RESUMO
Objective To investigate the value of MRI in the prenatal diagnosis of abnormal fetal kidneys. Methods From December 2014 to March 2016, 51 women underwent MRI and were confirmed as having fetuses with abnormal fetal kidneys when follow up. Their clinical and MRI profiles were analyzed retrospectively, including MRI manifestation, the fetal kidney signal intensity of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC). The signal intensity of DWI and ADC of the abnormal kidney and the normal opposite kidney, and those of the normal and abnormal kidneys in different individuals were compared. The accuracies of MRI and ultrasound in evaluating abnormal fetal kidneys were also compared. Results MRI could accurately demonstrate the morphological features of abnormal fetal kidneys. There was no statistically significant difference between DWI signal intensity and ADC value of the abnormal kidney[368 ± 125,(1.516 ± 0.420)× 10-3 mm2/s] and the normal opposite one[410 ± 125,(1.362 ± 0.251)× 10-3 mm2/s], P values were 0.165 and 0.184,respectively. The DWI signal intensity of normal kidneys(401 ± 124)was higher than that of renal cysts(182 ± 40, P<0.01), and the ADC value of normal kidneys[(1.306 ± 0.252)× 10-3 mm2/s] was lower than that of renal cysts[(2.912 ± 0.235)× 10-3 mm2/s] and multicystic dysplastic kidneys[(1.870 ± 0.654)× 10-3 mm2/s], P values were<0.01 and 0.045, respectively. The diagnostic accuracy of MRI and prenatal ultrasound for abnormal fetal kidneys were 94%(63/67)and 85%(57/67), respectively. However, there was no statistical difference between the two methods (P=0.070). Conclusion MRI have an important role in the prenatal diagnosis and evaluation of abnormal fetal kidneys.
RESUMO
Objective To contrast the accuracy rate of nuclear magnetic resonance imaging (MRI)-staging and the International Federation of Gynecology and Obstetrics (FIGO, 2009) clinical-staging, and evaluate the value of MRI in diagnosis of lymph node metastasis in cervical cancer. Methods The surgical pathology was used as golden standard, the accuracy rates of MRI-staging and FIGO-staging were compared in 86 patients of cervical cancer (surgical pathological staging≥Ⅰb). The lymph nodes with slightly hyperintense signal in diffusion-weighted magnetic resonance imaging (DWI) and with minor axis≥1 cm in T2WI-TRA (T2 weighted imaging-transverse section) were considered as metastatic lymph nodes, the characteristics of lymphatic metastasis diagnosed by MRI were analyzed, and the accuracy rate, the sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI were evaluated. Results The accuracy rate of FIGO-staging was 80.2%(69/86), and the accuracy rate of MRI-staging was 83.7%(72/86), there was no significant difference between them (P > 0.05). The accuracy rate of lymphatic metastasis diagnosed by MRI was 94.2%(81/86), the sensitivity was 73.3%(11/15), the specificity was 98.6%(70/71), the positive predictive value was 91.7%(11/12), and the negative predictive value was 94.6%(70/74). The true positive metastatic lymph nodes in 11 cases were located in the external iliac nodes or common iliac lymph nodes, the average short/long diameter was 0.76. The forms of lymph nodes were as follows:quasi-circular (n=3), border irregularity (n=3), huge fusion form (n=4), and 1 with central necrosis area. One case of false positive metastatic lymph node was located in the right external iliac node, with the sharp of huge fusion form in T2WI/TRA, comminution in T2WI-axial thin slices, and long strip in T2WI/SAG. Conclusion The accuracy rates of MRI-staging and FIGO-staging were both higher, which can diagnose lymphatic metastasis relatively accurately when they are combined together.
RESUMO
Objective To explore the diagnostic value of MR fast imaging sequences in fetal lung congenital cystic adenomatoid malformation(CCAM).Methods 8 cases with suspected CCAM by US were examined with MRI fast sequences,including single shot turbo spin echo (SSTSE)and balanced fast field echo(B-FFE),and undergone axial,sagital and coronal scanning sections of fetal chests.MRI findings were compared with surgery(2 fetuses),autopsy (3 fetuses)and CT examination (3 fetuses).Results 7 fetuses with CCAM and 1 fetus with bronchopulmonary sequestration(BPS)diagnosed by MRI were confirmed by following surgery,autopsy and CT examination.Among the 7 CCAM cases,2 leisions were on the left side,while the other 5 lesions were on the right side.Fur-thermore,2 cases were cystic type and the rest 5 cases were mass type.The BPS was located in the lower left lung lobar.Conclusion MR fast imaging sequences in fetal can clearly demonstrate location,type and extent of CCAM and can provide important supplement information of the prenatal fetal ultrasound examination.
RESUMO
Objective To analyse the multi-slice spiral CT(MSCT) findings of small cholangiocarcinoma of common bile duct.Methods 15 cases with pathologically verified small cholangiocarcinoma of common bile duct were undergone unenhanced and three-phase contrast-enhanced MSCT scan.The entire morphologic changes of common bile duct were analysed with curved planar reformation(CPR).Results The attenuation of tumor relative to pancreas was iso-density in all cases at plain CT scan,hypo-density in 10 cases,iso-density in 3 cases and hyper-density in 2 cases at arterial phase,hypo-density in 1 case,iso-density in 3 cases and hyper-density in 11 cases at portal phase,iso-density in 5 caaes and hyper-density in 10 cases at delayed phase.The focal wall thickening of common bile duct appeared as circular or eccentric in 13 cases,intraluminal nodule in 2 cases,common bile duct was narrowing sharply in 11 cases and ending abruptly in 4 cases at obstructive level.Conclusion The small cholangiocarcinoma of common bile duct is of certain characteristics at unenhanced and three-phase contrast-enhanced CT scan.