Risk Factors and Establishment of Prediction Model for Preoperative Lymph Node Staging Deficiency in Gastric Cancer / 肿瘤防治研究

Objective To analyze the risk factors of preoperative lymph node staging (N-stage) deficiency in gastric cancer and establish a preoperative assessment model to assist in predicting preoperative N-stage. Methods A retrospective method was used to analyze the clinicopathological data of 268 patients with gastric cancer. The patients routinely underwent preoperative thin-section enhanced CT to assess preoperative N-stage. Results The risk factors for preoperative N-stage deficiency were analyzed in combination with postoperative pathological findings. Multifactorial logistic regression analysis was performed to determine influencing factors, and Kaplan-Meier analysis was used to plot the survival curves of preoperative N-stage accurate group and deficiency group. The nomogram plot and ROC curves of the prediction model were drawn using the R package. AUC, 95%CI, sensitivity, and specificity were calculated. Results Age, BMI, poor differentiation, and Lauren's classification as diffuse were independent risk factors for preoperative N-stage deficiency in gastric cancer (P < 0.05). Prognostic survival was significantly worse in the preoperative N stage-inadequate group than that in the accurate group (P=0.041). The AUC area was 0.935, with a sensitivity of 85.9% and specificity of 96.9%. Conclusion Young age, high BMI, poor differentiation, and Lauren's classification as diffuse are independent risk factors for preoperative N-stage deficiency. The established preoperative assessment model based on age, BMI, differentiation degree, and Lauren's classification in this study has relatively high credibility.

Quality analysis of non-contrast-enhanced CT images synthesized from contrast-enhanced CT images by deep learning model / 中华放射医学与防护杂志

Objective:To synthesize non-contrast-enhanced CT images from enhanced CT images using deep learning method based on convolutional neural network, and to evaluate the similarity between synthesized non-contrast-enhanced CT images by deep learning(DL-SNCT) and plain CT images considered as gold standard subjectively and objectively, as well as to explore their potential clinical value.Methods:Thirty-four patients who underwent conventional plain scan and enhanced CT scan at the same time were enrolled. Using deep learning model, DL-SNCT images were generated from the enhanced CT images for each patient. With plain CT images as gold standard, the image quality of DL-SNCT images was evaluated subjectively. The evaluation indices included anatomical structure clarity, artifacts, noise level, image structure integrity and image deformation using a 4-point system). Paired t-test was used to compare the difference in CT values of different anatomical parts with different hemodynamics (aorta, kidney, liver parenchyma, gluteus maximus) and different liver diseases with distinct enhancement patterns (liver cancer, liver hemangioma, liver metastasis and liver cyst) between DL-SNCT images and plain CT images. Results:In subjective evaluation, the average scores of DL-SNCT images in artifact, noise, image structure integrity and image distortion were all 4 points, which were consistent with those of plain CT images ( P>0.05). However, the average score of anatomical clarity was slightly lower than that of plain CT images (3.59±0.70 vs. 4) with significant difference ( Z = -2.89, P<0.05). For different anatomical parts, the CT values of aorta and kidney in DL-SNCT images were significantly higher than those in plain CT images ( t=-12.89, -9.58, P<0.05). There was no statistical difference in the CT values of liver parenchyma and gluteus maximus between DL-SNCT images and plain CT images ( P>0.05). For liver lesions with different enhancement patterns, the CT values of liver cancer, liver hemangioma and liver metastasis in DL-SNCT images were significantly higher than those in plain CT images( t=-10.84, -3.42, -3.98, P<0.05). There was no statistical difference in the CT values of liver cysts between DL-SNCT iamges and plain CT images ( P>0.05). Conclusions:The DL-SNCT image quality as well as the CT values of some anatomical structures with simple enhancement patterns is comparable to those of plain CT images considered as gold-standard. For those anatomical structures with variable enhancement and those liver lesions with complex enhancement patterns, there is still vast space for DL-SNCT images to be improved before it can be readily used in clinical practice.

