Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose

Abstract Objectives: To highlight the prevalence of respiratory epithelial adenomatoid hamartomas in the olfactory cleft of patients with nasal polyposis. To demonstrate characteristics indicative of hamartoma on the CT scans of paranasal sinuses during surgery and in histopathological exams. Methods: Cross-sectional study carried out in Hospital das Clínicas da UFMG and Núcleo de Otorrino BH. We performed 114 nasal endoscopic surgeries for polyposis, between February 2015 and November 2019. We assessed the olfactory cleft width in all preoperative CT scans. Upon seeing an indication of hamartoma on the CT scan, we took a tissue sample from the olfactory cleft during the surgery and sent for histopathological exam. We referred the samples to a pathologist experienced in the anatomopathological diagnosis of respiratory epithelial adenomatoid hamartomas. Results: Of the 114 patients with polyposis, 54 (47.4%) had olfactory cleft enlargement and, 100% of them had tissue with a dense and hardened polypoid aspect, with a slight cerebri-form appearance in this region during the surgery. Histology confirmed a respiratory epithelial adenomatoid hamartoma. Conclusion: This observation suggests that the presence of hamartomas in polyposis is common, but underdiagnosed. Level of evidence: Step 3 (Level 3).

ThevalueofspectralCTimaginginmultiGparameterquantitativeanalysisof lungcancerwithdifferentpathologicaltypes / 实用放射学杂志

Objective ToexplorethevalueofspectralCTimaginginmultiGparameterquantitativeanalysisoflungcancerwithdifferent pathologicaltypes.Methods SpectralCTimagesof72patientswithlungcancerprovedbypathologywereanalyzed,includingadenocarcinoma (ADC)in44cases,squamouscellcarcinoma(SQCC)in23casesandsmallcelllungcancer(SCLC)in5cases.Theslopeof40－100keVspectralattenuationcurve(λH),effectiveatomicnumber(EffectiveGZ),Calciumconcentration,hydroxyapatite(HAP)concentration, normalizediodineconcentration(NIC)and Waterconcentration were measuredandcomparedrespectively.The O n eG W a y analysisof variance (ANOVA ) was used and a value of P＜0.05 was considered statistically significant.Results (1 )O n plain C T ,there were statisticallysignificantdifferencesinEffectiveGZandλHamongthreeGdiseasegroups(F＝3.423,P＝0.04,F＝3.476,P＝0.038,respectively). (2)IncontrastGenhancedarterialphase,theWaterconcentrationandλHshowedstatisticallysignificantdifferencesamongthreegroups (F＝6.303,P＝0.003,F＝5.833,P＝0.005,respectively).(3)Invenousphase,thedifferenceinNICandλH wasstatisticallysignificant amongthegroups(F＝3.974,P＝0.023,F＝6.766,P＝0.002,respectively).(4)Apairwisecomparisonshowedtherewerestatistically significantdifferencesinallquantitativeparametersofspectralCTbetweenADCandSQCCgroups.ROCcurveanalysisshowedthat thosequantitativeparametersinvenousphaseappearedtohavehighdiagnosticefficiencyindifferentiatingADCfromSQCC,especiallyfor theλHinVP,withaAUCof0.754,sensitivityof79.5%,specificityof69.6%andthresholdvalueof1.78.Conclusion CTSpectral multiGparameterimagingprovidesanewsupplementarymethodforpreoperativediagnosisofADCandSQCC,andλHinvenousphase hasthehighestvalueindifferentiatingADCfromSQCC.

