CT and MRI features of synovial sarcoma / 实用放射学杂志

Objective To analyze and evaluate the CT and MRI features of synovial sarcoma (SS).Methods Clinical and imaging data of 25 cases with SS confirmed by pathology were retrospectively analyzed.1 5 cases with CT scan,including 1 1 contrastGenhanced CT scan,and 1 2 cases with MRI scan,including 8 contrastGenhanced MRI scan.Results Among 25 cases,1 8 were located in the lower extremities,2 in the upper extremities and in the chest wall respectively,1 case in the lung parenchyma,mediastinum and spine respectively.1 8 cases were deep seated,while 1 9 cases were lobulated.On CT image,most of the lesions were isodense or hypodense to muscle,while 3 cases presented peripheral calcification,and 9 cases showed progressive enhancement.On MRI,10 cases were isointense or slight hypointense on T1 WI,while 9 cases presented hyperintense or slight hyperintense on T2 WI.9 cases showed cystic change (7 of them located in the periphery),and 8 cases showed short T1 signal.3 cases demonstrated "fluidGfluid levels",and 9 cases exhibited hypointense septa.7 cases revealed "triple sign"on T2 WI and 7 cases showed obviously heterogenous enhancement.Conclusion Synovial sarcomas are mostly located in the lower extremities,with clear margins,peripheral cystic changes,intramural hemorrhage,"triple sign"on T2 WI and progressive enhancement.

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.

Compared analysis of CT features and pathology of pulmonary solitary fibrous tumor / 实用放射学杂志

Objective To compare the CT features and pathology of pulmonary solitary fibrous tumor (SFT),to improve the diagnosis and differential diagnosis.Methods CT images and corresponding pathological results of 14 cases with pulmonary SFT were analyzed retrospectively. Results Among the 14 cases,6 were in the right lung and other 8 were in the left.The maximum diameters of tumors were ranged from 2.5 cm to 20.0 cm,and 6 cases were over 10.0 cm.All 14 cases represented as irregular solid nodule or mass,4 as unclear boundary and 1 as lobulation.Most of the cases showed heterogeneous and progressive enhancement.The light microscopy showed that tumor tissues were mainly composed of collagen fibers and spindle cells with different proliferation degrees,and 3 cases showed atypia cells.There were abundant blood vessels in the intercellular substance.Immunohistochemistry were done in 13 cases,presenting Bcl-2,CD99 and Vimentin positive expressions in all cases and CD34 expression in 9.Conclusion The CT features of pulmonary SFT are related to pathological features.CT scan is important in the localization and qualitative diagnosis of pulmonary SFT,and obvious inhomogeneous map-like and progressive enhancement should be considered for the diagnosis of SFT.

CT findings of ovarian sertoli-leydig cell tumor / 实用放射学杂志

Objective To study the CT findings of ovarian sertoli-leydig cell tumor (SLCT),to improve the understanding of SLCT imaging features.Methods CT images of 6 cases were reviewed retrospectively.CT plain scan was performed in 6 patients;CT enhancement scan was performed in 4 patients.Results All tumors were unilateral.On non-enhanced CT,5 cases showed cystic-solid masses with clear margin,and 1 case showed solid mass.After contrast administration,the cystic walls,septum and solid portions showed progressively obvious enhancement.Of these 6 cases, 3 cases showed increased testosterone levels,2 cases had high prolactin level,and 1 case was with raised AFP in plasma.Positive expressions of immunohistochemical markers were as following:Inhibin-α (6 cases),Vimentin (4 cases),Calretinin (2 cases), CD99 (1 case), Ki-67 (1 case), CK20 (1 case).Conclusion CT findings of SLCT have some certain characteristics, especially a unilateral, cystic-solid and well-defined mass, and marked solid part enhancement on contrast CT.Combined with clinical findings, especially increased plasma testosterone levels, SLCT should be included in the differential diagnosis of regional tumors.

