ABSTRACT
Objective:To investigate the imaging features of pancreatic mucinous cystic tumor (MCN) based on the European evidence-based guidelines on pancreatic cystic neoplasms and risk factors influencing tumor property.Methods:The retrospective case-control study was con-ducted. The clinicopathological data of 109 pancreatic MCN patients who were admitted to the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from March 2011 to April 2021 were collected. There were 5 males and 104 females, aged (49±15)years. There were 97 cases with benign tumors and 12 cases with malignant tumors. Observation indicators: (1) clinical characteristics of MCN patients with different tumor properties; (2) imaging features of MCN patients with different tumor properties; (3) multivariate analysis of factors affecting evaluating tumor pro-perties of MCN. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distri-bution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was performed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Statistically significant indicators in clinical and imaging characteristics were included in multivariate analysis. Multivariate analysis was performed by the Logistic regression model forward method. Results:(1) Clinical characteristics of MCN patients with different tumor properties. Gender(male, female), age, body mass index (BMI), cases with clinical symptoms (asymptomatically physical findings, abdominal pain and distension, emaciation, jaundice, pancreatitis, onset diabetes), cases with CA19-9 (<37 U/mL, ≥37 U/mL), cases with carcinoembryonic antigen (<5.0 μg/L, ≥5.0 μg/L), cases with surgical methods (pancreatoduo-denectomy, pancreatectomy of body and tail, segmental pancreatectomy), cases with tumor location (head of pancreas, tail of pancreas) were 4, 93, (47±14)years, (22±3)kg/m 2, 56, 35, 2, 1, 11, 5, 89, 8, 96, 1, 2, 90, 5, 4, 93 in the 97 cases with benign tumors, versus 1, 11, (59±17)years, (23±3)kg/m 2, 4, 4, 1, 0, 3, 2, 5, 7, 7, 5, 0, 12, 0, 0, 12 in the 12 cases with malignant tumors, showing significant differences in age, CA19-9 and carcinoembryonic antigen ( t=?2.69, χ2=22.57, 26.54, P<0.05) and showing no significant difference in gender, BMI, clinical symptoms, surgical methods and tumor location ( P>0.05) between them. (2) Imaging features of MCN patients with different tumor pro-perties. Of the 109 patients with pancreatic MCN, 85 cases underwent computed tomography (CT) plain and contrast-enhanced scan of pancreas, and 81 cases underwent magnetic resonance imaging (MRI) plain and contrast-enhanced scan of pancreas. There were 57 cases underwent both CT and MRI plain and contrast-enhanced scan of pancreas. Cases with tumor location (head of pancreas, tail of pancreas), cases with cyst morphology (circular, lobulated), cases with cyst diameter (<4 cm, ≥4 cm), diameter of cyst, cases with thickening of capsule wall, cases with calcification of capsule wall, cases with enhancing mural nodule of capsule wall, cases with pancreatic duct dilatation were 4, 93, 69, 28, 32, 65, 4.7(range, 3.3?6.8)cm, 38,20, 4, 13 in the 97 cases with benign tumors, versus 0, 12, 7, 5, 4, 8, 6.8(range, 3.3.?9.6)cm, 10, 2, 6, 4 in the 12 cases with malignant tumors, showing significant differences in thickening of capsule wall and enhancing mural nodule of capsule wall ( χ2=6.75, 21.75, P<0.05) and showing no significant difference in cyst morphology, cyst diameter, diameter of cyst, calcification of capsule wall and pancreatic duct dilatation ( P>0.05) between them. (3) Multivariate analysis of factors affecting evaluating tumor properties of pancreatic MCN. Result of multivariate analysis showed that age, carcinoembryonic antigen and mural nodule of capsule wall were independent factors affecting tumor properties of MCN ( odds Ratio=1.09, 19.67, 63.57, 95% confidence intervals as 1.01?1.18, 1.07?361.49, 4.07?993.49, P<0.05). Conclusions:Thickening of capsule wall and enhancing mural nodule of capsule wall are imaging features of patients with pancreatic MCN. Age, carcinoembryonic antigen and mural nodule of capsule wall are independent factors affecting tumor properties of pancreatic MCN.