Association between acute adverse reactions to iodinated contrast media and anxiety in patients undergoing contrast-enhanced CT examination / 中南大学学报(医学版)

OBJECTIVES@#As the use of iodinated contrast media has become more widely with advances in imaging, several guidelines have suggested that anxiety increases the risk of acute adverse reactions associated with iodinated contrast media. This study aims to evaluate the impact of anxiety on the occurrence of acute adverse reactions (AAR) to iodinated contrast media in patients undergoing contrast-enhanced CT examinations.@*METHODS@#Inpatients who underwent contrast-enhanced CT examinations at the Third Xiangya Hospital between February and October 2021 were prospectively recruited. Prior to the imaging examinations, all patients completed the Generalized Anxiety Disorder Scale-7 (GAD-7) assessment before the imaging examinations to determine the severity of anxiety, which was categorized as mild, moderate, or severe. Based on the occurrence of AAR, patients were classified into an AAR group and a non-AAR group. The difference in anxiety was compared between the 2 groups. Multivariate logistic regression analysis was used to identify independent risk factors associated with AAR. To ensure comparability between the 2 groups, propensity score matching (PSM) was utilized to align the clinical characteristics. Subsequently, the difference in anxiety within the matched groups was analyzed.@*RESULTS@#The study comprised 880 patients, with 80 patients in the AAR group and 800 patients in the non-AAR group. There was a significant difference in proportion of patients with mild-severe anxiety between the 2 groups (75% in the AAR group and 36% in the non-AAR group, P<0.001). Additionally, differences were also observed in occupation, income, underlying diseases, and allergy history (all P<0.001). The results of multivariate logistic regression analysis revealed that patients' income, allergy history, and anxiety were independent risk factors for AAR to iodinated contrast media (all P<0.05). Following PSM, each matched group included 66 cases, and no significant differences in clinical characteristics were observed between the 2 groups (all P>0.05). However, the proportion of patients with mild-severe anxiety remained significantly higher in the AAR group compared to the non-AAR group (75% in the AAR group and 31% in the non-AAR group, P<0.001).@*CONCLUSIONS@#Anxiety is associated with an increased risk of AAR to iodinated contrast media in patients undergoing contrast-enhanced CT examinations, suggesting the clinical importance of screening for anxiety before imaging examinations.

The value of enhanced computed tomography-based nomograph model in the differential diagnosis of gastric schwannoma and gastric stromal tumor / 中华消化杂志

Objective:To construct enhanced computed tomography (CT)-based nomograph model, to assist physicians in differentiating gastric schwannoma from gastric stromal tumor.Methods:From January 1, 2012 to January 1, 2022, at the Second Affiliated Hospital of Zhejiang University School of Medicine and Ningbo Hwamei Hospital, University of Chinese Academy of Sciences, 57 patients with gastric schwannoma and 275 patients with gastric stromal tumor confirmed by surgical pathology were retrospectively collected, among whom 39 patients with gastric schwannoma and 201 patients with gastric stromal tumor were enrolled in the training set, and the other 18 patients with gastric schwannoma and 74 patients with gastric stromal tumor were enrolled in the validation set. The contrast-enhanced CT imaging features (tumor size index, arterial phase CT value, venous phase CT value, necrosis, calcification, integrity of mucosal surface, and uniform enhancement, etc.) and clinical data (history of gastritis, carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen, and monocyte to lymphocyte ratio (MLR), etc.) were collected. The least absolute shrinkage and selection operator (LASSO) regression analysis was used to screen the independent predictive factors of imaging features in the differential diagnosis of gastric schwannoma and gastric stromal tumor, and a nomograph model was constracted. Logistic regression analysis was used to analyze and screen the independent predictive factors of clinical indicators to distinguish gastric schwannoma from gastric stromal tumor, and a clinical control model was established. The receiver operating characteristic curve(ROC) was used to analyze the area under the curve (AUC) of the nomograph model in the training set and the verification set, and concordance index (CI) and decision curve analysis (DCA) were used to evaluate the predictive efficiency and clinical application value of the nomograph model. DeLong test was used for statistical analysis.Results:The results of LASSO regression analysis showed that tumor size index, arterial phase CT value, venous phase CT value, necrosis, calcification, integrity of mucosal surface, and uniform enhancement were independent predictive factors of imaging features in the differential diagnosis of gastric schwannoma and gastric stromal tumor(all P<0.05). The results of logistic regression analysis indicated that the history of gastritis ( OR=0.280, 95% confidence interval 0.138 to 0.566), CA19-9 ( OR=0.940, 95% confidence interval 0.890 to 0.993), carcinoembryonic antigen ( OR=0.794, 95% confidence interval 0.661 to 0.952), and MLR ( OR=0.087, 95% confidence interval 0.009 to 0.860) were independent predictive factors of clinical indicators in the differential diagnosis of gastric schwannoma and gastric stromal tumor ( P<0.001, =0.028, 0.013 and 0.037). The AUCs of the nomograph model in the training and validation set were 0.881 and 0.850, respectively, and the AUCs of the clinical control model in the training and validation set were 0.814 and 0.772, respectively, and the differences were statistically significant ( Z=2.57 and 1.96, P=0.005 and 0.030). The average CI of the nomograph model was 0.885. The results of DCA analysis showed that the overall benefit of the nomograph model was higher than that of the clinical control model. Conclusion:The enhanced CT-based nomograph model can effectively distinguish gastric schwannoma from gastric stromal tumor, and can help physicians to make precise clinical decisions.