TheapplicationofspectralvirtualnonGcontrastCTinthyroiddiseases / 实用放射学杂志

Objective ToinvestigatethefeasibilityofspectralvirtualnonGcontrast(VNC)takingtheplaceoftruenonGcontrast (TNC)inthyroiddiseases.Methods CTimagesof30patientswiththyroiddiseasewerecollected,includingTNC,spectraldualGphase contrastandconventionaldelayedcontrastimaging.36lesionswithcorrespondingsurgeryandpathologicalconditionswereselected forretrospectiveanalysis.Theradiationdose,imagequality,meanCTvalues,SNRanddiagnosticefficacybetweenTNCand VNC werecompared.Results Theeffectivedose(ED)andtotaldoseGlengthproduct(DLP)ofthespectraldualGphasecontrastscanswere bothsignificantlylowerthanthoseofTNCincombinationwithconventionaldualGphasecontrast(P＜0.05).Thesubjectivequality scoreofVNCwasslightlylowerthanthatofTNC (P＜0.05),howeveritwasacceptableforradiologistwithascoreabove3.The SNRofVNCimageswassignificantlylowerthanthatofTNC (P＜0.05).The meanCTvaluesofVNCimageswerelowerthan thoseofTNCimagesbutwithoutasignificantdifference(P＞0.05).TheabilityofVNCtodelineatenecrosis,calcification,andlymph nodemetastasisinthelesionwasconsistentwithTNC (k＞0.75).Conclusion TheimagequalityofVNCissatisfiedinthediagnosis ofthyroiddiseases.VNChassimilardiagnosticefficacytoTNCwitheffectivelyreducdingradiationdose,whichisapromisingclinical application.

ThepredictiveanalysisofspectralCTportalveinimagingforesophagealGgastricvaricealbleeding / 实用放射学杂志

Objective ToinvestigatethevalueoftheoptimalCNR monoenergeticimagesofportalveininpredictingesophagealGgastric varicealbleeding(EVB).Methods FortypatientswithlivercirrhosisandportalhypertensionunderwentcontrastGenhancedspectral CTscan.TheoptimalCNR monoenergeticimagesand70keV monoenergeticimagesoftheportalveinphasewereselectedtocompare theimagingquality.TheconsistencyoftheoptimalCNR monoenergeticimageswithendoscopyforesophagealGgastricvaricealwas analyzed by Kappa test.A ccording to the E V B history ,the patients w ere divided into bleeding group and nonGbleeding group.T he ROCcurveswerecalculatedtoassessthevaluesofthemainportalvein(MPV)anditstributariesdiameterstopredictingEVB.Results TheCNRandobjectivescoreoftheoptimalCNR monoenergeticimagesweresignificantlyhigherthanthoseofthe70keVimages(P＜0.05).TheoptimalCNR monoenergeticimageshadgoodconsistency withgastroscopeintheclassificationofesophagealGgastric variceal(k＝0.769).ThereweresignificantdifferencesofthediametersofMPV,intrahepaticleftbranchofportalvein(LPV),splenic vein(SV)andleftgastricvein (LGV)betweenthebleedinggroupandnonGbleedinggroup (P＜0.05).ROCcurveanalysisshowed thattheincidenceofEVBwashighestwithasensitivityof76.92%andaspecificityof85.71%,whentheLGVwasgreaterthan6.1mm. Conclusion TheoptimalCNR monoenergeticimagesofportalveincouldimprovetheimagingquality,andLGVdiametershouldbe ariskindicatorforpredictingEVBinlivercirrhosis.

Imagingfeaturesofextramedullarydiseaseinmultiplemyeloma / 实用放射学杂志

Objective Toexploretheimagingfeaturesofextramedullarydisease(EMD)in multiplemyeloma(MM).Methods Theclinicalandimagingdataof17patientswithpathologicallydiagnosedMMcombinedwithEMDwereanalyzedretrospectively.Results EMDhadcertainpredilectionsites,Centralnervoussysteminvasion (6):meningealinvasion (3:1 multiple,2focal),spinalcanal invasion (1focal),thelefttemporalpoleinvasion(1focal),theleftsideforeheadinvasion(1focal);Headandneckinvasion(3:allfocal);Thoraxinvasion(8):pleuralinvasion(6:5 multiple,1focal),intrapulmonaryinvasion(1focal),anteriormediastinalinvasion(1focal);Subcutaneoussofttissueinvasion(5:allmultiple);Muscleinvasion(2focal);Lymphnodeinvasion (1 multiple).BothCTand MRI showedsofttissuenodulesormasses.ThevaluesofCTwereabout30~70HU,especiallyin30~45HU,whileMRIpresentedequal orslightlylowsignalonT1WI,equalorslightlyhighsignalonT2WI,andhighsignalinthesequenceofDWIcombinedwithmoderate toobviousenhancement,Generally,theboundaryofEMDwereclearandtheshapeoftheselesionswereregular,However,theinvasion tomuscleinsomelesionsshowedthepatternofinvasivegrowth.Conclusion EMDofmultiplemyelomamayhappenanywhere,and thepleural,meningesandsubcutaneoussofttissuesarethemostcommonlocation.CTandMRIcanshowtheEMDverywell.Thelocation, size,shapeandrelationshipwithsurroundingtissuesoftheselesionshavecertainreferencevaluesforthediagnosisanddifferential diagnosisofEMD.

