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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.
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Objective To clarify the distribution of etiological factors in elderly versus non-elderly outpatients with vertigo/dizziness for optimizing the diagnosis and therapy. Methods We retrospectively analyzed data of outpatients with vertigo/dizziness in Shaanxi Provincial People's Hospital from April 2015 to April 2017 and conducted diagnoses in accordance with the currently wide-accepted diagnostic criteria. Results A total of 3 356 patients with chief complains of vertigo/dizziness were recruited ,and their top seven etiological factors were benign paroxysmal positional vertigo (n＝ 1 320 ,39.3%) ,chronic subjective dizziness(n＝680 ,20.3%) ,vestibular migraine(n＝386 ,11.5%) ,posterior circulation ischemia (n＝213 ,6.4%) ,Meniere's disease (n ＝ 138 ,4.1%) ,vestibular neuritis (n＝ 121 ,3.6%) ,and vestibular paroxysmia(n＝76 ,2.3%). The top four etiological factors for the elderly patients (n＝1 255)were benign paroxysmal positional vertigo (n＝ 498 ,39.7%) ,chronic subjective dizziness (n＝ 279 ,22.2%) ,posterior circulation ischemia(n＝161 ,12.8%) ,and vestibular migraine(n＝73 ,5.8%) ;while the top four etiological factors for non-elderly patients (n＝ 2 101)were benign paroxysmal positional vertigo (n＝ 822 ,39.1%) , chronic subjective dizziness(n＝401 ,19.1%) ,vestibular migraine(n＝313 ,14.9%) ,and vestibular neuritis(n＝105 ,5.0%). The detection rate in elderly patients versus non-elderly patients was significantly higher in chronic subjective dizziness (22.2% vs.19.1%,P＝ 0.032 )and in posterior circulation ischemia (12.8%vs.2.5%,P＝0.000) ,and was significantly lower in vestibular neuritis (1.3% vs.5.0%,P＝ 0.000 ) ,in vestibular migraine(5.8% vs.19.4%,P ＝ 0.000)and in other causes (1.0% vs.2.7%,P ＝ 0.002) . Conclusions The ratio of posterior circulation ischemia is markedly higher in elderly outpatients than in non-elderly outpatients ,whereas the ratios of vestibular migraine and vestibular neuritis in elderly patients are lower than in non-elderly outpatients.
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Objective To compare the usefulness of contrast-enhanced T1 high resolution isotropic volume excitation (THRIVE) sequence and fat-saturated TSE sequence in detection of spinal metastases.Methods Thirty-one consecutive patients with spinal metastases were recruited.All patients received post-contrast TSE T1WI followed by a fat-suppressed THRIVE sequence.The number of lesions,SNR and CNR for both sequences,and the scoring of image quality concerning motion-artifact and tumor conspicuity were compared.Results Acquisition time of the post-contrast TSE T1W sequence and the THRIVE sequence was 2 min 55 s and 33 s,respectively.No significant difference was found in the number of lesions detected between the two sequences (Z=-0.816,P=0.414).The SNR (432.54±271.60) and CNR (233.27± 197.65) of the THRIVE sequence were significantly lower than the SNR (674.32±375.79) and CNR (312.38±207.49) of the TSE T1W sequence respectively (t=-4.366,-2.660,P＜0.001,0.012).Tumor conspicuity of the post-contrast TSE sequence was better than that of THRIVE sequence (Z=-4.082,P＜0.001),while the motion-artifact in TSE sequence was more severe (Z=2.291,P=0.022).Conclusion The post-contrast THRIVE sequence is capable of decreasing acquisition time and motion-artifact.Besides,its detected efficacy is equal to that of TSE sequence.There is practical possibility to replace the conventional post-contrast TSE T1WI sequence with the THRIVE sequence in the imaging of spinal metastases.
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Objective To investigate the three-dimensional spatial relationships of the sphenopalatine foramen ( SPF) , vidian canal ( VC ) , and foramen rotundum ( FR ) with regard to an endoscopic endonasal approach to the pterygopalatine fossa(PPF)using three-dimensional reconstruction of high resolution computed tomography (HRCT) scans. Methods The HRCT scans of 17 patients and a cadaver specimen were retrospectively evaluated .The morphology of the SPF, VC, and FR as well as the spatial relationship between the SPF and VC were measured on the image of three -dimensional CT reconstruction.Results The mean diameters of the SPF, VC, and FR were(6.26 ±1.59)mm,(2.35 ± 0.77)mm and(2.75 ±0.77)mm, respectively.The mean distance between the VC and posteroinferior margin of SPF was (4.03 ±1.15) mm.The mean vertical and horizontal distances on the image of three-dimensional CT reconstruction were between the VC and FR were(4.94 ±1.35)mm and(9.22 ±3.07)mm, respectively.The whole or partial margin of the VC was above the inferior margin of the SPF in 92%(33/36) of the VC and lateral to the posterior margin of the SPF in 97%(35/36) of the VC.Conclusion The endoscopic endonasal approach to the PPF is performed with greater safety through comprehension of the spatial relationships between the SPF , VC, and FR.
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Objective To investigate the correlation of clinical stage and treatment plan with prognosis in incidental prostatic carcinoma.Methods From 2004 to 2010,a total of 1076 patients diagnosed as BPH underwent transurethral plasma kinetic enucleation of prostate (TUPKEP) in our hospital,and their clinical data were respectively analyzed.Among them,42 cases were found to have incidental prostatic carcinoma.The correlation of clinical stage and treatment plan with prognosis in incidental prostatic carcinoma were observed.Results Among 1076 BPH patients undergoing TUPKEP operation,42 cases (3.9％) aged 56-88 years were found to have incidental prostatic carcinoma,which all displayed as prostatic adenocarcinoma including 18 cases at T1 a stage and 24 cases at T1b stage.10 cases received endocrinal therapy,14 cases received bilateral orchiectomy,14 cases underwent radical prostectomy and 4 cases were treated with watchful waiting.Patients were followed up for 24 to 96 months.The survival rates were 100.0％ and the rates of progression were 0.0％,20.0％,0.0％ in T1 a patients received watchful waiting,androgen-deprivation therapy and radical prostectomy,respectively.Total survival rate was 100.0％ and total rate of progression was 11.1％ in T1a patients.The survival rates were 71.4％,100.0％ and the rates of progression were 42.9％,0.0％ in T1 b patients received androgen-deprivation therapy and radical prostectomy,respectively.Total survival rate was 83.3 ％ and total rate of progression was 25.0 ％ in T1 b patients.Compared with T1 b patients,the total survival rate was higher (x2=18.19,P＜0.01) and the rate of progression was lower in T1 a patients (x2 =6.52,P＜0.05).Conclusions The survival rate in T1 a patients accepted androgen-deprivation therapy is similar to that in T1 a patients with watchful waiting.Compared with T1a patients,the survival rate is lower but the rate of progression is higher in T1 b patients received active androgen-deprivation therapy.The survival rate is higher in T1 b patients treated with radical prostectomy than in those received other treatments.Watchful waiting is acceptable for T1 a patients.T1 b patients should be treated with radical prostectomy for a better effect.
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Human cytomegalovirus (HCMV) is the most common cause of congenital infection, resulting in birth defects such as microcephaly. In this study, RT-PCR and Western Blotting were performed to quantify the regulation of endogenic nerve growth factor expression in neuroglia cells by HCMV infection. The results showed that basal, endogenous NGF expression in U251 was unchanged during early HCMV infection. NGF expression is strongly down-regulated during the latent phase of infection. These results suggest that HCMV can depress the NGF expression in U251 cells.