Comparison of CT manifestations of primary colorectal mucinous adenocarcinoma and signet ring cell carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the difference in CT manifestations between primary colorectal mucinous adenocarcinoma and signet ring cell carcinoma in order to improve radiologic diagnosis.</p><p><b>METHODS</b>Clinicopathological data and CT findings of 109 patients with colorectal mucinous adenocarcinoma and 46 patients with primary colorectal signet-ring cell carcinoma confirmed by surgery and pathology from March 2008 to February 2015 in the Tumor Hospital of Yunnan Province were retrospectively collected. Differences in age, gender, tumor location, length and thickness of the involved intestinal wall, thickening pattern of the intestinal wall, lesion density, calcification, contrast-enhanced form, peri-intestinal invasion, occurrence of intestinal obstruction and metastasis of other organs were compared between the two groups.</p><p><b>RESULTS</b>Among 109 patients with colorectal mucinous adenocarcinoma, 68 were men and 41 were women with a mean age of (56.8±15.4) years. Among 46 patients with primary colorectal signet-ring cell carcinoma, 26 were men and 20 were women with a mean age of (42.9±15.6) years. Compared with mucinous adenocarcinoma group, signet-ring cell carcinoma group showed more concentric bowel-wall thickening[93.5%(43/46) vs. 81.6%(89/109), χ=9.19, P=0.030], higher lesion density [(42.0±3.0) Hu vs. (28.5±1.5) Hu, t=37.30, P=0.000], more marked enhancement [54.3%(25/46) vs. 12.8%(14/109), χ=35.21, P=0.000], less vast-low-density region in enhanced CT imaging[2.2%(1/46) vs. 45.0%(49/109), χ=73.31, P=0.000] and more severe peri-intestinal invasion [41.3% (19/46) vs. 17.4%(19/109), χ=10.25, P=0.006]. Calcification was found in 18.3%(20/109) of mucinous adenocarcinoma cases, but was not found in signet-ring cell carcinoma cases (χ=9.69, P=0.002). Target ring sign in contrast-enhanced scan was observed in 15.2%(7/46) of signet-ring cell carcinoma cases, while in none of mucinous adenocarcinoma cases (χ=17.37, P=0.000). There were no statistically significant differences in lesion location, length and thickness of the involved intestinal wall, occurrence of intestinal obstruction, lymph node metastasis, liver or peritoneum metastasis between two groups(all P>0.05).</p><p><b>CONCLUSIONS</b>Signet-ring cell carcinoma is often found in younger patients, whose CT manifestation is characterized by the target ring sign in contrast-enhanced scan, while primary colorectal mucinous adenocarcinoma is often in older patients, whose CT manifestation is characterized by calcification in unenhanced scan and low density region in enhanced CT show.</p>

Radiographic and MRI features of the hemangiomas and vascular malformation in the deep soft-tissue of the extremities / 实用放射学杂志

Objective To explore radiographic and MRI features of the hemangiomas and vascular malformation in the deep soft-tissue of the extremities.Methods 89 cases confirmed by surgical pathology and angiography were analyzed retrospectively with clinical data and radiological findings.Imaging exams included plain X-ray performed in all patients,and MRI scan in 33 patients.Results On X-ray plain film,there was normal bone and soft tissue in 54 cases(60.7%),soft tissue abnormalities in 14 cases(1 5.7%),and phleboliths in 30 cases(33.7%).Also,plain X-ray film studies demonstrated bone changes adjacent to the deep soft tissue in 32 cases(36.0%), including periosteal reactions(13 cases),cortical erosion (1 6 cases),involvement of the bone marrow (10 cases)and 7 diffuse lesions with all above changes.On MRI,lesions were similar to honeycomb or sponge,and T1 WI showed isohypointense signal in 25 cases (75.8%),hypointense in 5 cases (1 5.2%),inhomogeneous slightly hyperintense in 3 cases (9.0%).On T2 WI,all lesions were well defined and showed hyperintense signals with hypointense septation,of which there were 9 cases with nodular hypointense areas and vascular flow effect.Hypointense phleboliths were showed in 10 cases(30.3%).Following injection of the contrast medium,all lesions had heterogeneous enhancement patterns.Of the 33 patients studies with MRI,lesions of 18 cases(54.5%)had bone changes which were adjacent to or partially or fully wrapped by neighbouring soft tissue lesions,in which lesions of 12 cases showed abnormal signal within bone marrow and lesions of 3 cases with vascular flow void phenomenon.In 15 cases (45.5%)without osseous change,lesions of 3 cases were adjacent to bone,and lesions of 12 cases were with fat and muscle septum between the bone and lesions.Conclusion The hemangiomas and vascular malformation in the deep soft-tissue of the extremities may cause changes in adjacent bones.Familiarity with the performance of reactive bone changes on X-ray and MRI may help to improve the diagnosis and avoid misdiagnosis.

Comparison of Contrast-enhanced CT Findings of Colorectal Signet-ring Cell Carcinomas and Adenocarcinomas / 中国医学影像学杂志

Purpose The study about the CT manifestations of primary colorectal signet-ring cell carcinoma is rarely reported by now, the purpose of this study is to explore the CT findings of primary colorectal signet-ring cell carcinoma, to improve the radiology acknowledge about it. Materials and Methods CT findings of 46 patients with primary colorectal signet-ring cell carcinoma and 46 patients with colorectal adenocarcinoma confirmed by surgery and pathology were retrospectively analyzed, the differences of age, gender, tumor location, length and thickness of the involved intestinal wall, the thickening pattern of the intestinal wall, the contrast-enhanced form, the peri-intestinal invasion, the occurrence of intestinal obstruction and metastasis of other organs were compared between the two groups. Results Compared with the colorectal adenocarcinoma group, patient age of colorectal signet-ring cell carcinoma group was younger (t=5.23, P0.05). Conclusion Signet-ring cell carcinomas are often found in younger patients, their CT manifestations including a long length of concentric bowel wall thickening and is characterized by the target ring sign in contrast-enhanced scan, which often involves the peri-intestinal space with peritoneal metastasis and peri-intestinal lymph node metastasis.

The CT and MRI diagnosis of presacral primary tumor / 实用放射学杂志

Objective To investigate the diagnostic values of CT and MRI by analysing the CT and MRI features of presacral tumor.Methods The CT and MRI imaging features of 37 cases of primary presacral tumor with surgical pathology were analyzed retrospectively,and the imaging findings were compared with the pathologic findings.All data were analyzed by Fishersχ2 test.Re-sults 9 cases of presacral tumors were cystic type,18 cases were solid type and 10 cases were cystic-solid type.90.3% (28/31)of benign tumors had round or oval shapes,83.3% (5/6)of malignant tumors were irregular form(χ2=16.093,P=0.001).The den-sity of lesions whether uniform or not,and the presence of enhancement showed no obvious statistical differences between benign and malignant lesions.In all 37 cases,28 cases of benign and 1 case of malignant tumor were found compressed the surrounding tissues and organs;4 cases of benign and 5 cases of malignant tumor invaded adjacent tissues and organs(χ2=13.547,P=0.002).Conclu-sion CT and MRI can differentiate benign and malignant tumor,and can make clear diagnosis in some cases.