DifferentialandpathologicalstudyofdifferentsubtypesofpapillaryrenalcellcarcinomabyCTimaging / 实用放射学杂志

Objective ToevaluatetheimagedifferencesofCTinsubtypepapillaryrenalcellcarcinoma(PRCC).Methods Aretrospective analysisof30multiphaseCTenhancedimagesofPRCCconfirmedbyoperationandpathologyinourhospitalwasperformed,followed byacomparativestudyofCT multistageenhancedperformanceandpathology.Results typeⅠ16cases,typeⅡ14cases,ofwhich 11casesofⅡtypePRCC wereirregularorlobulated,and4casesoftypeⅠshowedlobulated,therewarestatisticallysignificant differencesbetweenthetwogroups(P＝0.003).Venoustumorthrombusin5casesoftypeⅡPRCC,4casesoftypeⅡPRCClymph nodemetastasis,perirenalinvasionin6casesofⅡtypePRCC,but1caseofⅠPRCChadvenousthrombus,perirenalinvasionin2 cases,nocaseoflymphnodemetastasis,therewereobviousdifferencesbetweenthetwogroups(P＝0.044,P＝0.022,P＝0.025). PRCCplainscanCTvalue,CTvalueofexcretoryperiod,CTvalueaddedinthesubstantiveperiod,CTincrementduringexcretionperiod, therewarenosignificantstatisticalsignificancebetweentypetwogroups(P＝0.893,P＝0.169,P＝0.559,P＝0.155).CTvalueof corticalphase,CTvalueinperenchymalphase,CTvalueincrementincarticalphasehadsignificantlydifferencesbetweentwogroups (P＝0.013,P＝0.046,P＝0.008).Conclusion Therearecertaindifferenceintumormorphology,outsideinvasionsignsandenhancement degreebetweentypeⅠandtypeⅡPRCCandⅡtypePRCCispronetoappearperirenalinvasion,tumorthrombusandlymphnode metastasis.CTscanningishelpfulindifferentialdiagnosisofsubtypesofPRCC.

DiagnosticvalueofMSCTcombinedwithultrasonographyinpatientswithacuteappendicitis / 实用放射学杂志

Objective ToexploretheclinicalvalueofMSCTcombinedwithultrasonographyinthediagnosisofacuteappendicitis. Methods 238patientswithsuspiciousappendicitisunderwentMSCTandultrasonographybeforesurgery.Allpatientsweredivided intoappendicitisgroupandnormalappendixgroupaccordingtoCTappearances.TheefficacyofMSCTcombinedwithultrasoundin diagnosingappendicitiswasanalyzedbycomparisonofsurgicalpathologicalfindings.Results Therewere220casesinappendicitis group,whichhad165casesofappendicitisconfirmedbypathology,and55casesofnormalappendix.Therewere18casesinnormal group,2caseswereconfirmedappendicitisbypathology,and16caseswerenormalappendix.Theoveralldiagnosticperformancesof theCTscanwere98.8%ofsensitivity,22.5%ofspecificity,82.5%ofpositivepredictivevalue,88.9%ofnegativepredictivevalue, and76.1%ofaccuracy.TheperformancesofMSCTcombinedwithultrasonographywere90.4%ofsensitivity,93.0%ofspecificity, 96.8%ofpositivepredictivevalue,80.5%ofnegativepredictivevalue,and91.2%ofaccuracy.Thedifferencewasstatisticallysignificant indiagnosisperformancesbeforeandafterMSCTcombinedwithultrasonography (P＜0.001).Conclusion MSCTcombinedwith ultrasonographyexaminationcouldimprovethediagnosticaccuracyofappendicitis,andmayreducethenegativerateofappendectomy.

