Résumé
Objective@#To investigate the imaging diagnosis, treatment and prognosis of primary hepatic neuroendocrine tumors.@*Methods@#The clinical features, imaging manifestations, histopathological and immunohistochemical findings and interventional therapy of 6 patients identified with pathologically confirmed primary hepatic neuroendocrine tumors were retrospectively analyzed, and the related literatures were reviewed.@*Results@#All 6 patients presented with symptoms of abdominal pain. 4 patients had solitary hepatic mass and 2 patients had multiple hepatic masses. Magnetic resonance imaging showed low signal intensity on T1 weighted imaging, high signal intensity on T2 weighted imaging and clear boundary; the arterial phase of enhancement scan was uneven and enhanced, and portal venous phase or delayed phase showed continuous enhancement, surrounded by ring enhanced capsule. A pathological diagnosis was primary neuroendocrine tumor of the liver. After interventional treatment, 6 patients had some therapeutic effects. Among them, 4 patients underwent multiple interventional therapies, followed by 4 years of follow-up has shown satisfactory results.@*Conclusion@#Primary hepatic neuroendocrine tumors are very rare and their imaging manifestations are specific. Eventually, relies on pathological and immunohistochemical diagnosis. Transarterial chemoembolization therapy can bring satisfactory results in the treatment of primary hepatic neuroendocrine tumor.
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Objective To investigate the effect of split-bolus spectral computed tomography(CT) on the portal venography and radiation dose.Methods The prospective study was adopted.The clinical data of 119 patients who underwent spectral CT at China-Japan Union Hopital from September 2014 to March 2015 were collected.Patients were randomly divided into the portal venography with split-bolus spectral CT single-phase enhanced scan group and portal vein multi-phase scan group by random sequence method.In the portal venography with split-bolus spectral CT single-phase enhanced scan group,the spectral CT was used with the method of split-bolus single phase imaging,and in the portal vein multi-phase scan group,standard spiral CT was used to perform three-phase scan.Two observers evaluated CT portal venography subjectively and objectively,measured CT values,contrast to noise ratio (CNR),signal noise ratio (SNR),and calculated radiation dose.Observed indices included (1) choice of optimal monochromatic images.(2) CT values of portal veins,measurement of CNR and SNR.(3) Subjective scoring of portal venography quality.(4) Comparison of radiation dose.Measurement data with normal distribution were presented as x ± s,comparison between groups was analyzed by independent sample t test.Comparison of count data was analyzed by chi-square test.Results The 113 patients were screened for eligibility,including 59 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 54 in the portal vein multi-phase scan group.(1) Choice of optimal monochromatic images:optimal monochromatic images were abstracted at 60 keV from spectral CT portal venography.(2) CT values of portal veins and measurement of CNR and SNR:the CT values of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were (319 ± 44) HU,(328 ± 53) HU,(294 ± 45) HU in the reconstructed images at the energy level of 60 keV in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (213 ±41)HU,(228 ±49)HU,(210 ±41)HU in the portal vein multi-phase scan group,with significant differences between the 2 groups(t =8.04,6.34,6.82,P ＜ 0.05).The CNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 15 ± 5,24 ± 8,22 ± 7 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 13 ± 4,20 ± 6,19 ± 6 in the portal vein multi-phase scan group,respectively,with no significant difference (t =-1.13,-1.89,-1.51,P ＞ 0.05).The SNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 31 ± 6,29 ± 6,27 ± 6 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 29 ± 7,28 ± 9,26 ± 6 in the portal vein multi-phase scan group,respectively,with no significant differences (t =-0.688,0.615,0.600,P ＞ 0.05).(3) Subjective scoring of portal venography quality:the subjective score of image quality of portal venography was 14.3 ± 1.0 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 12.5 ± 1.8 in the portal vein multi-phase scan group,with a significant difference (t =12.43,P ＜ 0.05).(4) Comparison of radiation dose:the radiation dose was (8.1 ± 1.1)mSv of patients in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (17.4 ± 7.5) mSv in the portal vein multiphase scan group,with a significant difference (t =24.14,P ＜ 0.05).Conclusion Spectral CT portal vein imaging combined with split-bolus protocol can achieve better manifestations of portal vein and its branches,and reduce radiation dose in the scanning process.
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Objective To know the current situation and its related risk factors for hypertension in elderly residents in Wendeng City. Methods In August, 2008, with a multi-stage stratified random sampling method, 3 415 residents aged 35 yrs were investigated by questionnaire with the "Health information record" of the national integrated chronic diseases prevention and control techniques, and taken physical examination, blood pressure test and related risk factors for hypertension by single-and multivariate analysis of Logistic regression analysis. Results Of the 3 415 residents aged over 35 yrs, 1 257 suffered from hypertension, the prevalence rate was 39.87%, and the standardized prevalence rate was 37.68%, and prevalence rate of hypertension increased with age (?2=285.54, P