Application of LBW index combined with energy spectrum CT in reducing the contrast agent dose of liver enhanced CT / 西安交通大学学报(医学版)

【Objective】 To compare the enhancement effects of lean body weight （LBW） and total body weight （TBW） as indexes to calculate the contrast agent dosage under the condition of energy spectrum CT scanning. 【Methods】 A total of 218 patients who received liver enhancement CT from November 2018 to January 2019 were enrolled in this study. There were 101 patients in LBW group and 117 patients in TBW group. Both groups were scanned by energy spectrum CT， and the parameters of scanning and reconstruction were identical. The contrast agent dose was 500 mgI/kg （LBW） in LBW group and 450 mgI/kg （TBW） in TBW group， and the injection rate was 2.8 mL/s. Images were transferred to a GE AW4.7 workstation and the 50 keV monochromatic images were analyzed. We compared the dosage of contrast medium， CT value of aorta in arterial phase （HU-aorta）， hepatic enhancement CT value in venous phase （-liver）， the rate of reaching the enhancement standard and variability in the two groups. 【Results】 Compared with TBW group， LBW group had lower contrast agent dosage， HU-aorta and ∆-liver （P0.05）. The variation rate of HU-aorta and ∆-liver in LBW group was lower than that in TBW group. Using LBW as an index to calculate the dosage of liver enhanced CT also made the enhancement of liver parenchyma more consistent in different patients. 【Conclusion】 Even on the premise of energy spectrum CT scanning， using LBW-based contrast injection in liver enhanced CT can not only reduce contrast dose， but also make the enhancement in liver parenchyma more consistent among different patients.

Main pulmonary artery diameter assessment in a large sample of Indian population: a MDCT based study

Background:The gold standard for pulmonary artery pressure measurement is right heart catheterization but its invasive nature precludes its routine use. Main pulmonary arterial trunk calibreincrease is a strong indicator of underlying pulmonary arterial hypertension. MDCT can accurately measure the diameter of main pulmonary artery. The objective of the study was to establish the normative values of main pulmonary artery caliber using contrast enhanced CT and try to ascertain any significant difference in main pulmonary artery calibers between two genders and correlation of age and main pulmonary artery diameter. Methods:Contrast enhanced CT images of 462 subjects were analysed on a PACS workstation monitor and widest diameter perpendicular to long axis of the main pulmonary artery as seen on reformatted axial image was measured with electronic caliper tool at the level of the main pulmonary artery bifurcation.Results:The mean main pulmonary artery diameter in females was 22.54±2.19 mm and 23.34±3.06 mm in males. The mean pulmonary artery diameter in males was larger than females with statistically significant difference seen (p<0.05). The correlation coefficient between age of whole sample and their mean main pulmonary artery was found to be 0.1006 with no statistically significant difference.Conclusions:There is a statistically significant difference in the mean main pulmonary artery calibre between males and femaleswith no strong correlation between the age and mean main pulmonary artery calibre. Further studies are warranted to find the complex interaction between main pulmonary artery diameter and sex, age and body mass index

Doppler US and CT Diagnosis of Nutcracker Syndrome

Nutcracker syndrome (NCS) is a syndrome caused by compression of the left renal vein (LRV), between the abdominal aorta and the superior mesenteric artery, resulting in hypertension of the LRV and hematuria. Doppler ultrasonography (US) has been commonly used for the diagnosis of NCS. However, several technical issues, such as Doppler angle and sample volume, need to be considered to obtain satisfactory results. In addition, morphologic changes of the LRV and a jetting phenomenon across the aortomesenteric portion of the LRV on contrast-enhanced computed tomography (CECT) are diagnostic clues of NCS. With proper Doppler US and CECT, NCS can be diagnosed noninvasively.