Theimagingmanifestationsoffocalnodularhyperplasiaofliverwithoutcentralscar / 实用放射学杂志

Objective ToinvestigatetheMSCTand MRIcharacteristicsoffocalnodularhyperplasia(FNH)oftheliverwithout centralscar.Methods Aretrospectiveanalysisofimagingdatawascarriedoutin10patientswithFNH withoutcentralscar,confirmed bypathologyandfollowGupreview.PlainscanandenhancedCT wereperformedin10patients,5ofwhomunderwenttheplainscan andenhancedMRI.Results Lesionswerehomogeneousandslightlylowdensityin10casesonplainMSCT,andhypoGorisoGintensity onT1WIandhyperGorisoGintensityonT2WIin5cases.Nocentralscarwasfoundinalltheselesions.Thecorrelationcoefficientsof thechangeofCTvaluewere0.772onportalvenousphaseand0.827ondelayedphaseinnormalhepaticgroupandlesiongroup(P＜0.05).Theenhancedvolumeof8lesionswasslightlylargerontheportalvenousanddelayedphasethanthatonarterialphase.Conclusion MSCTand MRIcanclearlydisplaytheimagefeaturesofFNH withoutcentralscar.Thereisastrongcorrelationoftheenhancement curvebetweenthelesionsandnormalliverparenchymaonportalvenousanddelayedphase,whichishelpfulformoreaccuratediagnosis.

CTfeaturesofpulmonarycomplicationsfollowinghematopoieticstemcelltransplantation / 实用放射学杂志

Objective ToexploreimagingfeaturesanddiagnosticvalueofCTonpulmonarycomplicationsafterhematopoietic stemcelltransplantation (HSCT).Methods ThoracicCTimagesoffiftyGfourpatientswithpulmonarycomplicationafter HSCT werecollectedandtheimagingfindingswereretrospectivelyanalyzed.Results Accordingtoclinicaldiagnosis,fiftyGfourpatientswere classifiedasfungalinfection (30cases),cytomegalovirus (CMV)pneumonia(6cases),bacterialpneumonia(5cases),diffusealveolar hemorrhage(DAH)(4cases),pulmonaryedema(2cases),idiopathicpneumoniasyndrome(IPS)(1cases),bronchiolitisobliterans (BO)(3cases)andbronchiolitisobliteransorganizingpneumonia (BOOP)(3cases).OnCT,thefungalinfectionappearedasscattered nodule,consolidationorgroundglassopacity,andaircrescentsignwasseeninsixcases.Thebacterialpneumoniaappearedaspatchy, lineandgroundglassopacityorlargeconsolidation.TheDAHappearedasdiffuseexudate,alveolarnodularorconsolidation.Thepulmonary edemaappearedastypical"batwing"pattern.TheCMVpneumoniaandIPSappearedasdiffusegroundglassopacity,nodular,consolidation oratelectasis.TheBOshowedlargegroundglassopacitywithdilatedbronchioles,whiletheBOOPappearedaspatchyconsolidation andgroundglassopacity.Conclusion Patientsafter HSCT mayhavepulmonaryinfectiousandnonGinfectiouslesions.CTfeatures combinedwithclinicalsymptomsandpostGtransplantationtimecanhelptoevaluatecomplicationsaccuratelyandreducemortality.