Benign ovarian cystic lesions: CT and MRI findings / 实用放射学杂志

Objective To study the CT and MRI features of benign ovarian cystic lesions (BOCL) and to improve the understanding of imaging features.Methods CT and MRI findings were retrospectively reviewed and analyzed in 48 patients with BOCL proved by surgical pathology.CT scan was performed in 35 cases, among which 20 cases were performed with CT enhancement scan;MRI scan was performed in 8 cases, among which 3 cases were performed with MRI enhancement scan and diffusion weighted imaging(DWI).Five cases were performed with both CT and MRI.Results There were 11 cysts (3 simple cysts, 3 corpus luteum cyst, and 5 endometriotic cyst), 10 serous cystadenomas with 13 lesions, 8 mucinous cystadenomas, 9 teratomas with 10 lesions, and 10 struma ovarii.The CT and MRI characteristics of the lesions in size, shape,thickness of cyst wall,wall nodule,density or signal intensity,and enhancement features were helpful in differential diagnosis of BOCL.Conclusion CT and MRI findings of BOCL have certain characteristics, which is significant in the diagnosis, preoperative evaluation and prognosis.

The diagnostic value of dual energy virtual non-contrast images of dual-source CT in the diagnosis of com-mon benign liver diseases / 实用医学杂志

Objective To investigate the diagnostic value and limitations of dual-energy virtual non-con-trast images of dual-source CT in common benign liver diseases. Methods Dual-source CT was performed on 226 upper abdomen pathogenesis patients. The conventional non-contrast (CNC) scan was performed with single-energy mode, the arterial phase and portal phase scans were performed with dual-energy mode. The virtual non-contrast (VNC) images were derived from the portal data using liver virtual non-contrast software. 117 patients with common benign liver diseases were retrospectively analyzed in CNC and VNC. The lesion detectability, effective radiation doses for single-energy mode and dual-energy mode were compared. Results Among 117 patients, there were 28 (73.6%) hemangiomas, 58 (85.3%) calcifications or stones in VNC, but the hemangiomas, calcifications or stones in CNC were 37 (97.3%) and 68 (100%), respectively. The hemangiomas, calcifications or stones in VNC and CNC were significantly different (P 0.05). The CTDIvol, DLP and ED of dual-energy mode were obviously lower than those of single-energy mode (P < 0.05). Conclusion The detection of hemangiomas, calcifications or stones on VNC images is lower than CNC images. There is no difference in detecting cyst and hepatic steatosis. In addition, radiation dose will be reduced due to adopting VNC.VNC has potential clinical application value.

Malignant adrenal tumors:CT and MRI findings with corresponding pathological basis / 实用放射学杂志

Objective To study the CT and MRI features of malignant adrenal tumors(MAT)for improving the understanding of the disease and imaging diagnosis.Methods CT and MRI findings were retrospectively reviewed in 1 7 patients with MAT proved by surgical pathology.CT scan was performed in 1 7 cases,and CT enhancement scan was performed in 14 cases;MRI scan was comple-ted in 3 cases,and MRI enhancement scan was performed in 2 cases;CT and MRI scans were examinated in 3 cases.Results Among 1 7 patients with MAT,there were 3 adrenocortical carcinomas,2 neuroblastomas,1 malignant pheochromocytoma,1 lymphoma,1 leiomyosarcoma,and 9 adrenal metastatic tumors.The CT and MRI characteristics in size,shape,boundary,density or signal,and en-hancement features,can discriminate MAT.Conclusion CT and MRI findings of some MAT have a certain characteristic;The ima-ging findings combined with clinical data are helpful in correctly making preoperative diagnosis.

