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Objectives To investigate the diagnosis, treatment and genetic characteristics of pheochromocytoma (PGL) in children. Methods Clinical characters and gene mutation analysis of a child with PGL were retrospectively analyzed and discussed;similar cases in the literature were reviewed. Results The patient was a 10-year old-boy without obvious complaint but transient headache. Urine 3 methyl-4 hydroxy mandelic acid and homovanillic acid were in normal range, and the pathological reports revealed some malignant cells located at the margin of the tumor, while CT scan of the neck, chest and abdomen were negative, and the cranial plus spine revealed no significant abnormalities by MRI. Gene test of the patient and his parents found mutations in SBHB gene. Thus the diagnosis was confirmed as benign, nonfunctional, extra adrenal pheochromocytoma. The patient was treated with surgery, without chemotherapy, and followed up regularly. Conclusions The diagnosis of PGL relies on pathological analysis, and the classification was made by catecholamine metabolites, imaging results, and gene sequencing. Implementation of chemotherapy was dependent upon if there is any distant or invasive metastasis, or a relapse is present.
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Objective To evaluate the role of multiple sequences MRI in diagnosis and preoperative evaluation of non-palpable undescended testis.Methods 58 patients with unilateral or bilateral non-palpable undescended testis underwent abdominal and pelvic MRI 2 weeks before surgery.Multiple sequences MRI included diffusion-weighted imaging(DWI)with b values of 400 and 800 s/mm2,T1 and T2-weighted sequence,and T2-weighted fat-suppressed sequence.Preoperative images including the conventional MRI images,DWI images,and the conventional-MRI and DWI images together.ADC value was detected.Pathological findings were used as the gold standard to evaluate the diagnostic accuracy of multiple sequences MRI in detection of non-palpable undescended testis and its differential diagnosis with lymph nodes.Results The combination of DWI and conventional MRI was the most sensitive method in detection of non-palpable undescended testis,with the sensitivity,specificity and accuracy of 96.5％,87.5％,and 95.3％,respectively.Malignant non-palpable undescended testes were all detected.The ADC value of the non-palpable undescended testis,lymph nodes and malignant non-palpable undescended testis was(1.18 ± 0.17) × 10-3 mm2/s,(1.49 ± 0.27) × 10-3 mm2/s,and (0.84 ± 0.20) × 10-3mm2/s,respectively.The difference had statistical significance (P ＜ 0.05).Conclusion Multiple sequences MRI improves the diagnostic accuracy of non-palpable undescended testis,which can be routinely used in preoperative evaluation of non-palpable undescended testis.
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This paper summarizes the genesis of PACS (Picture Archiving and Communication System, PACS) and its development outside China. Its status inside China and the problems existing in the exploiture are also discussed.