CTdiagnosisofthepulmonarychondroma / 实用放射学杂志

Objective ToanalyzetheCTfeaturesandthediagnosticvalueofpulmonarychondroma.Methods Tencasesofpulmonary chondromaprovenbypathologywereretrospectivelyanalysed.Thenumber,location,size,shape,margin,calcificationpatternandCT valueofthelesions wereanalysedonnonGenhancedandenhanced CTscans.Results Allthe10casesofpulmonarychondroma showedsolitary,mildlylobulated,wellGcircumscribed masses.6lesionswerelocatedintherightlung,and4lesionswereintheleft lung.Thesizeofthelesionsrangedform1.3cm×0.8cmto10.7cm×9.8cm.OnplainCTimages,9lesions(90%)showedvaried calcification,withpunctatecalcificationin8lesionsandringcalcificationin1lesion.OncontrastGenhanced CTimages,6lesions showedslighthomogeneousenhancement(enhancedvalue≤14HU).Conclusion Pulmonarychondromaisusuallylocatedintheperiphery ofthelung.Thenodulehasasmoothboundary,withsignificantcalcificationandslightlyenhancement,whichcouldbehelpfulindiagnosis ofthedisease.

MSCTimagingfeaturesofcoronaryarteryfistulawithsurgicalindicationsanditsclinicalvalue / 实用放射学杂志

Objective ToinvestigatetheMSCTfeaturesanditsclinicalvalueofcoronaryarteryfistula(CAF)withsurgicalindication. Methods CTfindingsof36patientswithluminaltumorGlikedilationCAFprovedbysurgerywereanalyzedretrospectively.Bymeans ofMIP,CPR,MPRandVRreconstruction,wearrangedtheabnormalvesselsintogroupsaccordingtoitscharacteristics,andmeasured thediameterofdilatation.ThediagnosticaccuracyofMSCTforCAFwascomparedwithtransthoracicechocardiography.Results Among the36cases,drainagesitesof8caseswererightatrium,14casesrightventricle,2casespulmonaryartery,1caseleftatrium,9cases leftventricle,and2casescoronarysinus.Amongallcases,4casesoriginatedfromleftmainartery,2casesfromleftanteriordescending, 5casesfromcircumflexartery,and25casesfromrightCAF.Ofwhich,24casesunderwentfistulaligationwithextracorporealcirculation. 12casesweretreatedwithminimallyinvasivesurgery.ThediagnosticaccuracyofMSCTbeforesurgerywas100%(36/36),andthat ofechocardiographywasabout80.6%(29/36).Conclusion ReconstructiontechniqueofMSCTcanprovidetheinformationofthe CAFvesselsanditsorigin,courseandshapeoffistulaorificium.MSCTcanaccuratelylocateandguidethesurgicalapproach,especially forpreGinvasivesurgery,providingimportantinformationfortreatment.MSCTshouldbethebestimagingmethodforCAF.

Applicationof"blendsign"onCTpredictingearlyhaematomaexpansioninacuteintracerebralhaemorrhage / 实用放射学杂志

Objective Toinvestigatethevalueof"blendsign"onCTtopredictearlyhaematomaexpansioninacuteintracerebral haemorrhage(ICH).Methods SeventyGninepatientswithacuteICH whounderwentbaselineCTscanwithin6hourswereenrolled retrospectively.TheywerealsorecheckedwithCTscanin24hours.Allpatientsweredividedintoearlyhaematomaexpansiongroup and nonGhae m ato m a expansion group according to the change of hae m orrhage volu m e.M ultivariable L o g istic regression analysis w as usedtodetermineindependentriskfactorsofearlyhaematomaexpansion.Results Therewere28cases (35.4%)withhaematoma expansionin79patients."Blendsign"wasobservedin23patientsonbaselineCTscan,16of23 (69.6%)patientsappearedhaematoma expansion.Thesensitivity,specificity,positivepredictivevalue,negativepredictivevalueof"blendsign"forpredictingearlyhaematoma expansion w ere 57.1%,86.2%,69.6%,78.6%.M ultivariable L o g istic regression analysis sho w ed baseline hae m orrhage volu m e and"blendsign"wereindependentlyassociatedwithhaematomaexpansion.Conclusion "Blendsign"canbeusedtopredicthematoma expansioninacuteICH,whichishelpfultoidentifyhighriskpatientswithearlyhaematomaexpansiontomakethetreatmentmore promptlyandaccurately.

