIaresolid-cystic massandmarked-enhancementofwallnodule,withdifferentdegreeofedemaaroundthetumor.