Observation on the application effect of power port in cancer patients receiving contrast-enhanced CT scans / 中国实用护理杂志

Objective@#To investigate the application effect of Power port in contrast-enhanced CT scans.@*Methods@#Totally 220 cancer patients who needed contrast-enhanced CT scans after chemotherapy were selected in Changhai hospital From September 2017 to September 2018, including 110 cases in the observation group and 110 cases in the control group with convenient sampling method.The observation group was injected contrast medium through Power port for CT scans. Contrast medium was injected into the control group by 22G of Peripheral venous access devices (Introcan®). The incidence of contrast medium exosmosis, nursing time and patient satisfaction were compared between the two groups.@*Results@#The incidence of extravasation of contrast medium in the observation group was 0, lower than that in the control group 9.1% (10/110), the difference was significant(χ2=10.476,P=0.015); the nursing time in the observation group was (2.60 ±0.15) minutes per time, which was lower than that in the control group (5.60 ± 5.29) minutes per time), the difference was significant (t=5.934, P=0.000); the patient satisfaction in the observation group was higher than that in the control group, the difference was statistically significant (Z=-12.695, P=0.000).@*Conclusions@#Contrast medium injection through Power port for CT scans can reduce the incidence of contrast medium exosmosis, reduce nursing hours and improve patient satisfaction.

Observation on the application effect of power port in cancer patients receiving contrast-enhanced CT scans / 中国实用护理杂志

Objective To investigate the application effect of Power port in contrast-enhanced CT scans. Methods Totally 220 cancer patients who needed contrast- enhanced CT scans after chemotherapy were selected in Changhai hospital From September 2017 to September 2018, including 110 cases in the observation group and 110 cases in the control group with convenient sampling method. The observation group was injected contrast medium through Power port for CT scans. Contrast medium was injected into the control group by 22G of Peripheral venous access devices (Introcan?). The incidence of contrast medium exosmosis, nursing time and patient satisfaction were compared between the two groups. Results The incidence of extravasation of contrast medium in the observation group was 0, lower than that in the control group 9.1% (10/110), the difference was significant(χ2=10.476,P=0.015); the nursing time in the observation group was (2.60 ±0.15) minutes per time, which was lower than that in the control group (5.60 ± 5.29) minutes per time), the difference was significant (t=5.934,P =0.000); the patient satisfaction in the observation group was higher than that in the control group, the difference was statistically significant (Z=-12.695, P=0.000). Conclusions Contrast medium injection through Power port for CT scans can reduce the incidence of contrast medium exosmosis, reduce nursing hours and improve patient satisfaction.

Diagnostic value of contrast-enhanced ultrasound for the maximum diameter ≤2 cm metastatic liver cancer: compared with contrast-enhanced CT / 中华超声影像学杂志

Objective@#To compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) with contrast-enhanced computed tomography (CECT) for the maximum diameter ≤2 cm metastatic liver cancer (MLC).@*Methods@#Sixty-nine pathologically diagnosed MLC patients (maximum diameter ≤2 cm) were retrospectively recruited. The lesion detection rate, diagnostic confidence and enhancement pattern of CEUS and CECT for MLC were analyzed. Diagnostic value of CEUS and CECT for MLC were evaluated and compared by using diagnostic test.@*Results@#The cases of 0, 1, 2, multiple lesions detected by CEUS and CECT in these 69 patients with ≤2 cm MLC were 0 case (0%), 41 cases(59.42%), 13 cases(18.84%), 15 cases(21.74%) and 9 cases(13.04%), 29 cases(42.03%), 13 cases(18.84%), 18 cases(26.09%), respectively. The positive cases detected by CEUS and CECT were 69 cases(100%) and 60 cases(86.96%) respectively, with a statistically significant difference between the two groups (P=0.006). However, for the detection rate of non-single-lesion cases, there was no statistical difference between CEUS and CECT (P=0.409). The cases showed typical manifestation in CEUS and CECT were 56 cases(81.16%)and 29 cases(42.03%)(P<0.001). The cases with diagnostic confidence level of 3, 4, 5 in CEUS were 3 cases(0.04%), 11 cases(15.94%), 55 cases(79.71%), and those of CECT were 19 cases(27.54%), 20 cases(28.99%), 20 cases(28.99%), respectively. The diagnostic sensitivity of CEUS and CECT for ≤2 cm MLC were 100% (69/69) and 85.51% (59/69), with statistically significant difference(P=0.001).@*Conclusions@#The lesion detection rate and diagnostic value of CEUS for the maximum diameter ≤2 cm MLC might be superior to that of CECT, but the detection rate shows no significant difference in the non-single-lesion cases. CEUS has important clinical value in the diagnosis of ≤2 cm MLC.

