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Objective:To investigate the application value of computed tomography (CT) and magnetic resonance imaging (MRI) examination in clinical diagnosis of gallbladder tumor with perigallbladder invasion.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 80 gallbladder tumor patients with perigallbladder invasion who were admitted to 3 medical centers (21 cases in The First Affiliated Hospital of Northwest University, 42 cases in The First Affiliated Hospital of the Air Force Medical University, 17 cases in The First Affiliated Hospital of Dalian Medical University) from January 2021 to December 2022 were collec-ted. There were 45 males and 35 females, aged (56±4)years. Observation indicators: (1) CT and MRI examinations; (2) surgical conditions. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) CT and MRI examinations. Of 80 patients, cases with gallbladder cancer and gallbladder adenoma were 73 and 7, respectively. Cases with endoluminal nodular type, mass type and localized thick-walled type were 33, 39 and 8, respectively, with tumor diameter as 1.55 cm×1.35 cm×1.33 cm, 1.64 cm×1.37 cm×1.36 cm and 5.72 cm×4.07 cm×4.36 cm. Results of CT examination of endoluminal nodular type showed local nodular protrusions into the endoluminal area, and local enhancement on enhanced scanning. Results of CT examination of localized thick-walled type showed the cavity wall of lesion was locally or diffusely irregul-arly thickened, with a thickness of 1.10(range, 1.10-2.21)cm. Of 80 patients, results of CT and MRI examinations showed invasion of liver parenchyma in 68 cases, which was manifested as local mass, blurred demarcation, and abnormal protrusion. The maximum depth was (4.22±0.25)cm, (4.22±0.22)cm, (4.28±0.16)cm of cross-sectional, coronal, sagittal view in CT examination, respectively. The minimum depth was (0.22±0.10)cm, (0.25±0.08)cm, (0.24±0.12)cm. The depth of liver parenchyma invaded was (1.64±1.38)cm, (1.68±1.46)cm, (1.66±1.40)cm. Results of CT and MRI examinations showed invasion of perigallbladder, which was manifested as local invasion of the gastric antrum in 12 cases. (2) Surgical conditions. Of 80 patients, results of CT and MRI examina-tions showed that 60 patients had localized masses in the gallbladder cavity with or without infiltration of surrounding tissues. After confirming the absence of other organs and distant metastasis, cases undergoing radical resection and palliative resection were 44 and 16, respectively. Results of CT and MRI examina-tions showed that 20 patients had malignant gallbladder tumors with peri-pheral liver infiltration and multiple intrahepatic metastases with distant organ metastases, which were unresectable.Conclusion:For patients with gallbladder cancer and perigallbladder invasion, CT or MRI examina-tions can show their structural characteristics.
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In recent years, PET/CT imaging targeting prostate specific membrane antigen (PSMA) has been increasingly used in the diagnosis and treatment of prostate cancer. PSMA PET/CT has high sensitivity, strong specificity and good diagnostic efficiency for primary and metastatic lesions in prostate cancer. It is suitable for staging, restaging and detection of early biochemical recurrence. It is more accurate and comprehensive than conventional imaging methods for detection of occult lymph node and bone metastasis. Moreover, PSMA PET/CT shows good application prospects in tumor localization, radiotherapy biological target contour, efficacy evaluation, and prognosis prediction of prostate cancer, and may become a clinical indication in the future. False positive and false negative are important problems affecting the judgment of imaging. With the continuous accumulation of clinical experience and constant in-depth clinical research, the reporting accuracy will continue to improve.
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Abstract Distal radial fractures are very common. Vicious consolidation can occur in up to one third of these fractures, resulting in wrist pain, restricted movement, and, eventually, physical limitation or disability. The treatment of this condition consists in corrective osteotomy, which requires careful preoperative planning due to its three-dimensional complexity, especially in injuries with joint involvement. Recently, prototyping based on three-dimensional (3D) reconstruction of computed tomography (CT) scans has been used for osteotomy planning in a 3D anatomical model. It allows a better understanding of the deformity in a realistic surgical approach, leading to safer, faster, and more predictable procedures. The aim of the present study is to present this technique and show its use in two clinical cases.