AnapplicationofMDCTtissuesegmentationtechnologyonthequantitativeevaluation andthevolumedegreedivisionofthepleuraleffusion / 实用放射学杂志

Objective Toexploreasimpleandaccuratemethodfordeterminingthequantitativeevaluationandthevolumedegree divisionofpleuraleffusionbyMDCTtissuesegmentationtechnology.Methods Thevolumeofwaterinjectedintothreecontainersof differentshapeswasmeasuredby MDCTtissuesegmentationtechnique,andwerefurthercomparedwiththevolumeoftheactual waterinjection.Byusingthesamemethod,theliquidvolumeofpleuraleffusionbeforeandafterpumpingfrompatientswasmeasured andthedifferencebetweentheanteriorandtheposteriorwascalculated.Thenthedifferencebeforeandafterthepumpingwascomparedwiththe actualvolumeofclinicalfluidpumping.Atthesametime,thespecificmethodtodeterminethedegreedivisionofpleuraleffusionwas established.Results Forcontainersofdifferentshapes,theresultfromtheCTscanningliquidmeasurementwasthesameasactualwater injection,andhadahighcorrelation.Thedifferencebetweenbeforeandafterfluidextractionandclinicalactualfluidextractionwas linearcorrelated(positivecorrelation,r=0.986,P<0.001).Accordingtothemethodfordegreedivisionofadulthemothorax,MDCT tissuesegmentationtechnologydividedthevolumeofpleuraleffusionbeforethepumpingintosmall,mediumandlargeamounts.There were44caseswithsmallpleuraleffusion,11caseswithmoderatepleuraleffusionand7caseswithlargepleuraleffusion.Conclusion The volumeofpleuraleffusion measuredby MDCTtissuesegmentationtechnologycanreflecttheactualvolumeofpleuraleffusionin clinictoacertainextent,and MDCTtissuesegmentationtechnologycanbeusedtodividethevolumedegreeofpleuraleffusion.

Applicationvalueofanewgenerationmodel-basediterativereconstructioninchestCTscan / 实用放射学杂志

Objective ToinvestigatetheimpactofCTimagequalityforfilteringbackprojection(FBP),conventionalmodel-based iterativereconstruction(MBIRC)andnewgeneration model-basediterativereconstruction (MBIRN)onchest.Methods Thirtypatientswith chestCTscanwerecollected.FBP,MBIRCandMBIRN wereusedtoreconstructtheimage.Objectivequality[standarddeviation(SD) valueoftheROI,SNR],thenoisereductionrateandSNRimprovementrateofMBIRCand MBIRN withrespecttoFBP werecom-paredacrossthethreeimages.Atthesametime,tworadiologistsusedtheblind methodtoevaluatetheintrapulmonarystructurein thelungalgorithm FBP,MBIRC,MBIRN,andthemediastinalstructure (5-pointsystem)inthestandardalgorithmsFBP,MBIRC, MBIRN.Results ComparedwithFBP,theimagemusclenoisesofMBIRCand MBIRN were76.71% and86.06%lowerthanFBP,respectively, andthefatnoiseswere66.91% and78.18%lowerthanFBP,respectively.Thedifferencewasstatisticallysignificant(P<0.05).The imageSNRofMBIRCandMBIRN were74.12% and84.97% higherthanthatoftheFBPgroup,respectively.ThefatSNRwere65.63% and 76.02% higherthanthatoftheFBPgroup (P<0.05).Thethreealgorithmsshowedstatisticallysignificantdifferencesinsubjective noise,intrapulmonaryvascular,bronchialresolution,mediastinalbloodvessels,andlymphnodes.MBIRN hadthelowestsubjective noise,andthehighestSNR,mediastinalstructure,andintrapulmonaryvesselsandbronchi.Conclusion Comparedwith MBIRC and FBPwithnormaldosechestCTscan,MBIRN cansignificantlyreducethenoiseofchestCTscanimages,improveSNR,and more clearlyshowthedetailsofthescanrangeandlesionedgefeatures.

