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Background@#Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. @*Methods@#The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson’s coefficient. @*Results@#The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the P < 0.001), while the ADC values were significantly higher (P = 0.003, P < 0.001, and P = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 (P < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = –0.420, P = 0.037 and r = 0.531, P = 0.006, respectively) was found. @*Conclusions@#DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.
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Objective To explore the changes of serum tryptase(TPS)and interleuk-6 (IL-6)levels before and after TACE treatment in patients with hepatocellular carcinoma (HCC).Methods ELISA was used to detect the serum TPS and IL-6 levels in 5 1 patients with HCC 1 day before and 1 day,1 week and 1 month after TACE.30 healthy people were enrolled as a control group.Results Serum TPS and IL-6 levels in observation group before TACE were higher than those in control group (P＜0.05),and serum TPS level in the observation group was positively correlated with serum IL-6 level (P＜0.05)before TACE.Serum TPS and IL-6 levels in the response group one month after TACE were lower than those one day before TACE (P＜0.05),while compared with those one day before TACE ,the non-response group increased slightly and non significance was showed(P＞0.05).Conclusion Serum TPS and IL-6 levels are closely related to the response of HCC to TACE treatment,thus these may be used to evaluate the efficacy of TACE in treatment of HCC.
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Purpose To synthetically evaluate MR diffusion kurtosis imaging (DKI) using Meta-analysis to differentiate diagnostic value of benign and malignant breast lesions and quantitatively analyze mean kurtosis (MK) values of benign and malignant breast lesions in an attempt to provide evidence-based facts for clinical decision making. Materials and Methods Computer-based retrieval of Chinese and English literatures concerning differential diagnosis of benign and malignant breast lesions with application of DKI publicly published at home and abroad in PubMed, Ebsco, Embase, CNKI, Cochrane Library, CBM, VIP Data database from January. 1, 2006 to September. 30, 2017. Two valuators independently screened and extracted data according to inclusion and exclusion criteria, and drew on QUADAS for quality assessment, Stata 12.0 and Meta-Disc 1.4 software for Meta analysis and extraction of relevant parameters. Results Totally 8 up-to-standard literatures were included, including 3 in English and 5 in Chinese. The total number of focus was 689. Corresponding effect model analysis revealed that MK value in malignant breast lesion group was higher than that in benign lesion group, the difference of which was statistically significant. The optimal diagnostic threshold was determined by the maximum Youden index, which was approximately 0.71 in size,with combined sensitivity of 0.907(95% CI 0.860-0.939),specificity of 0.910(95% CI 0.856-0.945),positive likelihood ratio of 10.053(95% CI 6.293-16.059),negative likelihood ratio of 0.102(95% CI 0.068-0.154),and diagnostic test odds ratio of 98.203(95% CI 55.014-175.296).The area under receiver operating characteristic curve was 0.96.MK value suggested 94% posterior malignant rate of malignant breast lesions, and 13% malignant rate of benign breast lesions. Conclusion MK value has high diagnostic value for benign and malignant breast lesions with good sensitivity and specificity.
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Percutaneous imaging-guided cryoablation (PICA) is a recently developed technique,which applies extreme hypothermia to destroy tumors guided with CT,MRI or ultrasound images.Compared with other oncologic cryoablation therapies,PICA has some advantages,such as treating under local anesthesia,superior monitoring capability on multimodal imaging,less intraoperative and postoperative pain and preservation of tissue collagenous architecture.In recent years,PICA has been used in treatment of tumors in lung,liver,kidney,breast,prostate and so on.In this article,the principle of cryoablation and the application progresses of PICA in oncotherapy were reviewed.
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Photodynamic therapy(PDT)is a new type of minimally invasive treatment in recent years.After the photosensiti-zer is injected into the body for a period of time,it specifically accumulates in the tumor tissue.At this time,the tumor tissue site is ir-radiated with light of a specific wavelength and the photosensitizer occurs photodynamic reaction to kill tumor cells.With the continu-ous progress of endoscopic guidance technology and the emergence of new photosensitizers,PDT has made significant progress in the treatment of gastrointestinal malignancies and the curative effect is remarkable.This article describes the principle of PDT,and focuses on the application of PDT in gastrointestinal cancer for clinical treatment and research as a reference.
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Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.
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Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.
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Objective To discuss the optimalselection of the puncture path in performing CT-guided pericardial drainage,and to evaluate its clinical feasibility and safety.Methods A total of 114 patients with pericardial effusion,who were admitted to authors' hospital during the period from May 2013 to March 2016,were enrolledin this study.The appropriate body position and suitable needle-puncturing route were selected,and CT-guided pericardial drainage with Seldinger'stechnique was performed.Results Successful puncturing and catheter drainage was obtained in all 114 patients,no any serious complication occurred.The time used for manipulation was 18-30 min.Conclusion The use of right puncture path is of great importance for the performance of CT-guided pericardial drainage for pericardial effusion,this technique is highly feasible and safe for relieving the clinical symptoms of pericardial tamponade.