Comparative analysis of contrast-enhanced ultrasound and contrast-enhanced CT in differential diagnosis of benign and malignant space-occupying lesions of gallbladder / 国际生物医学工程杂志

Objective To compare the efficacy of contrast-enhanced ultrasound (CEUS) and enhanced CT (CECT) in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.Methods The clinical data of 68 cases of space-occupying lesions of gallbladder confirmed by surgery and biopsy were retrospectively analyzed.The diagnostic accuracy,sensitivity and specificity of CEUS and CECT were analyzed and compared.Results In a total of 68 cases of space-occupying lesions of gallbladder,31 cases were benign lesions and 37 were malignant lesions (gallbladder cancer).For the benign lesions cases,CEUS and CECT were mainly hyper-enhanced in the early stage of enhancement,which were 90.3％ and 83.9％,respectively.In the late stage of enhancement,they were mostly low-enhanced,which were 93.5％ and 87.1％,respectively.For the gallbladder cancer cases,CEUS and CECT were predominantly hyper-enhanced in the early stage of enhancement,which were 94.6％ and 89.2％,respectively,and were all low-enhanced in the late stage of enhancement.In the differential diagnosis for benign and malignant space-occupying gallbladder lesions by CEUS,the differences in peak time,extinction time,peak intensity and average transit time were statistically significant (all P＜0.01).The inhomogeneous enhancement rates were 41.9％ and 48.4％ respectively for CEUS and CECT in the benign lesions cases,and 94.6％ and 91.9％ in the gallbladder cancer cases.Besides,the incomplete gallbladder wall rates are 89.2％ and 91.9％ in the gallbladder cancer cases.However,these differences were all not statistically significant (all P＞0.05).In the diagnosis of benign and malignant lesions cases,the diagnostic accuracy of CEUS and CECT were 92.6％ and 89.7％,the sensitivity was 93.5％ and 90.3％,and the specificity was 89.2％ and 83.8％,respectively,but the differences were not statistically significant (all P＞0.05).Conclusion CEUS and CECT have comparable efficacy in differential diagnosis of benign and malignant space-occupying lesions of gallbladder.CEUS has advantages over CECT and is worthy of extensive clinical application and promotion.

Multi-modality imaging in the diagnosis and differential diagnosis of small renal mass / 天津医药

Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.

Comparative observation on the diagnostic value of enhanced CT and gastroscopy for esophageal varices / 中国医学装备

Objective:To study the diagnostic value about enhanced CT and gastroscopy for esophageal varices.Methods: Ninety eight patients with esophageal varices were selected as objects. All the patients underwent enhanced CT and gastroscopy, took detailed records of the test results, and analyzed CT scan at the portal vein and spleen vein values.Results: The results of enhanced CT detection and gastroscopy diagnosis were similar in liver cirrhosis combined with esophageal varices, liver cirrhosis combined with esophageal and gastric fundus varices, and liver cirrhosis complicated with gastric fundus varices. The diagnosis of enhanced CT is significant difference (F=33.06,F=20.22;P<0.05) in detection of portal vein value and spleen vein value for mild, moderate, and severe patients.Conclusion: The enhanced CT and gastroscopy for detecting of esophageal and gastric fundus has satisfactory value, and enhanced diagnostic CT for detecting severities of the esophageal and gastric fundus varices also has a important significance.

