Value of double contrast-enhanced ultrasound QontraXt three-dimensional pseudocolor quantitative analysis to therapeutic effect evaluation of preoperative neoadjuvant chemotherapy in advanced gastric cancer patients / 中华肿瘤杂志

Objective@#To investigate the value of tumor perfusion parameter measured by using double contrast-enhanced ultrasound (DCEUS) QontraXt three-dimensional pseudocolor quantitative analysis to the therapeutic effect evaluation of preoperative neoadjuvant chemotherapy (NAC) in advanced gastric cancer (AGC) patients.@*Methods@#Eighty-nine AGC patients underwent 3 cycles of preoperative NAC (XELOX) followed by complete resection of lesion. The DCEUS QontraXt three-dimensional pseudocolor was performed one or two weeks before the NAC and operation were applied, respectively. The peak enhancement (PE), time to peak (TP), sharpness of the bolus (β) and area under the enhancement curve (AUC) of primary gastric tumor were measured by QontraXt three-dimensional pseudocolor quantitative analysis. These DCEUS parameters between respond and non-respond groups before and after NAC therapy were compared. The prediction accuracy of DCEUS to the therapeutic effect evaluation of preoperative NAC was determined by the receive operating characteristic (ROC) curves.@*Results@#Among 89 AGC patients, 52 patients responded to NAC therapy, while 37 patients resisted to NAC therapy. Twelve cases in respond group and 26 cases in non-respond group were mucinous carcinoma. Forty cases in respond group and 11 cases in non-respond group were non-mucinous carcinoma (P<0.05). In responder group, the PE and TP before NAC were (53.7±9.3)% and (14 521±2 667) ms, and (32.2±5.5)% and (17 235±1 898) ms after NAC. The ratio of changes of PE (ΔPE) and TP (ΔTP) were 0.43±0.17 and 0.36±0.14, respectively. In non-respond group, the PE and TP before NAC were (54.4±7.2)% and (13 869±3 247) ms, and (45.3±6.1)% and (15 127±1 423) ms after NAC therapy. The ratio of ΔPE and ΔTP were 0.24±0.20 and 0.22±0.12. The PE and TP after NAC, the ratio of ΔPE and ΔTP were significant different among these two groups (all of P<0.05). The ROC curves showed that the ratio of ΔPE in assessing the respond of gastric cancer patients to NAC was superior compared to other parameters (AUC=0.784, P=0.004). The optimal cut-off value of the ratio of ΔPE was 24% and its sensitivity and specificity to the therapeutic effect evaluation of NAC in gastric cancer were 82.7% and 64.9%.@*Conclusion@#DCEUS QontraXt three-dimensional pseudocolor quantitative analysis might be a novel, noninvasive and reliable method to evaluate the therapeutic effect of preoperative NAC in AGC patients.

Application of Double Contrast-enhanced Ultrasonography in the Diagnosis of Gastric Cancer / 昆明医科大学学报

Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS) for the diagnosis of gastric cancer.Methods A retrospective analysis was performed to review the DCUS data of 26 patients which were diagnosed as gastric cancer by pathology in the third affiliated hospital of Kunming Medical University from October 2014 to July 2015.The analysis results were compared with postoperative pathology to get accuracy rates.Results The located accuracy,qualitative accuracy and accuracy at T phase of DUCS was 100％ (26/26),100％ (26/26) and 88.5％ (23/26),respectively.Compared with color doppler flow imaging (CDFI),the qualitative accuracy of DUCS was much higher (P ＜ 0.05).The accuracy of DUCS at T phase was higher than that of CDFI with no statistical significance (P ＞ 0.05) Conclusion DUCS has an important application value in the diagnosis of gastric cancer.

