Feasibility of diagnosing and staging liver fibrosis with diffusion weighted imaging / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the clinical feasibility of diagnosing and staging liver fibrosis by apparent diffusion coefficient (ADC).</p><p><b>METHODS</b>Totally, 43 patients (mean age 29.3 years) with chronic hepatitis by liver biopsy and 7 healthy controls (mean age 39.9 years) underwent liver diffusion weighted imaging (DWI) with four b values: 0, 200, 500, and 1000 s/mm2 respectively. The liver fibrosis was staged according to Ishak fibrosis stage. The ADC value of liver fibrosis patients and healthy controls was compared. The correlation of ADC value and liver fibrosis staging was analyzed.</p><p><b>RESULT</b>The histological staging showed 8 stage 1 patients, 10 stage 2 patients, 6 stage 3 patients, 9 stage 4 patients, 8 stage 5 patients and 2 stage 6 patients. The mean ADC value of liver fibrosis patients was significantly lower than that of healthy controls except for stage 1 group (P < 0.05). There was a negative correlation between liver fibrosis staging and ADC value (r = -0.697 with b=500 s/mm2, P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of advanced liver fibrosis (Ishak stage F3 and higher) showed that area under curve = 0.913, 0.825, and 0.794 with b = 500, 1000, and 200 s/mm2, respectively (95% confidence interval: 83.6%-99.0%, 70.7%-94.3%, 66.5%-92.4%; P < 0.05). When b value was 500 s/mm2, the sensitivity (84%) and specificity (80%) of DWI for diagnosis of advanced liver fibrosis were the highest.</p><p><b>CONCLUSION</b>DWI is proved to be a useful clinical tool in the quantitative evaluation of liver fibrosis and in the prediction of the process of liver fibrosis with the recommendable b value (500 s/mm2).</p>

Detection of computer tomography perfusion in gastric cancer / 中华消化杂志

Objective To evaluate the relationship between CT perfusion imaging and clinicopathological features in gastric adenocarcinoma.Methods CT perfusion was performed in 31 cases of gastric cancer diagnosed by endoscopy and biopsy one week prior to operation.After an oral intake of 1000—1200 ml of water and an injection of hypotonic agent,perfusion scan was adopted in sixteen multi- slice spiral CT (MSCT) with 60 s of cine duration.Data were analyzed by a commercial software to cal- culate tumor blood flow (BF),blood volume (BV),mean pass time (MTT) and permeability surface (PS).Microvessl density (MVD) was evaluated by using immunohistochemical staining of surgical specimens with anti-CD34.All these findings were prospectively analyzed and correlated with the clinicopathological find- ings (histological grading,presence of lymph node metastasis,serous involvement,TNM staging and MVD). Results There was significant difference of PS value not only between patients with and without lymphatic in- volvement (P＜0.05),but also in different histological grade (P＜0.05) and TNM staging (P＞0.05). However BF,BV,MTT and MVD of gastric cancer revealed no significant correlation with the clinicopatholog- ical findings above (P＞0.05).Condusion The analysis of CT perfusion imaging in gastric cancer,especially PS value,might be helpful in predicting the prognosis.