Clinical values of contrast-enhanced ultrasound in diagnosis and classification of portal vein tumor thrombosis / 吉林大学学报(医学版)

Objective:To explore the clinical application values of contrast-enhanced ultrasound in the diagnosis and classification of portal vein tumor thrombosis (PVTT)by comparing with enhanced CT.Methods:43 patients with PVTT confirmed by clinic and pathology were selected, and the accuracy rates of the diagnosis and clinic classification of contrast-enhanced ultrasound and enhanced CT were compared. Results:The characteristic of PVTT in contrast-enhanced ultrasound was“quick in fast out”;88.4% (38/43)of PVTT were hyper-enhancement in the arterial phase, 81.4% (35/43 ) of PVTT were hypo-enhancement in the vein phase, and all tumor thrombosis showed hypo-enhancement in the delay phase. The diagnostic accuracy rate of contrast-enhanced ultrasound in PVTT was 100%,and the accuracy rate of enhanced CT was 97.7% (42/43).The classification accuracy rate of contrast-enhanced ultrasonic was 95.3% (41/43),and the accuracy rate of enhanced CT was 93.0% (40/43 );there was no statistically significant difference between two methods (P > 0.05 ). Conclusion:Dynamiccontrast-enhanced ultrasonography can display the blood perfusion characteristics of PVTT, and displays the actual infiltrating tumor thrombosis. Ultrasonic imaging and enhanced CT in the qualitative diagnosis of PVTT and clinical classification have a good consistency.Contrast-enhanced ultrasound can be used as an important imaging method to evaluate the PVTT before treatment.

Valuea of contrast-enhanced imaging and enhanced CT in diagnosis of traumatic spleen rupture / 实用医学杂志

Objective To explore the value of contrast-enhanced ultrasound in the diagnosis and classification of traumatic spleen rupture , as compared with enhanced CT. Methods The manifestations of contrast-enhanced ultrasound on surgically or clinically confirmed spleen rupture in 40 patients were retrospectively analyzed. The performance of contrast-enhanced ultrasound on diagnosis and classification was compared with that of enhanced CT. Results For 40 patients with traumatic spleen rupture , the of accuracy of enhanced CT and contrast-enhanced imaging in the diagnosis of traumatic spleen rupture was 97.5%, with no significant statistical differences (chi-square = 0, P = 1). On contrast-enhanced ultrasound examination, 14 patients were diagnosed as true splenic rupture , 9 as subcapsular spleen rupture , and 16 as central splenicrupture, with a accuracy rate of 92.5% (37/40); and accuracy rate for enhanced CT was 90.0% (36/40), there was no significant statistical difference (chi-square = 1.97, P > 0.05). Conclusions Contrast-enhanced and enhanced CT have good consistency in the diagnosis and classification of traumatic spleen rupture. Contrast-enhanced ultrasound can accurately determine the scope and degree of spleen damage , resulting in more accurate classification; and it has values in the diagnosis of traumatic spleen rupture and choice of therapies.

A clinical analysis of 36 cases of systemic lupus erythematosus with lupus mesenteric vasculitis / 中华风湿病学杂志

Objective To analyze the clinical profiles of lupus mesenteric vasculitis (LMV).Methods Thirty-six SLE patients diagnosed with LMV and 72 SLE patients (1:2) without LMV at West China Hospital between October 2009 and January 2012 were enrolled.The imaging,clinical manifestation,laboratory examinations data were analyzed retrospectively.Quantitative differences were analyzed by the Student's t and Z tests and qualitative data were compared with Chi-square.P value less than 0.05 was considered as statistically significant.Results ① The prevalence of LMV in patients with SLE was 1.2％(36/3 051),while 47％(17/36) as the initial symptom of SLE.Thirty-six LMV patients were all female.The prevalence of abdominal pain was 78％(28/36),nausea or vomitting was 58％(21/36),abdominal distension was 50％(18/36),diarrhea was 47.2％ (17/36),intestinal perforation was 3％ (1/36) and incomplete obstruction was 8％ (3/36).Enhanced CT scan showed 81％(25/31) patients suffered from intestinal dilation and (or) mesenteric edema;SLEDAI (17±5),C3 (0.44±0.25) g/L,C4 (0.10±0.09) g/L,Z value on above items were 4.30,-3.85 and-2.94 respectively compared to SLE patients without LMV,and all P＜0.05,the differemces were significant.In addition,Also,the proportion of ANA and anti-ENA antibody showed no significant difference.68.6％(13/36) patients were also diagnosed with lupus nephritis;61％(22/36) patients were treated with methylprednisolone more than 200 mg/d resulting in relief of symptom.Conclusion Female patients with SLE may be more likely to suffer from LMV;Enhanced abdominal CT scan is still essential to the diagnosis of LMV.LMV is correlated with urinary system malfunction.LMV always occurs in active lupus with low C3 and C4 level.More than half patients should be treated with corticosteroid and cyclophosphamide pulse therapy.