Comparison between CT Colonography and Double-Contrast Barium Enema for Colonic Evaluation in Patients with Renal Insufficiency

OBJECTIVE: To compare the CT colonography (CTC) and double-contrast barium enema (DCBE) for colonic evaluation in patients with renal insufficiency. MATERIALS AND METHODS: Two sequential groups of consecutive patients with renal insufficiency who had a similar risk for colorectal cancer, were examined by DCBE (n = 182; mean +/- SD in age, 51 +/- 6.4 years) and CTC (n = 176; 50 +/- 6.7 years), respectively. CTC was performed after colon cleansing with 250-mL magnesium citrate (n = 87) or 4-L polyethylene glycol (n = 89) and fecal tagging. DCBE was performed after preparation with 250-mL magnesium citrate. Patients with colonic polyps/masses of > or = 6 mm were subsequently recommended to undergo a colonoscopy. Diagnostic yield and positive predictive value (PPV) for colonic polyps/masses, examination quality, and examination-related serum electrolyte change were retrospectively compared between the two groups. RESULTS: Both the CTC and DCBE were positive for colonic polyps/masses in 28 (16%) of 176 and 11 (6%) of 182 patients, respectively (p = 0.004). Among patients with positive findings, 17 CTC and six DCBE patients subsequently underwent a colonoscopy and yielded a PPV of 88% (15 of 17 patients) and 50% (3 of 6 patients), respectively (p = 0.089). Thirteen patients with adenomatous lesions were detected in the CTC group (adenocarcinoma [n = 1], advanced adenoma [n = 6], and non-advanced adenoma [n = 6]), as compared with two patients (each with adenocarcinoma and advanced adenoma) in the DCBE group (p = 0.003). Six (3%) of 176 CTC and 16 (9%) of 182 DCBE examinations deemed to be inadequate (p = 0.046). Electrolyte changes were similar in the two groups. CONCLUSION: In patients with renal insufficiency, CTC has a higher diagnostic yield and a marginally higher PPV for detecting colorectal neoplasia, despite a similar diagnostic yield for adenocarcinoma, and a lower rate of inadequate examinations as compared with DCBE.

Radiologia do intestino delgado de cães por meio da técnica de duplo-contraste / Small bowel double-contrast study in dogs

Radiographic exams still the main form to evaluate small bowel in all its extension, and when surveyprojections are not diagnostic, barium series are used although its sensibility can be imitated by filledoverlapped loops, difficulting detailed mucosa visualization. The objective of this study was to adjust anexam technique with intestinal double-contrast, based on techniques used in the human medicine, whichresulted satisfactorily in the demonstration of the mucosal surface in the 30 dogs submitted to the exam.The double-contrast in the lumen was achieved by a combination of a positive contrast medium,recovering the mucosal surface, and a negative filling the lumen. Ambient air and carboximethylcelullosewere the negative contrast medium tested and both were radiographicaly similar.

Artrografia com meio de contraste positivo e duplo contraste na articulação do úmero de cães / Double-contrast and single contrast arthrography in humeral joint of the dogs

A artrografia com duplo contraste é uma técnica de diagnóstico, que prevê a injeção de um meio de contraste positivo (MCP) no espaço articular, seguido de um meio de contraste negativo, a fim de evidenciar lesões nas superfícies articulares e demais estruturas que as compõem. Essa técnica é um procedimento eficaz e minimamente invasivo, já consolidado na medicina humana e na espécie eqüina, com resultados melhores que os obtidos com métodos usuais de diagnóstico. Este trabalho teve como objetivo descrever e avaliar a técnica de artrografia com duplo contraste, aplicada à articulação do úmero de cães, a qual não consta na literatura. O trabalho apresenta a comparação dessa técnica em relação à artrografia com MCP, na avaliação da superfície articular da cabeça do úmero, porção intra-articular do tendão do músculo bíceps e cápsula articular dos 11 cães submetidos ao exame. O duplo contraste no interior da articulação foi obtido pela combinação de meio de contraste positivo à base de iodo, recobrindo as superfícies articulares e os limites capsulares, e um meio de contraste negativo (ar ambiente), preenchendo o espaço intra-articular. As informações coletadas por quatro radiologistas permitiram concluir que, na avaliação da superfície articular da cabeça do úmero, a técnica de artrografia com duplo contraste demonstra uma melhor imagem em relação à artrografia com MCP, porém, na avaliação do contorno da porção intra-articular do tendão do músculo bíceps, a artrografia com MCP produziu uma imagem melhor que a primeira.