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Objective To evaluate the value of CT guided percutaneous transthoracic needle biopsy (PTNB) for the diagnosis of lung ground‐glass opacity (GGO) with a Meta‐analysis .Methods Relevant English and Chinese language studies were searched on the PubMed ,EMBASE ,EBSCO ,OVID ,CNKI ,CBM ,VIP and WANFANG databases ,respectively .Data were calculated with software of Stata 12 .0 and Meta‐Disc 1 .4 .Results 6 of 82 retrieved studies were included (n=341) .The pooled sensitivity ,specifici‐ty ,LR+ ,LR- ,DOR ,AUC and 95% CI were 0 .92(0 .86-0 .95) ,0 .98(0 .85-1 .00) ,49 .03(5 .72-420 .18) ,0 .08(0 .05-0 .15) , 586 .24(65 .18-5 272 .83) and 0 .99(0 .98-1 .00) ,respectively .Conclusion CT guided PTNB can be used as one of the primary examination modalities for lung GGO with moderate sensitivity and specificity .
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Objective To investigate the recent effect and safety of magnetic resonance guided focused ultrasound (MRgFUS) for treating uterine fibroids with a Meta analysis. Methods Such databases as Cochrane Library,PubMed,EMbase, CBM,CNKI,CQVIP and Wanfang were searched from their establishment. After thestudy selected, assessment and data extraction conducted by two reviewers independently, Meta-analysis were performed by using the Comprehensive Meta-analysis V2 software. The volume of non-perfusion ratio (NPVR), fibroid shrinkage, clinical symptom severity (SSS score) and adverse reactions were analyzed.Results Nighteen retrieved articles were included, with a total of 1 549 patients. The results of Meta-analysis showed that:(1)nonperfused volume ratio (NPVR),Mean=57.1%(95%CI 45.0% —69.2%).(2)Percentage of FBs shrinkage:mean=31.4% (95% CI 29.2% —33.6%).(3)Symptom severity score (SSS):baseline mean=51.00(95%CI 41.61—60.40),3 months mean=32.50 (95%CI 25.90—39.10),6 months mean=28.62(95%CI(23.57—33.66),12 months mean=24.46(95%CI 15.44—33.49), the average of the severity score of the patient symptoms had a tendency to reduce.(4)The degree of adverse reactions were mild and could relieve itself, there was fewer serious adverse reactions. Conclusions The current evidence indicates that MRgFUS in treatment of uterine fibroidsis reliable and safe. MRgFUS can significantly reduce the volume and the symptom severity score ofthe patients.
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Objective To evaluate the value of contrast enhanced MR imaging (CEMRI)for the diagnosis of focal liver lesions with Meta analysis.Methods Relevant English and Chinese language studies were searched on the Pubmed,EMBASE,EBSCO,OV-ID,CNKI,CBM,VIP,WANFANG databases,respectively.Data were calculated with software of STATA 1 1.0 and Meta Disc 1.4. Results 1 7 of 2836 retrieved studies were included,the pooled sensitivity and specificity for CEMRI with 95% confidence interval (95%CI)were 0.85(0.84-0.87)and 0.86(0.84-0.88),respectively,the AUC of SROC was 0.91 6 8.Conclusion CEMRI can be used as one of the primary examination modalities for focal liver lesions with moderate sensitivity and specificity.
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<p><b>BACKGROUND</b>Several previous studies have shown that diffusion-weighted imaging (DWI) can provide additional information for focal pancreatic lesions by demonstrating more restricted diffusion in solid malignant tumors than in chronic pancreatitis, which can be indicated by a decreased apparent diffusion coefficient (ADC). However, these studies have a modest sample size and convey inconclusive results. The aim of this study was to determine, in a meta-analysis, the diagnostic performance of quantitative diffusion-weighted magnetic resonance imaging in distinguishing pancreatic carcinoma from mass-forming chronic pancreatitis.</p><p><b>METHODS</b>We determined the sensitivities and specificities across studies. A summary receiver operator characteristic (sROC) curve was constructed to calculate the area under the curve (AUC).</p><p><b>RESULTS</b>The pooled sensitivity of DWI was 0.86 (95% CI: 0.80-0.91) and the pooled specificity was 0.82 (95% CI: 0.72-0.89). The AUC of the sROC was 0.91 (95% CI: 0.88-0.93).</p><p><b>CONCLUSIONS</b>DWI may be a potentially technically feasible tool for differentiating pancreatic carcinoma from mass-forming chronic pancreatitis. However, large-scale randomized control trials are necessary to assess its clinical value.</p>
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Humans , Diffusion Magnetic Resonance Imaging , Methods , Pancreatic Neoplasms , Diagnosis , Pancreatitis, Chronic , DiagnosisABSTRACT
Objective To assess whether the Couinaud's segmengtation of the liver in transaxial imaging is an accurate indicator of hepatic segment with 16-slice spiral CT hepatic portography and venography.Methods One hundred healthy subjects underwent 16-slice spiral CT hepatic portography and venography.Three-dimensional maximum intensity projection(MIP) and volume rendering(VR) of the portal and hepatic venous structures were created.The portal and hepatic vein branches were observed and the relationship between portal and hepatic veins was evaluated with tracking the branches of portal vein.Results Segmental branches of portal vein supplied correspondingly hepatic segment,and hepatic vein and its branches located between adjacent hepatic segments.Branches of portal vein could cross the adjacent hepatic vein.The boundaries of hepatic segments were not simple straight lines or flat planes.Conclusion Couinaud's segmengtation of the liver in transaxial imaging has limitations.Three-dimension(3D) angiography of portal and hepatic venous systems can be applied to divide hepatic segment accurately.Hepatic segment analyzed by tracking the branches of portal vein is of more clinical value.