Application of Iohexol Used in Enhanced CT Scanning / 医药导报

Objective To investigate the application of iohexol in enhanced CT scanning. Methods The total of 623 patients taking iohexol for enhanced CT scanning were sampled to record relevant data for reference. According to evaluation standards for rational use of contrast media,the risk factors,selection of contrast media,medication time,usage and dosage,and drug combination were analyzed statistically. Results Among 623 patients used iohexo for enhanced CT scanning,302 patients had the risk factors of adverse reaction(the incidence rate as 48.48%) and 115 patients received psychological intervention(the incidence rate as 18.46%).And 206 patients had been given with the reasonable fluid therapy before and after angiography(the incidence rate as 33.07%),there were only 124 patients who performed the renal function and urine routine examination 48-72 h before and after angiography(the incidence rate as 19.90%).And 33 patients occured allergic reaction with the incidence rate as 5.30%. Conclusion There existed irrational phenomenon in application of diodone in enhanced CT scanning.It is necessary to further standardize the clinical application of diodone and make complete measures for rational use of diodone.

Primary Pulmonary Low-Grade Angiosarcoma Characterized by Mismatch between 18F-FDG PET and Dynamic Contrast-Enhanced CT

We report a rare case of primary pulmonary low-grade angiosarcoma on dynamic contrast-enhanced CT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging. A 38-year-old, asymptomatic woman was hospitalized because of an abnormality on chest radiography. A dynamic contrast-enhanced chest CT showed a 1.2 cm-sized irregular-margined nodule with strong and persistent enhancement in the right lower lobe. The lesion had low metabolic activity on an 18F-FDG PET/CT scan. The patient underwent a wedge resection for the lesion, and pathology revealed a primary pulmonary low-grade angiosarcoma.

Application of enhanced CT-guided percutaneously transthoracic lung biopsy / 天津医药

Objective To investigate the clinic value of enhanced CT-guided percutaneously transthoracic lung biopsy. Methods A total of 423 patients who underwent CT-guided percutaneously transthoracic lung biopsy were retrospectively analyzed. The percentage of specimen are satisfactory,the rate of sample with pathological findings,the number of cases with complications,the average goes of unsuccessful biopsy and the times of changing puncture point were compared between the enhanced CT group and the plain CT group. Results Compare parameters in patients whose procedure were guided with the enhanced CT group and with plain CT group, the average goes of unsuccessful biopsy, the times of changing puncture point in patients, the percentage of specimen that were satisfactory, the rate of sample with positive pathological findings and the rate that complicated with pneumothorax or hemorrhage show statistical significance.(3.08±1.05 vs 3.75±1.34, 8.52%vs 18.54%,90.13%vs 73.60%, 76.62%vs 63.36%, 15.51%vs 27.53%, 7.76%vs 14.04%, P<0.05). Conclusion In patient whose biopsys were guided by enhanced CT, the percentage of samples that are satisfactory is higher, the incidence of complication is fewer and the sample with pathological finding is higher compared to those in patients whose biopsys were guided by plain CT. Therefore, enhanced CT-guided percutaneous transthoracic biopsy is more valuable than plane CT.

Preoperative evaluation of axillary lymph node in breast cancer / 中华内分泌外科杂志

Objective To evaluate diagnostic value of the combined examination of ultrasound , contrast-enhanced CT and physical examination in axillary lymph node status in breast cancer .Methods 316 cases of breast cancer were studied from Jan .2012 to Dec.2013.The axillary lymph nodes were divided into negative group, suspicious negative group , suspicious positive group and positive group by physical examination , axillary ultrasound , and contrast-enhanced breast CT imaging .ROC curve was used to evaluate diagnostic value and the sensitivity,specificity,and accuracy were analyzed .Results The evaluation model presented the AUC of 0.859. The accuracy, sensitivity, specificity, positive and negative predictive value was 91.3%, 93.8%, 92.5%, 94.0%and 90.9%in negative group and positive group .Conclusion This evaluation method can accurately predict the axillary lymph node status and may be instructive to clinical operation mode selection .