The double contrast artrography is a diagnostic method in which positive contrast material (MCP) is injected in the joint space followed by negative contrast in order to outline lesions on the articular surfaces and adjacent structures. This technique is an effective and minimally invasive procedure already consolidated in human medicine as well as in the equine species with better results than the ones achieved by using usual diagnostic methods. In dogs this is not widely applied. The present study aimed to describe and evaluate the double contrast artrography technique applied to the humeral joint of canine species to compare with artrography with MCP in the evaluation of the articular surface of humerus head, intra-articular portion of the biceps muscle tendon, and articular capsule of eleven adult dogs. The double contrast within the joint has been produced by combining a small amount of iodine-based half of positive contrast covering the articular surfaces and capsular limits and a larger amount of a negative contrast filling the intra-articular space. The information collected from four radiologists have allowed to conclude that in the evaluation of the articular surface of the humerus head the double contrast artrography technique determinates a better image than with MCP. In addition, in the evaluation of the outline of the intra-articular portion of the biceps muscle tendon the artrography with MCP produced a better image than with double contrast artrography.

Treatment of posterior shoulder instability with bone block procedure and posterior capsulorrhaphy / 中华创伤骨科杂志

Objective To investigate clinical results of the treatment of posterior shoulder instability in a combined way of bone block procedure and posterior capsulorrhaphy. Methods The double contrast CT arthrography was performed for 5 patients suffering from posterior shoulder instability so as to detect the pathology. The treatments combining bone block procedure and posterior capsulorrhaphy were carried out according to the pathological conditions of bone and soft tissue. Results The double contrast CT arthrography showed posterior bone defects, posterior glenoid labrum tear and enlargement of posterior capsular cavity. After the bone block procedure and posterior capsulorrhaphy, no patients complained shoulder instability in the follow-up of 5 to 38 months. Conclusions Many pathological factors may induce posterior shoulder instability, which should be corrected by an appropriate operation rather than a “standard”method of operation. For patients involving several pathological factors, a combined operation may be needed in order to correct various pathological changes.

Application Value of Aer-barium Sulphate Double Contrast Radiograph in Diagnosis of Digestive Tract Diseases / 医疗卫生装备

Objective To discuss the application value of aer-barium sulphate double contrast radiograph in digestive tract diseases diagnosis. Methods The author analyzed 197 cases' images retrospectively which had positive performance in radiograph and had been clinical defined in our hospital from January to June 2008. Results In all these cases, there are 83 cases origin from mucous membrane which include inflammation, tumor and anabrosis; 24 cases origin below mucous membrane which include interstitialoma, lymphoma and scleroderma; 38 cases mainly changed in the shape, structure and position of organs which include hiatus hernia, Oblique inguinal hernia, diverticulum, malrotation of intestine and megacolon; 29 cases mainly changed in the power and function of organs which include functional disorder of esophagus, mesentery-compressed syndrome funtional disorder of small intestine and irritable colon; 17 cases' performance caused by the factor outside intestinal canal which include mesentery shift, stomach shift and small intestine shift, and other cases which include fistula between esophagus and mediastinum, rectovaginal fistula, foreign body in esophagus and small intestine ascariasis. Conclusion Aer-barim sulphate double contrast radiograph is the best method to diagnose the digestive tract diseases because it has forte as follow: convenient, easy prepared, less painful, large-scale examine limit and reliable diagnosis.