Resumo As fraturas da porção distal do rádio estão entre as mais comuns do esqueleto. A consolidação viciosa pode ocorrer em até um terço dessas fraturas e acarretar restrição de movimento e dor no punho, com consequente limitação ou incapacidade laboral. O tratamento desta condição implica em osteotomia corretiva das deformidades, o que necessita de um planejamento pré-operatório criterioso em virtude de sua complexidade tridimensional, notadamente naquelas em que há acometimento articular. Assim, recentemente, tem sido utilizada a prototipagem a partir da reconstrução 3D da tomografia computadorizada (TC), o que permite o planejamento com realização da osteotomia em modelo anatômico tridimensional, com o melhor entendimento da deformidade, aproximando-se da situação realística da cirurgia, o que torna o procedimento mais seguro, ágil e previsível. O objetivo do presente estudo é apresentar esta técnica e seu emprego em dois casos clínicos.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Osteotomia , Rádio , Tomografia Computadorizada por Raios X , Fraturas Ósseas , Impressão Tridimensional , Modelos AnatômicosRESUMO
[Objective]To investigate the value of multi-phase dynamic enhanced MR scanning with 3D-VIBE sequence in HCC by comparing with enhanced multiple slice computer tomography(MSCT)scanning.[Method]23 patients who were pathologi?cally proven of HCC,and underwent both abdominal enhanced 3.0T MR multi-phase dynamic scanning with 3D-VIBE sequence and enhanced MSCT scanning were enrolled. The enhancement features of HCC on enhanced MR multi-phase dynamic scanning and en?hanced CT scanning were compared.[Results]There were 23 lesions confirmed by pathology. All the 23 lesions were detected by en?hanced MR multi-phase dynamic scanning with 3D-VIBE sequence,and 21 lesions were detected by enhanced MSCT scanning. The enhanced features of"fast enhanced and fast washout"in HCC can be observed more frequently on enhanced MR multi-phase dynam?ic scanning with 3D-VIBE sequence than enhanced MSCT scanning (78.3% vs 54.5%). Obvious enhancement feature can be ob?served more frequently on the enhanced MR multi-phase dynamic scanning when the tumor diameter ≤ 3 cm(P=0.037).[Conclu?sion]The enhanced MR multi-phase dynamic scanning with 3D-VIBE sequence can greatly improve the sensitivity and accuracy of HCC diagnosis,especially for the small HCC(tumor diameter≤3 cm).
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[Objective] To summarize image manifestations in intestinal tuberculosis (ITB) examined by multi-slice computed tomography enteroclysis (MSCT) and evaluate the diagnostic value of MSCTE in ITB,[Methods] The imaging findings were retrospectively analyzed in 15 cases of ITB that were confirmed by endoscopy or postoperative pathologic examination,including the location,number,shape,edge,surrounding tissue alterations of ITB and other associated changes in the peritoneum,mesentery and solid abdominal organs,and compared with endoscopy and pathology.[Results] In 15 patients,ileocecum was involved in 13 cases (87%),4 cases (27%) showed multi-segmental symmetric intestinal mural thickening,9 patients (60%) showed solid masses,1 case (7%) showed multi-segmental symmetric intestinal mural thickening and solid masses,1 case (7%) showed homogenous enhanced masses and perforation,12 cases (86%) showed enlarged lymph nodes (LNs) with rim enhancement,and 2 cases (13%) showed the comb sign of enhanced mesenteric vessels.Based on enhancement pattern of MSCTE,ITB was divided into three types:homogenous enhancement type (n=5);target sign type (n=2);caseous necrosis type (n=2).[Conclusion] The imaging features of ITB are diverse.MSCTE can clearly display the shape of intestinal mucosa,the alterations of intestinal wall and the relationship between lesion and adjacent tissues,which provides valuable information for the clinic diagnosis of ITB.