CTfeaturesofganglioneuroblastoma / 实用放射学杂志

Objective ToimprovethediagnosticaccuracybyassessingtheCTfeaturesofganglioneuroblastoma(GNB).Methods 38patientswithGNBconfirmedbypathologicalresultsandunderwentplainandcontrast-enhancedCTscanwereanalyzedretrospectively. Results GNBoftenoccurredinchildren.Allthecasesappearedassolitarylesion,7werelocatedinthemediastinum,12intheadrenal,15inthe retroperitoneal,3inthethoraxcavityand1inthepelviccavity.PlainCTshowed36lesionswithheterogeneouslowdensitywithnecrosisand cysticdegeneration,and28caseswithcalcifications,2withhomogeneouslowdensity.Thesolidlessionofallcasesshowedprogressive enhancement(4casesshowedslightprogressivecontrastenhancement,11casesshowed moderateenhancement,23casesshowed markedlyenhancement).Peripheralvesselsweredisplacedbytumorin19casesandembeddedbytumorin13cases.13casesshowed thepresenceofsmallvesselsin/aroundthetumorarrangedinclumpsorinline.Conclusion ThespecificCTfindingsofheterogeneouslowdensity withnecrosis,calcifications,peripheralvesselsdisplaced,moderatetomarkedlyprogressiveenhancement,mightbeusefulforthediagnosisofGNB.

ThevalueofGd-EOB-DTPA-enhanced MRIindiagnosisofhepatocellularcarcinoma / 实用放射学杂志

Objective ToexplorethediagnosticvalueofenhancedCTandGd-EOB-DTPA-enhanced MRIinthedetectionofhepatocellular carcinoma (HCC).Methods 41patientswith52HCCsunderwentenhancedCTandGd-EOB-DTPA-enhancedMRIrespectively.The imagingmanifestationswereanalyzed,andthelesionsweregrouped.Theimagingdiagnositicresultswerecomparedwiththepathologicalresults, andtheefficacyofthetwomodalitieswasevaluatedusingtheaccuracyindex.Results Ofthetotal52HCCs,42lesionswereidentifiedexactlyby enhancedCT,and51byGd-EOB-DTPA-enhancedMRI.Foralllesions,includingsmalllesions(≤2cm),theaccuracyratioofGd-EOB-DTPA-enhancedMRIwashigherthanthatofenhancedCT withastatisticallysignificantdifference(P<0.05),however,therewasnosignificant differenceforthelesionsbiggerthan2cm (P>0.05).Conclusion EnhancedCTislimitedindiagnosisoftheHCCssmallerthanor equalto2cm.ThediagnosticefficacyofGd-EOB-DTPA-enhanced MRIishigherthanthatofenhancedCT,anditcansignificantly improvethediagnosisofsmallHCC.

CTcharacteristicsoftracheobronchialtuberculosiswithdifferentpathologicaltypes / 实用放射学杂志

Objective ToexploretheCTcharacteristicsoftracheobronchialtuberculosis(TBTB)withdifferentpathologicaltypes. Methods CTdataof80patientsdiagnosedasTBTBbybronchoscopywereanalyzedretrospectively.Results CTcharacteristicsofTBTBwere follows:(1)Directsignsweredetectedin127cases.Therewere47cases(37.0%)withbronchialwallthickening,57cases(44.9%) withbronchiostenosisand23cases(18.1%)withbronchialocclusion.ForactiveTBTB,therewereonly2caseswithbronchialwall thickeningand1casewithbronchiostenosisin9casesintypeⅠ,40cases(31.5%)withbronchialwallthickeningandbronchiostenosisintypeⅡ, 41cases(32.3%)withallthreedirectsignsintypeⅢ.AmongstableTBTB,22cases (17.3%)withbronchialwallthickeningand bronchiostenosisintypeⅣ;TherewerefewcasesintypeⅤ,butallwithbronchialocclusion.(2)Indirectsign:54cases(45.4%)with bronchialdisseminated,13cases(10.9%)withdestroyedlung,25cases(21.0%)withcavities,27cases(22.7%)withmediastinallymphnodes enlargementamongthe119cases.BronchialdisseminatedlesionsinactiveTBTBweresignificantlymorethandestroyedlungandcavitylesions (P<0.01).Conclusion DifferentpathologicaltypesofTBTBhavedifferentCTcharacteristics.ActiveTBTBischaracterizedbydirectsignsand oftenaccompaniedwithindirectsignssuchasbronchialdissemination.

