RESUMEN
Objective To investigate the value of iFlow color-coding technique in quantitative real-time analysis of hemodynamic changes after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) . Methods A total of 31 patients who were diagnosed with HCC in Shanghai Fifth People's Hospital from December 2015 to January 2017 were enrolled. No patient underwent surgical operation or ablation. All patients underwent TACE with the same contrast agent, high-pressure injector parameters, and place of angiographic catheter. The iFlow technique was used to generate two-dimensional color-coded images and time-density curve (TDC) before and after surgery and measure the opening of the angiographic catheter and the time to peak (TTP) of the starting and ending points of the major tumor feeding arteries, as well as the ratio of the areas under the curve (AUC) of TDC of tumor tissue and the opening of the angiographic catheter. The paired t-test was used for comparison of continuous data between groups. Results TTP of the major tumor feeding arteries was 4.64 ± 0. 49 s before TACE and 5. 97 ± 0. 84 s after TACE (t = 11. 57, P ＜ 0. 01), and there was a significant difference in AUC between the tumor tissue and the opening of the angiographic catheter (0. 53 ± 0. 15 vs 0. 16 ± 0. 12, t = 25. 85, P ＜ 0. 01) . There was no significant difference in TTP between the opening of the angiographic catheter and the major tumor feeding arteries before and after TACE (P＞ 0. 05) .Before TACE, the TDC of tumor feeding arteries had a shape of"rapid increase-rapid reduction"with relatively high slope and peak value, while after TACE, the TDC had a shape of "increase-flat-reduction"with reductions in slope and peak value. Conclusion The iFlow technique can perform real-time measurement of TTP and TDC of the region of interest and helps with quantitative evaluation of hemodynamic changes in HCC. Therefore, it can provide objective quantitative indices for evaluating the degree of tumor embolism.
RESUMEN
Objective To investigate the application value of CT perfusion imaging (CTPI) combined with CT angiography (CTA) for determination and diagnosis of transient ischemic attack (TIA).Methods Totally 50 TIA patients from April 2014 to April 2016 in the neurology department of some hospital underwent examinations by CT scan,CTPI and CTA in time,and the values of cerebral blood volume (CBV),cerebral blood flow (CBF),mean transit time (MTT) and time to peak (TTP) were calculated at the uninjured and injured sides of the areas of interest.The relationship between cerebral blood perfusion and cerebral angiostenosis of the TIA patient was analyzed.Results The 50 patients had the values of CBF and CBV at the injured sides lower while the ones of MTI and TTP higher than those at the uninjured sides (P＜0.05).The numbers of the abnormal cerebral blood perfusion patients found by CT scan,CTPI and CTA were 28 (56.00％),45 (90.00％) and 38 (76.00％) respectively,who were confirmed clinically simultaneously.There were significant differences between the TIA positive result rates by CT scan,CTPI and CTA (P＜0.05).Conclusion Carotid artery hypoperfusion is one of the pathogeneses of TIA,and positive rate by CTPI is closely related to the conditions of TIA.CTPI combined with CTA contributes to the diagnosis of TIA,and can be used for its individualized treatment.
RESUMEN
Objective To explore the mixed mucinous breast carcinomas(MMBC)and pure mucinous breast carcinomas(PMBC) imaging features,and evaluate the diagnostic value of ultrasound,X-ray and MRI for mucinous breast carcinoma(MBC).Methods Totally 48 cases of MBC proved by postoperative pathology were analyzed retrospectively.Manifestations of ultrasonography,X-ray and MRI of MMBC and PMBC were summarized,and diagnostic values of three methods were compared.Results Most PMBC showed regular shaped (round,oval or lobulated)mass with clear edge,but most MMBC showed irregular shaped mass with unclear edge in three imaging examinations.On sonogram,MBC mainly showed mixed cystic-solid echo,most PMBC showed low blood signal with rear echo enhancement,and most MMBC showed rich blood signal with various rear echo.On MRI,MBC usually demonstrated high or strongly high signal intensity on T2 WI.On DCE-MRI,PMBC was mainly characterized by rim enhancement with persistent enhancement pattern, and MMBC was exhibited more heterogeneous or rim enhancement with plateau enhancement pattern.Three imaging methods were no significant difference in the accuracy of diagnosis between PMBC and MMBC.There was no statistical significance in three imaging methods.Conclusion PMBC and MMBC with different the appearances of ultrasonography,X-ray and MRI have some characteristics.Fully aware of imaging features can not only identify two types of MBC,but also reduce missed diagnosis and misdiagnosis of MBC.
RESUMEN
Objective To explore the mixed mucinous breast carcinomas(MMBC)and pure mucinous breast carcinomas(PMBC) imaging features,and evaluate the diagnostic value of ultrasound,X-ray and MRI for mucinous breast carcinoma(MBC).Methods Totally 48 cases of MBC proved by postoperative pathology were analyzed retrospectively.Manifestations of ultrasonography,X-ray and MRI of MMBC and PMBC were summarized,and diagnostic values of three methods were compared.Results Most PMBC showed regular shaped (round,oval or lobulated)mass with clear edge,but most MMBC showed irregular shaped mass with unclear edge in three imaging examinations.On sonogram,MBC mainly showed mixed cystic-solid echo,most PMBC showed low blood signal with rear echo enhancement,and most MMBC showed rich blood signal with various rear echo.On MRI,MBC usually demonstrated high or strongly high signal intensity on T2 WI.On DCE-MRI,PMBC was mainly characterized by rim enhancement with persistent enhancement pattern, and MMBC was exhibited more heterogeneous or rim enhancement with plateau enhancement pattern.Three imaging methods were no significant difference in the accuracy of diagnosis between PMBC and MMBC.There was no statistical significance in three imaging methods.Conclusion PMBC and MMBC with different the appearances of ultrasonography,X-ray and MRI have some characteristics.Fully aware of imaging features can not only identify two types of MBC,but also reduce missed diagnosis and misdiagnosis of MBC.