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BACKGROUND: The sacrococcygeal morphology of Arabs and Europeans has been studied using computed tomography (CT) or magnetic resonance imaging to determine the cause of coccydynia. Studies have suggested differences in sacrococcygeal morphology among ethnic groups. However, there are no data on the sacrococcygeal anatomy of Koreans. METHODS: We conducted a retrospective analysis of 606 pelvic CT scans that were taken at Cheju Halla General Hospital between 2008 and 2014. Fractures of the sacrum or coccyx were excluded. Differences in the sacrococcygeal morphology among age groups stratified by decade of life and between genders were analyzed using sagittal plane pelvic CT scans. The morphological parameters studied were the sacral and coccygeal curved indexes, sacrococcygeal angle, intercoccygeal angle, coccygeal type, coccygeal segmental number, and sacrococcygeal fusion. RESULTS: The average sacral and coccygeal curved indexes were 6.15 and 7.41, respectively. The average sacrococcygeal and intercoccygeal angles were 110° and 49°, respectively. Type II coccyx was most common, and the rate of sacrococcygeal fusion was 34%. There was a moderate positive correlation between age and the sacral curved index (r = 0.493, p = 0.000) and a weak negative correlation between age and the coccyx curved index (r = −0.257, p = 0.000). There was a weak negative correlation between age and the intercoccygeal angle (r = −0.187, p = 0.000). The average intercoccygeal angle in males and females was 53.9° and 44.7°, respectively. CONCLUSIONS: The sacrum tended to be more curved and the coccyx straighter with age. The coccyx was straighter in females than males. Knowledge of the sacrococcygeal anatomy of Koreans will promote better understanding of anatomical differences among ethnicities and future studies on coccydynia.
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Feminino , Humanos , Masculino , Árabes , Povo Asiático , Cóccix , Etnicidade , Hospitais Gerais , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Sacro , Tomografia Computadorizada por Raios XRESUMO
Objective: To investigate the value of positron emission tomography and computer tomography(PET-CT)in determining the target volume for three-dimensional conformal radiotherapy (3D-CRT) of locally advanced pancreatic carcinoma (LAPC), so as to lay a foundation for PET-CT-based precision radiotherapy. Methods: The target volume for 13 confirmed LAPC patients who were referred for radical radiation therapy were delineated on both CT imaging and PET-CT fused imaging. The gross tumor volume (GTV), clinical target volume (CTV), planned target volume (PTV), and received doses in the normal tissues were compared between the two images produced by the two methods. Results: PET-CT image altered GTV and PTV on CT images. For all the 13 patients, the GTVCT versus GTVPET-CT was (57.3±22.9)cm3 versus (68.4±31.7)cm3, CTVCT versus CTVPET-CT was (119.9±38.7)cm3 versus (132.7±47.5)cm3,and PTVCT versus PTVPET-CT was (288.6±52.1)cm3 versus (312.4±79.4)cm3, with significant difference found for all the three parameters (P<0.05). GTV of 6 patients was increased by more than 20%, with an average increase of 36.5%. PET-CT image changed the parameters of dose-volume histograms (DVH). When delivering the same target dose of 60 Gy in 30 fractions, received doses in the normal tissues were different for the two plans created by the two methods, but showing no statistical significance. Conclusion: PET-CT fused imaging can accurately delineate the target volume for 3D-CRT of LAPC while keeping the received doses in the normal tissues within clinically acceptable level, which can help to create better 3D-CRT, but further conclusion still needs larger sample studies.
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Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.
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Objective To establish a function model to modulate the tube current according to the chest circumference at Coronary CTA scan,and to evaluate the feasibility of using the function model individually.Methods Sixty-eight consecutive patients who underwent thoracic scan with automatic current modulation were studied to establish a function model of tube current and chest circumference.The other 64 consecutive patients underwent coronary CTA scan using the new function model.The image quality was scored,and the noise,tube current and radiation dose were recorded and statistically evaluated.Results The POW function model was the best one to adjust tuber current to the chest circumference (R2 =0.691,P < 0.05).The mean image quality score,noise,tube current,radiation dose (CTDIvol) and dose-length product (DLP) were (3.38±0.72) scores,(31.02 ±3.97) HU,(390.63± 89.30) mA,(34.83±10.72) mGy,(751.67 ±175.16) mGy·cm,respectively.Conclusions Tube current modulation based on the chest circumference would be feasible to reduce the radiation dose individually in coronary CT angiography.
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Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21% ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21% ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.