InfarctionofthearteryofPercheron:5casesandliteraturereview / 实用放射学杂志

Objective Toanalyzetheimagingcharacteristicsandearlydiagnosticvalueofpatientswithinfarctionofthearteryof Percheron(AOP).Methods Theclinicaldataandimagingfeaturesof5patientswithAOPinfarctionwereanalyzedretrospectively, andrelevantliteratures werereviewed.Results Allof5patientspresented withdisturbanceofconsciousness.MRIof5patients showedsymmetricalhighsignalonDWIinthebilateralparamedianthalami,and1patientwithanteriorthalamiclesionand1patient withmidbrainlesionshowed "V"sign.Inaddition,MRAshowedlocalizedstenosisoftheP1segmentoftheposteriorcerebralartery in2patients.Conclusion TheclinicalpresentationsofpatientswithAOPinfarctionarevariable.Thesymmetricalhighsignalinthe bilateralparamedianthalamionDWIishelpfulforearlydiagnosisandclinicaltreatmentofAOPinfarction.

ClinicalstudyofnonGpresseddirectmethodinCTimagingoflowerextremityvein / 实用放射学杂志

Objective Toinvestigatetheeffectofpressureandnon-pressureonthedirectimagingoflowerlimbdeepveinswith CTvenography(CTV).Methods 100patients(50malesand50females,aged30－80yearsold,mean (63.5±13.5yearsold)with suspectedlowerextremityvenousdiseasesfrom September2015to October2018 wereretrospectivelyanalyzed.50patientswere scannedafterpressingtheankle(controlgroup),andtheother50werescannedwithoutpressingtheankle(experimentalgroup).Results Therewerenosignificantdifferencesbetweenthecontrolandexperimentalgroupsintheauxiliaryveinscore (t＝－0.20,P＝0.82), femoralveinscore(t＝－0.1,P＝0.91),andtotaliliacveinscore(t＝－0.03,P＝0.97).Conclusion CTV withoutpressingtheankle demonstratescomparableefficacytodirectimagingoflowerlimbdeepveins,withgoodimagequality,reducedcomplicationsandeasy toapply,sothatitshouldbewidelyusedinclinicalpractice.

CTdiagnosisofinfantilehepatichemangioendothelioma / 实用放射学杂志

Objective ToexploretheCTcharacteristic manifestationsoftheinfantilehepatichemangioendothelioma (IHHE). Methods 10cases(5malesand5females)withIHHE (agerangefromonly1dayto8months,withthemeanageof53days)were collected.Theclinicalmanifestationsincludedabdominalmassesin5cases,vomitingin2andjaundicein1.Therewasababygirlwith congenitalcholedochalcyst.Allpatientsunderwenttheplainandcontrast-enhancedscans.Results CTshowedlocalandsingleintrahepatic massin6cases(including2casesinrighthepaticlobe,2casesinquadratelobeand2casesinleftlobe),2－3massesinliverin2,and diffusenodulesin2.PlainCTshowedallmasseswithlowdensityorlow-equalhybriddensity.Themarginswereclearin4cases,and unclearin6cases,withspottedcalcificationin2cases.TheenhancedCTshowedall10caseswithrosette-likemarginalenhancement, and6caseswithgradualwash-inindelayedphase.Threepatientsreceivedinterventionaltreatmentswithintrahepaticarterialembolization, andthenthediffuselesionsintwopatientssignificantlyreducedafter20monthsand33monthsrespectively,whilethesinglelesionin 1casealsosignificantlyshrankafter6monthsoftreatment.Conclusion CTisaneffectivemethodforthediagnosisofinfantilehepatic vascularendothelioma.Marginalring-enhancementisthecharacteristicmanifestationofIHHE,anditdoesnotinvadeadjacentliver parenchymaandbloodvessels,whichcanbedistinguishedfromotherliveroccupyinglessions.