Colonic Diseases:The Comparative Study on Imaging and Colonoscopy / 实用放射学杂志

Objective To study the value of double contrast barium enema(DCBE),colonoscopy and spiral CT in examination of colonic disease.Methods 325 cases with colonic disease underwent DCBE,colonoscope and CT examinations.The detecting rates and the accurate rates in localizing the lesions were compared among these three examinations.Results The detecting rate of lesions by DCBE,colonoscope and CT were 91.1,89.8 and 64.6,respectively,there was no statistical difference between the former two,but there was difference between the former and CT(P

Small Intestinal Quickly Air-Barium Double Contrast Examination with non-intabatton / 实用放射学杂志

Objective To explore a simple and convenient method of small intestine double contrast examination:small intestine double contrast radiography with air-barium by non-tube fast.Methods 130 cases were randomly divided into study group(67) and control group(63).In study group,the enteric-coated capsules to be full of aerogenic powder,barium and cisapride were taken orally by the patients,while in control group,only barium was given orally,and metoclopramide injected by muscle,then the small intestinal air-barium double contrast examinations were performed.Results In the study group,the effect of examinations was satisfactory,ordinary and no effect in 53,12 and 2 cases respectively,and one patients fell because of swallowing difficulty,the total efficiency was 97.02% and the average examination time was(34.63?16.66) minute.In the control group,the effect of examinations was all ordinary and lasted time was(77.12?32.98) minute.These two methods were of remarkable difference in effect and lasted time in statistics(P

Imaging Findings of Gastrointestinal Stromal Tumors / 实用放射学杂志

Objective To investigate the imaging features of gastrointestinal stromal tumors (GIST) and its diagnostic value. Methods The clinical and imaging data of 41 patients with GIST proved by operation and pathology were analysed. Results Tumors located in the stomach in 20 cases, small bowel in 5 cases, rectum in 3 cases, esophagus in 2 cases and extra gastrointestinal sites in 11 cases. There were 27 malignant GIST diagnosed by imageologic examination,of them, 21 mass exceeded 5 cm in diameter, margins were vague, 19 cases had obvious adhesion or directly involved with around tissue,13 cases with obvious necrosis and cystic changes within the mass. 5 cases with metastase focus.Benign GIST in 14 cases, 11 cases were less than 5 cm in diameter, most of them had smooth margin,homogeneous density and symmetrical enhancement effect.Conclusion X-ray gastrointestinal double contrast radiography examination finds easily inside antrum and inside-and-outside antrum type GIST; CT examination offsets deficiency of general gastrointestinal radiography. It is valuable in localizing precisely, judging benign and malignantin, guiding clinical therapy and estimating prognosis for GIST.

A Study Correlation Between X-ray Features and Pathologic Infiltration of Early Gastric Cancer / 实用放射学杂志

Objective To study the relationship between X-ray features and pathologic infiltration of early gastric cancer.Methods 19 cases of early gastric cancer were analyzed, which were proved by pneumobarium double-contrast examination, operation and pathology. Results There were 9 cases of mucosa cancer and 10 cases of submucosa cancer in 19 patients of early gastric cancer certified by operation. The main X-ray features of mucosa cancer were: a lessened flexibility of local wall, indistinct outline, small trivialities became small nodes and small ditches became indistinct, they looked like pomegranate seeds. The main X-ray features of submucosa cancer were: the local wall was stiff, the density was high, there were small filling defects and small irregular niches, the rugae in the zone involved by the tumour became stiff, large even disappear, small trivialities and small ditches were destroyed. The X-ray findings of early gastric cancer had functional changes, abnormal contraction, more liquid in stomach.Conclusion Pneumobarium double-contrast examination is a voluable method for the diagnosis of early gastric cancer.

The Diagnostic Value of Colonoscopy Compared with Colon Double Contrast Radiography to Colon Carcinoma / 实用放射学杂志

Objective To evaluate the value of diagnose of colon carcinoma by colonoscopy and double contrast radiography.Methods The results and data of radiography diagnosis,colonscopy diagnosis,biopsy and post-operation pathology were analyzed retrospectively.Results The rate of accordance by X-ray diagnosis was 85.4%,colonscopy 80.5% and biopsy 84.6%.Conclusion The method of examination of colon double contrast radiography preceeds to colonoscopy examination when the patients were suspected suffering from the right colon or left colon carcinoma accompanying by masses;colonoscopy is the first method of diagnosis to choose when the patients were suspected suffering from carcinoma of sigmoid colon or colon polyps undergoing malignant changes.