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Giant hiatal hernia (GHH) with intrathoracic stomach is a rare condition. It is a type 3 or mixed hernia (with sliding and paraesophageal component) with more than 30 percent of the stomach protruding into the chest cavity. These hernias are usually associated with gastric rotation, mostly with organoaxial twist. They have nonspecific clinical manifestations, which include vomiting, and chest or epigastric pain. Complications such as volvulus, perforation, or gastric obstruction constitute a medical emergency. In many cases, these hernias can be detected incidentally on a chest radiograph. Imaging studies, mainly multidetector CT and upper gastro-intestinal series represent vital tools for diagnosis and anatomical characterization of these lesions. The treatment of GHH requires an open or laparoscopic surgical approach. We report the case of a patient evaluated in our department who was diagnosed with giant hiatal hernia with intrathoracic stomach and organoaxial gastric rotation.
La hernia hiatal gigante (HHG) con estómago intratorácico es una enfermedad poco frecuente. Corresponde a una hernia tipo 3 o mixta (componente por deslizamiento y paraesofágico) que contiene más del 30 por ciento del estómago a nivel del tórax. Es común que estas hernias se asocien a rotación gástrica, preferentemente del tipo órgano-axial. Sus manifestaciones clínicas son inespecíficas e incluyen vómitos y dolor torácico o epigástrico. Pueden presentar complicaciones como vólvulo, perforación u obstrucción gástrica, constituyendo una emergencia médica. En muchos casos pueden ser detectadas en forma incidental en una radiografía de tórax. El estudio dirigido con imágenes, particularmente tomografía computada multidetector y estudio baritado esófago-estómago-duodeno, resultan fundamentales para el diagnóstico y caracterización de la anatomía de estas lesiones. El tratamiento es quirúrgico, sea por cirugía abierta o laparoscópica. Presentamos el caso de una paciente evaluada en nuestro servicio, en quien se realizó el diagnóstico de HHG con estómago intratorácico, con rotación gástrica órgano-axial.
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Idoso , Hérnia Hiatal/complicações , Hérnia Hiatal , Volvo Gástrico/complicações , Volvo Gástrico , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator (DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run-off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography (MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. METHODS: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age ranged from 30 to 55 years. The CT scan was performed using a 64-slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). RESULTS: One perforator or two major perforators were marked on image in good relation with a hand-held Doppler examination and intraoperative findings. All vascular run-off systems were cleared before operation. CONCLUSION: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial to the patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.
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Feminino , Humanos , Angiografia , Artérias , Artérias Epigástricas , Retalhos de Tecido Biológico , Mamoplastia , Mastectomia , Tomografia Computadorizada Multidetectores , Reto do Abdome , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. METHODS: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. RESULTS: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn't be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. CONCLUSION: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn't be found on CXR to be verified, which helped us to could accurately evaluate patients.
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Humanos , Contusões , Diagnóstico Precoce , Emergências , Hemotórax , Lacerações , Prontuários Médicos , Pneumotórax , Estudos Retrospectivos , Fraturas das Costelas , Enfisema Subcutâneo , Traumatismos Torácicos , Parede Torácica , Tórax , Tomografia por Raios X , Sinais VitaisRESUMO
Although diseases of the parotid gland are relatively uncommon in children, a variety of benign and malignant lesions may occur and the use of imaging is essential for accurate diagnosis and treatment. Ultrasonography (US) is the initial imaging modality utilized for suspected parotid lesions, and its use may suggest a correct diagnosis in an adequate clinical setting. The use of computed tomography (CT) and magnetic resonance imaging (MRI) are useful for the assessment of large and atypical lesions. These modalities also allow the ability to image the deep parotid lobe and to better define the nature of a lesion. CT is the preferred imaging modality for inflammatory processes, including suspected sialolithiasis, abscesses and salivary duct obstructions, whereas MRI is usually used to evaluate tumors due to excellent anatomic resolution and a lack of ionizing radiation exposure, especially in children. This report describes the imaging findings of various parotid gland lesions in children. Familiarity with these findings will aid in lesion characterization and should facilitate optimal clinical management.
