RESUMO
Objective To explore the value of MRS and DWI in diagnosis of cervical spinal cord injury.Methods The MRI plain scan images of 95 cases who suffering from cervical spinal cord injury were analyzed.They were divided into two groups according to the T2 signal of cervical cord,63 cases in Group A(incomplete injury group)with no abnormal on T2 ,32 cases in Group B(complete injury group)with high signal on T2 .The other 50 cases with no injury of cervical cord were recruited as control group (Group C). All the cases were performed with MRS and DWI.The N-acetyl aspartic acid(NAA),choline compounds(Cho)and creatine(Cr)as well as the peak area of lactic acid (Lac)on MRS,and apparent diffusion coefficient(ADC)on DTI were measured separately.Mean-while,NAA/Cho,NAA/Cr,Cho/Cr,Lac/Cho and ADC were analyzed.Results On MRS sequence,the values of NAA/Cho and NAA/Cr were lower in Group B (P <0.05)when compared with Group A.The values of NAA/Cho and NAA/Cr were also lower in Group B,when compared Group C.However,the value of Lac/Cho in Group B was higher than it in Group C(P <0.05).When com-pared Group A with Group C,the value of Lac/Cho only increased in the former.However,on DWI,the value of ADC in Group A was(0.79±0.1 7)×10 -3 mm2/s,lower than that of Group C(0.93±0.1 5)×10 -3 mm2/s (P =0.026);the value of ADC in Group B was(1.21±0.20)×10 -3 mm2/s,significantly higher than that of Group C(P =0.01 7).When compared with Group B,the value of ADC in Group A was a lightly lower (P =0.143)with no statistical significance.Conclusion MRS can noninvasively and quantita-tively reflect the changes of metabolism of medium in injured cervical cord and help characterize the severity and degree of cervical cord injury from metabolic and molecular level.DWI has high sensitivity on early diagnosis of cervical cord injury.The combination of MRS and DWI has important value for formulating reasonable treatment plan and prognostic evaluation.
RESUMO
Objective To study the value of EUS-FNA cytology and fluid carcinoembryonic antigen (CEA) for differential diagnosis of malignant and benign pancreatic cystic lesions.Methods Data of 27 patients who underwent EUS-FNA were reviewed.According to Youden exponent,the optimal cut-off points for cyst fluid CEA were determined by receiver operating characteristic (ROC) curve.Compared with surgical pathology,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of the EUS imaging,cytology as well as cyst fluid CEA were determined.Results Of the 27 cases,14 were diagnosed as benign lesions,13 were diagnosed as malignant or premalignant lesions.The accuracy,sensitivity,specificity,PPV and NPV of EUS imaging were 77.8％ (21/27),69.2％(9/13),85.7％ (12/14),81.8％ (9/11) and 75.0％ (12/16).The accuracy,sensitivity,specificity,PPV and NPV of EUS-FNA cytology were 85.2％ (23/27),76.9％ (10/13),92.9％ (13/14),90.9％ (10/11),and 81.3％ (13/16).The corresponding values of fluid carcinoembryonic antigen under the ROCderived ideal cut-off were 74.1％ (20/27),84.6％ (11/13),64.3％ (9/14),68.8％ (11/16) and 81.8％ (9/11) (CEA ＞ 22.24 ng/ml).Conclusion EUS-FNA cytology is highly accurate and specific for differential diagnosis of malignant and benign pancreatic cystic lesions.Cyst fluid CEA shows better sensitivity.EUS-FNA cytology and cyst fluid CEA analysis can basically meet the requirement of differentiating the benign and (pre)malignant pancreatic cystic lesions.