Evaluation and analysis of the tibial coronal alignment after total knee replacement with the extramedullary tibial cutting guided by the tibial tubercle and anterior tibial tendon in Chinese patients / 北京大学学报(医学版)

Objective:To evaluate the efficiency of the tibial coronal alignment after total knee arthro-plasty with the extramedullary cutting system guided by the tibial tubercle and anterior tibial tendon,and to discuss the potential risk factors for the postoperative malalignment.Methods:A retrospective study of 212 primary unilateral TKA surgeries (in 188 patients)in our hospital between June to December in 2014 had been analysed.All the cases were performed by one surgical group.An extramedullary tibial cutting guide system had been used,with a landmark of one third inner-medial tibial tubercle as a proxi-mal anatomy reference,and anterior tibial tendon as a distal marker.The mechanical axis of lower ex-tremity in full-length X-ray was measured before surgery,and the tibial prosthetic coronal alignment was checked two weeks postoperation,evaluating the accuracy of this extramedullary cutting system guided by our method.Results:Since good alignment was defined as an angle within 3 degrees of the perpendicular to the mechanical axis,the tibial component positions were acceptable in 191 knees (90.1%),five knees were in valgus postoperative,and sixteen knees were in varus.There were seventeen(8.7%)in 179 knees with a preoperative varus presented malalignment after surgery,and four in 12 preoperative valgus kneess howed malalignment also,no statistical difference was found by Chi-square test (χ2 =2.778,P=0.096),which cannot define the relationship between the varus or valgus deformity preopera-tion and the malalignmentposition in tibial prosthesis after surgery.Twenty-two knees suffered a severe preoperative deformity as a varus or valgus angle larger than 20 degrees with absolute value of mechanical axis before surgery and tibial prosthetic coronal alignment were 21.95°(20.00°,26.90°)and 1.85° (0.10°,7.10°),showed a significant difference (Z =2.11,P =0.035 )compared with the data [10.65°(0.50°,19.80°)in preoperative mechanical axis and 1.10°(0.00°,4.60°)in the tibial pros-thetic coronal alignment]of 190 knees who presented a mild deformity before surgery(less than 20 de-grees),the result indicated the severe preoperative deformity might be a potential mal-alignment risk fac-tor within this cutting system in TKA surgery.Conclusion:The tibial coronal alignment after total knee arthroplasty could achieve good results with extramedullary cutting guide,by using one third inner-medial tibial tubercle and anterior tibial tendon as a proximal and distal anatomy marker.Postoperative varus might occur in this system,and tibial prosthetic malalignment appeared more often in the patients who suffered a severe deformity before surgery.

Struma ovarii:CT findings with corresponding pathological basis / 实用放射学杂志

Objective To study the CT findings of struma ovarii(SO)and improve the understanding of SO imaging features. Methods CT images of 6 cases were retrospectively reviewed.CT plain scan was performed in 6 patients;CT enhancement scan was performed in 2 patients.Results All tumors were unilateral.On non-enhanced CT,the lesions presented as well-defined irregu-lar cystic-solid masses.The cystic portions presented as well-defined,multiple,various size,and there were entire cystic walls with smooth inner wall.Four tumors showed high attenuation lesions in the cyst portion of the mass on precontrast scans.The solid por-tions showed irregular tissue density,and were often distributed in the cysts.The tumors showed stippled calcification in solid por-tions and/or cystic wall in 4 cases.One tumor accompanied a great of ascites liquid.After contrast administration,the cystic por-tions showed no enhancement,and the cystic walls and the solid portions showed mild enhancement.Conclusion CT findings of SO have certain characteristics such as a cystic-solid and well-defined mass with calcification,high attenuation lesion on plain CT,and marked solid part enhancement on contrast CT.

CT diagnosis and differential diagnosis of peripheral lung cancer cavity / 中国医学影像技术

Cavity is the frequent imaging findings of lung diseases. Many pulmonary diseases can form cavity in the course and are difficult to distinguish. Peripheral lung cancer is a common malignant tumour and can form cavity. The definition and pathological basis of lung cavity, CT diagnosis and differential diagnosis of peripheral lung cancer cavity and the application of multi-slice spiral CT in the diagnosis of lung disease with cavity were reviewed in this article.