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Criança , Humanos , Abscesso , Imageamento por Ressonância Magnética , Glândula Parótida , Radiação Ionizante , Reconhecimento Psicológico , Ductos Salivares , Cálculos das Glândulas Salivares , Tomografia por Raios XRESUMO
Actualmente el sistema de tomografia computarizada Cone-beam(CBTM) puede ser empleada en el mundo médico y odontologico. Este sistema tiene como principio un algoritmo que corrige las deformidades e inestabilidades de las imágenes tomográficas computarizadas posibilitando mejor visualización y mayor exactitud en imágenes de tumores o áreas de interés profesional. Desta forma, el profesional consigue localizar fácilmente, con un minino de error, el local de interés para tratamientos quirúrgicos, radioterápicos y otros, permitiendo un mejor planeamento a sus pacientes
The cone-beam computed tomography (CBCT) has been applied to Dentistry and Medicine all over the world. This system is based on an algorithm which corrects the deformities and instabilities of the tomographic images, providing a more precise visualization of tumors and regions of interest. Therefore, the professional will easily localize, with a minimum degree of mistake, the target for surgical and radiotherapic treatments, among others, and achieve a better treatment plan for the patient
Atualmente o sistema de tomografia computadorizada Cone-beam (CBCT) vem sendo empregado em todo o mundo na Medicina e na Odontologia. Este sistema baseia-se em um algoritmo que corrige as deformidades e instabilidades das imagens tomográficas computadorizadas possibilitando assim visualizar com maior precisão as imagens de tumores ou áreas de interesse para o profissional. Desta forma o profissional consegue localizar facilmente, com mínimo de erro, o alvo de interesse para tratamentos cirúrgicos, radioterápicos, entre outros; permitindo um melhor plano de tratamento aos seus pacientes
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Feminino , Tomografia Computadorizada por Raios X , OdontologiaRESUMO
MDCT has recently been used as a diagnostic tool to evaluate coronary artery stenosis and to detect coronary artery anomalies. The accuracy of MDCT has improved the assessment of stenosis as the number of detectors has increased. In addition to its excellent role in evaluating coronary artery stenosis, MDCT can provide information regarding the left ventricular function without having to perform additional scanning, and the myocardial viability of the left ventricle can be assessed on a delayed scan. MDCT has several disadvantages such as the amount of radiation exposure and the use of an iodine contrast medium, which might cause an adverse reaction, when combined with the reconstruction of the systolic and diastolic phases and the delayed scan. Yet MDCT may provide the opportunity to evaluate the coronary anatomy, the left ventricular function and the tissue characterization in one single imaging session that lasts less than 15 minutes.
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Constrição Patológica , Estenose Coronária , Vasos Coronários , Ventrículos do Coração , Infarto , Iodo , Miocárdio , Perfusão , Tomografia Computadorizada por Raios X , Função Ventricular EsquerdaRESUMO
Objective To study the correlation of supratentorial gliomas and ependymoma between the features of pathology and the characteristic of CT,MRI and provide relevant data for diagnosis and treatment.Methods We analysised 60 patients with gliomas and 40 with ependymoma,contrasted their characteristic of CT,MRI with the features of pathology.Results The feature of irregular appearance,lobulation,tumor wall,tumor tubercle,necrotic cystiform zone,hemorrhage and tumor blood vessels were showed in CT and MRI,which was accord with the alteration of ultrastructure and the expression of tumous label.Conclusion Studying the morphology of supratentorial gliomas and ependymoma may be helpful to raise the veracity of pathologic grading,provide evidence to select treatment,operation and anti-vasoformation of the tumor etc.
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Objective To analyze and compare the imaging features of chromophobe cell renal carcinoma(CCRC)with pathologic findings in order to improve the diagnostic accuracy.Methods The data of CT and MRI of 12 patients with CCRC were reviewed retrospectively.Ten patients underwent CT examination,including precontrast scan,the contrast eortieomedullary phase scan and the parenchymal phase scan(one patient without corticomedullary phase scan).Two patients underwent MR examination including precontrast T_1WI,T_2WI and enhanced T_1WI of the corticomedullary phase and the parenchymal phase.Results Four lesions located in left kidney and eight in right kidney.Maximum diameter of lesions ranged from 24 mm to 125 mm,average 56.7 ram.Homogenous density was observed in six lesions of ten on unenhanced CT scan and five lesions had homogenous enhancement on enhanced CT scan,which was due to the less incidence of necrosis,liquefaction and hemorrhage on pathologic findings.Nine Lesions showed hyperdense compared with renal medulla but the density was lower than renal cortex on the corticomedullary phase.The enhanced degree was positively correlated with microvessel density(MVD).All ten lesions became hypodense compared with renal medulla on the parenchymal phase scan.Central stellate scar was found in two big lesions and psudocapsula were observed in four lesions confirmed by pathology.Two patients underwent MRI examination.Compared with medulla,the two lesions showed hyperintense on unenhanced T_1WI and obviously hypointense on unenhaneed T_2WI.The enhancement pattern of them was similar to CT. Conclusion The imaging features of CCRC,such as homogeneity,special enhancement pattern and distinct hypointensity on T_2WI,help to differentiate CCRC from other renal tumors.
