The diagnosis value of DWI in duodenal papillary adenocarcinoma / 实用放射学杂志

Objective To investigate the MRI findings of duodenal papillary adenocarcinoma(DPA),and to evaluate the importance of diffusion-weighted imaging(DWI)in diagnosis of DPA.Methods A complete data of 52 patients with DPA were prospectively collected.All patients underwent surgery within 72 hours after conventional MRI,DWI and MRCP scans.Before surgery,four different MRI findings were used to calculate the sensitivity,specificity and the probability of correctness.Two experienced radiologists who were blind to the pathologic diagnosis handled the MRI findings.Thirty eight patients were pathologically diagnosed for DPA.Based on the pathological diagnosis,the detection rate of DPA by the MR sequence was recorded and the chi square test was used to do the statistical analysis. Results The accuracy rate in diagnosis of DPA with MRI was 78.8% in our study.The findings of DPA consist of thickening wall of duodenal,duodenal papilla node imaging,DWI showing high signal of duodenal papilla and"beak"sign of dilated bile duct.Corresponding sensitivities were 70.5%,66.7%,86.3% and 87.9%,and specificities were 75.0%,30.0%,50.0% and 63.1% respectively.The incidences of positive on T2WI and T1WI,MRCP,DWI scans were 60.5%,76.3% and 92.1% respectively.The detection rate of each sequence has significant difference(χ2=10.48,P<0.005).Conclusion The MRI manifestations of DPA consist of thickening wall of duodenal,duodenal papilla node imaging,DWI showing high signal of duodenal papilla and"beak"sign of dilated bile duct.The detection rate of DWI sepuence on DPA lesions is significantly higher than that of other sequences.

Surgical treatment of the sequela of deep vein thrombosis of lower extremity / 中国普通外科杂志

Objective To study the effective surgical methods for the sequela of deep vein thrombosis(DVT) of lower extremity . Methods The clinical data of 32 patients with the sequela of DVT of lower extremity in 36 limbs treated by surgery since 1992 were analysed retrospectively. Results Diagnosis accuracy rate of angiography in sequela of DVT was 100%. There were type I in 5 limbs, type IIA in 4, type IIB in 12,and type III in 15. External constriction valvuloplasty of superficial fomoral vein(SFV) was performed on 16 limbs,valvuloplaasly of SFV on 3 limbs,great saphenous vein popliteal vein anastomosis in situ in 6 limbs,muscular loop plasty on popliteal vein in 4 limbs,common iliac vein SFV anastomosis with artificial vessel interposition in 3 limbs,great saphenoas vien ansatomosed to opposite SFV in 4 limbs. After treatment,symptoms totally disappeared in 28 limbs ( 77.8% ), and improved in 8 limbs. Conclusions The vasography is diagnostic chrysindicatrix of the DVT sequela. Different operations based on the damage of valves should be chosen.

One stage resection combined with chemotherapy for the treatment of colorectal cancer with hepatic metastasis / 中国普通外科杂志

Objective To evaluate the effect of one stage resection combined with chemotherapy for the treatment of colorectal cancer with hepatic metastasis.Methods In this study 17 out of 36 colorectal cancer patients with hepatic metastasis underwent one stage tumor resection embolization and chemotherapy via hepatic artery and portal vein through pumps in 10 cases. The remaining 19 cases in which metastatic tumors judged as nonresectable received embolization and chemotherapy alcohol injection and electrothermotherapy for the metastatic tumors.Results Recurrence developed in 6 out of 7 patients not receiving primary combined embolization and chemotherapy. The diameter of tumors in the 19 patients decrased by 57% on average, among which 4 patients underwent secondary resection of the metastatic tumors. The 1,2,3 year′s survival rate was 94%, 82%, 65% in combined group, and 74%, 53%, 32%(P