Clinical imaging characters of gastric lymphoma and diagnostic significance of different examinations / 中国微创外科杂志

Objective To summarize clinical imaging characters of the gastric lymphoma in gastroscopy and double contrast radiography of upper gastrointestinal tract.Methods We reviewed 24 cases of gastric lymphoma from January 1996 to June 2006 and analyzed their endoscopic and X-ray features,as well as their pathological results.Results The most frequently involved parts were gastric body(75%,18 cases) and antrum(67%,16 cases).The most common changes were: ①ulcer(71%,17 cases),especially multiple shallow ulcers which had different forms;②nodular protuberance(67%,16 cases),sometimes submucous giant protuberance;③giant duplicature(54%,13 cases);and ④involvement spreading along the gastrointestinal tract(21%,5 cases).Conclusions The characters of gastric lymphoma are ulcer,nodular protuberance,giant duplicature,and so on.The combination use of gastroscopy,radiography,endoscopic mucosal resection,endoscopic ultrasound,and laparoscopy is important for definite diagnosis.

A Case af Chronic Cholecystitis Diagnosed with Double Contrast Study of the Gallbladder / 대한소화기내시경학회지

The combined diagnostic modalities using abdominal ultrasound, endoscopic ultrasound and endascopic retrograde cholangiopancreatogram are useful for the diagnosis of gall bladder disease. But, these diagnostic methods have limitations for the detection of early flat-type gallbladder cancer. To cope with these problems, double contrast study of gallbladder disease is being recently used to diagnose the flat-type cancer of gallbladder in Japan. Herein we report a case of chronic cholecystitis confirmed histologically and assisted by double contrast method of gallbladder, which was diagnosed as a gallbladder polyp by abdominal sonogram at first. The method requires the cystic duct cannulation and placement of the catheter to the gallbladder. And then Barium sulfate and CO2 are injected through the catheter. The patient didnt experience any complication during and after this procedure except for hyperamylasemia. After the simple cholecystectomy, he improved completely. In conclusion, double contrast study of gallbladder can be useful in the diagnosis of the gallbladder disease and compensate for the other dignostic tools.

Double Contrast Diagnosis of Small and Micro Gastric Carcinoma at the Beginning of Early Gastric Carcinoma / 实用放射学杂志

Objective:To improve the diagnostic accuracy of double contrast radiography of small and micro gastric carcinoma.Methods:The X-ray findings of small gastric carcinoma(9 cases)and micro-gastric carcinoma(3 cases) proved by surgical pathology were analyzed and compared with pathologic finding.1 misdiagnosed cases and 1 missed cases were analyzed.The double contrast films of acute gastric ulcer were reviewed and differentiated with SGC and MGC.Results:8 cases were examined by the double contrast procedure before gastroscopy,4 were diagnosed small gastric carcinoma,1 was diagnosed micro-gastric carcinoma,1 was misdiagnosed ulcer and 1 was missed,1 was suspected of being carcinoma.4 were examined by the double contrast procedure after gastroscopy,2 were small gastric carcinoma and 1 was micro-gastric carcinoma,which accorded with gastroscopy finding.One of micro-gastric carcinoma missed by gastroscopy was detected by DC.Conclusion:The imaging method of double contrast examination is the most effective one in detecting and diagnosing early gastric cancer.The detecting rate should be obviously increased by combining with gastroscopy closely. [

Application and Study of Simple and Manual Contrast Board in Double Contrast Examination / 医疗卫生装备

Objective To study a simple and manual contrast board in Double Contrast Examination,so as to decrease labor intensity and the X-ray influence to the work staff.Methods The integrated design consisted of two parts:filled gas and oppressive container.The gas and Barium was injected into the large intestine by manual control and its volume may be adjusted casually according to the requirement.Results It is proved in clinical application that the design is reasonable,the structure is simple and the operation is convenient.Conclusion The device makes the relationship between medical staff and patients more harmonious.It worth popularizing.