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BACKGROUND: Bronchial asthma is a clinical syndrome characterized by reversiblity of airway obstruction. however, many asthma patients have evidence of residual airway obstruction. It has become evident that the repair of chronic inflammatory process can lead to various irreversible changes. It is generally accepted that the most common cause for change is cigarette smoking but it is controversial whether asthma progresses to emphysema. High resolution computed tomography (HRCT) is more sensitive and more accurate than chest plain films in determining the type and extent of emphysema. This study was carried out to determine whether asthma can be a cause of emphysema without the effect of cigarette smoking and to evaluate clinical characterics in asthma patients with emphysema. METHODS: We studied 58 asthmatic patients with reversible airway obstruction and evaluated the presence of emphysema using HRCT and pulmonary function test. According to HRCT findings, they were divided into 2 groups: Asthma patients with and without emphysema. RESULTS: Of the 58 patients, 7 were judged to have emphysema. (1) 6 asthma patients with emphysema were smokers, but one patient was nonsmoker. (2) Highly significant differences between patients with and without emphysema were found in cigarette smoking (p<0.01), smoking consumption (p<0.01). (3) There was no significant differences in the duration of asthma, age or sex between patients with and without emphysema. (4) There was no significant differences in FEV1 (%), FEV1/FVC (%), diffusing capacity for carbon monoxide (DLco) (%), DLco/alveolar volume between patients with and without emphysema (5) Differences between asthma patients without emphysema and those with emphysema were found to be significant in bronchial wall thickening (p<0.05) and in total Ig E (p=0.07). CONCLUSION: These results indicate that smoking is a main factor to cause emphysema in the patient with asthma.
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Humanos , Obstrução das Vias Respiratórias , Asma , Asma Induzida por Exercício , Monóxido de Carbono , Enfisema , Enfisema Mediastínico , Testes de Função Respiratória , Fumaça , Fumar , Tórax , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Bronchial asthma is a clinical syndrome characterized by reversiblity of airway obstruction. however, many asthma patients have evidence of residual airway obstruction. It has become evident that the repair of chronic inflammatory process can lead to various irreversible changes. It is generally accepted that the most common cause for change is cigarette smoking but it is controversial whether asthma progresses to emphysema. High resolution computed tomography (HRCT) is more sensitive and more accurate than chest plain films in determining the type and extent of emphysema. This study was carried out to determine whether asthma can be a cause of emphysema without the effect of cigarette smoking and to evaluate clinical characterics in asthma patients with emphysema. METHODS: We studied 58 asthmatic patients with reversible airway obstruction and evaluated the presence of emphysema using HRCT and pulmonary function test. According to HRCT findings, they were divided into 2 groups: Asthma patients with and without emphysema. RESULTS: Of the 58 patients, 7 were judged to have emphysema. (1) 6 asthma patients with emphysema were smokers, but one patient was nonsmoker. (2) Highly significant differences between patients with and without emphysema were found in cigarette smoking (p<0.01), smoking consumption (p<0.01). (3) There was no significant differences in the duration of asthma, age or sex between patients with and without emphysema. (4) There was no significant differences in FEV1 (%), FEV1/FVC (%), diffusing capacity for carbon monoxide (DLco) (%), DLco/alveolar volume between patients with and without emphysema (5) Differences between asthma patients without emphysema and those with emphysema were found to be significant in bronchial wall thickening (p<0.05) and in total Ig E (p=0.07). CONCLUSION: These results indicate that smoking is a main factor to cause emphysema in the patient with asthma.