RESUMEN
Diffusion-weighted magnetic resonance imaging (DW-MRI) is a functional imaging technique which can exhibit the diffusion characteristics of water molecules in vivo and thus indirectly reflect cellular density, the integrity of cell membrane, and capillary perfusion. The main applications of DW-MRI in hepatic lesions, especially in hepatocellular carcinoma, staging of liver fibrosis, and monitoring of tumor therapy, are described. Although this technique, which can be applied without need for contrast agent, is still insufficient, it will have broad application prospects with the development of software and hardware.
RESUMEN
Diffusion-weighted magnetic resonance imaging (DW-MRI)is a functional imaging technique which can exhibit the diffusion characteristics of water molecules in vivo and thus indirectly reflect cellular density,the integrity of cell membrane,and capillary perfusion. The main applications of DW-MRI in hepatic lesions,especially in hepatocellular carcinoma,staging of liver fibrosis,and monitoring of tumor therapy,are described.Although this technique,which can be applied without need for contrast agent,is still insufficient,it will have broad application prospects with the development of software and hardware.
RESUMEN
Objective To determine the optimal volume proportion of iodize d oil (Lipiodol)-ethanol mixture by comparing the clinical efficacy of transhepatic arterial embolization-ablation therapy using different volume proportion of Lipiodol-ethanol mixture in treating experimental rabbit models with VX 2 liver cancer. Methods VX2 tumor was implanted in eighteen adult male New Zealand white rabbits. The 18 VX 2 rabbit models were randomly and equally divided into the following six groups according to the Lipiodol-ethanol volume ratio ∶ group A (3 ∶ 1), group B (2 ∶ 1), group C (1 ∶ 1), group D (1 ∶ 2), group E (1 ∶ 3) and group F (1 ∶ 4). One week after the treatment, all the rabbits were sacrificed and their livers were removed and sent for pathologic examination. The tumor growth rate, the microvascular density, the apoptosis index (AI) of tumor tissues and the injury of the hepatic tissue adjacent to the tumor were evaluated. Results After the treatment, the tumor’s size was increased in group A, E and F. The tumor growth rate of group A was significantly higher than that of the other five groups , and the difference was statistically significant (P 0.05). The proportion of ethanol in Lipiodol ∶ethanol mixture bore a negative relationship to the microvascular density counts (R2= 0.840, F = 89.432, P 0.05), while the difference in AI between group B and group C or between group B and group F was statistically significant (P 0.05). The injury extent of the hepatic tissue adjacent to the tumor in group A and B was remarkably milder than that of other groups (P < 0.05). Conclusion When considered in terms of safety, the optimal volume proportion of Lipiodol-ethanol mixture should be 2 ∶ 1. Successful super-selective catheterization of the tumor feeding artery, strict and close fluoroscopic monitoring of the injection and proper increase in the proportion of ethanol can definitely improve the therapeutic efficacy.
RESUMEN
Objective To investigate the CT manifestations of gastric carcinoma invasion to lesser omentum and to assess the im-pact of lesser omentum on the spreading of gastric carcinoma.Methods We retrospectively reviewed CT findings in 48 patients with gastric carcinoma and lesser omentum involved for primary tumor and the lesser omentum abnormalities.The influence of lesser o-mentum on the extension of gastric carcinoma as well as the accompanied ascites were also analyzed.Results CT manifestations of lesser omentum involvement in gastric carcinoma included the following items:① direct infiltration (35.4%,1 7/48),which was mainly shown as increased density of fatty tissue and the development of mass within the lesser omentum,including spreading into the liver through the lesser omentum directly in two cases;② omental seeding (25.0%,12/48),including smudged appearance (1 1 cases)and omental caking (1 case);③ metastasis of lymph nodes (64.6%,31/48),including enlargement and increase of lymph nodes (27 cases)and cystic mass (4 cases).Ascites was found in 1 1 patients and fluid collection in the lesser sac was shown in 3 of these 1 1 patients.The lesser omentum forms the anterior wall of the lesser sac and separates the fluid collection in the lesser sac from the ascites in the greater peritoneal cavity.Ascites was associated with the omental seeding statistically.Conclusion CT scan is helpful for detecting lesser omentum invasion by gastric carcinoma.The imaging features consist of mass sign,enlargement of lymph nodes,smudged andcakingappearance,and so on.Lesser omentum may also play a certain role in both the extension of gastric carcinoma and the compartmentalization of ascites due to gastric carcinoma.
RESUMEN
Magnetic resonance diffusion-weighted imaging (MR-DWI) is a functional technology at the molecular level.Compared to other imaging exams (such as DSA,CT,US),DWI is non invasive,has no radiation,and objective.Thus,it is widely accepted in clinical settings.As a means to assess the therapeutic efficacy of intervention,DWI has a promising prospect.In this article,we review the application of MR-DWI in evaluating the therapeutic efficacy of hepatocellular carcinoma intervention.