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The imaging performance and clinical value of contrast-enhanced ultrasonography (CEUS) combined with CT in diagnosis of liver cancer were investigated. A total of 426 liver cancer patients treated in Yuhuangding Hospital (Yantai, China) from February 2011 to May 2016 were selected. Among them, 222 patients underwent CEUS examination, 204 patients underwent CT examination, and 102 patients underwent CEUS combined with CT examination. Sensitivity and specificity of the three methods were examined. CT showed a low density in 92.6% of patients (189 patients) and a high-low hybrid density in 6.4% (13 patients), with calcification seen in 2.5% of patients (5 patients) and bleeding in 3.4% (7 patients). Lesions: 76.5% (156 cases) of patients with multiple type, 23.5% (48 cases) with single type. CEUS showed overall enhancement in 53.2% patients (118 cases), heterogenous enhancement in 16.7% (37 cases), peripheral enhancement in 18.9% of patients (42 cases), necrosis of liquefaction in 11.3% (25 cases). In 65.3% (145 cases) of patients, the portal venous phase and the delayed phase showed a low enhancement, while 34.7% (77 cases) showed no enhancement. The sensitivity and specificity rates of CEUS combined with CT detection of liver cancer were 87.8, 88.2 and 94.1%, respectively. The ROC curve analysis showed that the sensitivity and specificity of CEUS in the diagnosis of liver cancer were 76.8 and 78.9%, respectively. The sensitivity and specificity of CT were 81.2 and 85.5%, respectively. The sensitivity and specificity of CEUS combined with CT were 90.4 and 92.7%, respectively. CEUS combined with CT detection can make-up for the deficiencies of each other and effectively improve the coincidence rate of liver cancer diagnosis, which can be used as an effective examination method for the diagnosis of liver cancer.
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Objective:To evaluate the bone alteration subject to remodeling and analyze the esthetic result following immediate implant placement of incisors.Methods:In this study,20 patients (1 3 women,7 men)were involved,who needed implants for incisors of maxilla.The patients received 23 im-mediate implants totally.On the day of surgery and 6 months after the implants were placed,Cone beam CT (CBCT)was taken.The thickness of the alveolar ridge and the vertical change of marginal bone levels onthe mesial and distal aspects of theimplants were measured using the computer software (Planme-caRomexis Viewer 3.6.0.R).The evaluation of esthetic result by labial convexity score (LCS)and pa-pilla index score (PIS)were analyzed pre-operation and one year after the final crown was delivered.The statistics with paired-t test for the measurement data and Willcoxon test for rating data were done by SPSS 20.0.Results:The survival rate in the two-year follow-up was 1 00%.The measuring point 1 (MP1 ), MP2,MP3 and MP4 (0,2,4,6 mm apical to the implant platform,respectively)got significant altera-tions after 6 months of the follow-up.These differences were statistically significant (P<0.05 ).The major alteration happened at MP1 and MP4,which got (-0.89 ±2.06)mm and (-0.75 ±1 .28)mm reduction of the alveolar,respectively.The marginal alveolar ridge resorption was (-0.42 ±1 .24)mm and(-0.91 ±1 .96)mm for Ankylos System and Replace System,respectively,and the difference was not statistical significant .The esthetic results were quite acceptable.Before treatment,1 8 incisors rated 3 for LCS,and 2 incisors rated 4 for LCS;after final restoration,only 5 incisors rated 3 for LCS,and 1 4 incisors rated 2 for LCS.Before treatment,1 5 incisors rated 3 for PIS;after final restoration,1 3 incisors rated 3 for PIS.There was no statistically significant difference for the PIS pre-operation and 1 year after final restoration,while there was statistically significant negative change for LCS.Conclusion:Even fol-lowing the proper surgical technique,the alveolar ridge wall still can’t be maintained after immediate im-plant placed in fresh socket of incisors.The inter-dental papilla could be well maintained,while due to the remodeling of labial bone,labial convexity will inevitably collapse.Therefore immediate implant still has esthetic risk.
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Aim To investigate the effects of predni-sone on trabecular microstructure and biomechanical properties of femur in a rat model of type II collagen-induced arthritis (CIA ) using micro-CT and biome-chanics.Methods Forty 8-week-old male Lewis rats were randomly divided into 2 groups:control (CON ) group with 6 rats,and the remaining 34 rats were used to establish the CIA model.3 weeks after immunization screening CIA rats were randomly divided into CIA group,CIA plus prednisone 4.5 mg · kg-1 · d -1 group and CIA plus prednisone 9 mg · kg-1 · d -1 group.Rats in CON group were given vehicle as well as in CIA group.Rats in the other two groups were treated with prednisone at 4.5 mg·kg-1 ·d -1 or 9 mg ·kg-1 · d -1 .After 90 days treatment,all rats were euthanized,and the left femur was collected for biome-chanics,micro-CT scanning and three-dimensional re-construction.Results Micro-CT data showed that tra-becular thickness,trabecular number,bone volume/total volume,bone mineral density in CIA group were significantly lower than those in CON group.While tra-becular separation,structure model index were signifi-cantly higher than those in CON group.Compared with CON group,biomechanical properties (elastic load, maximum load,break load and stiffness)were signifi-cantly decreased in CIA group.Compared with CIA group,bone volume/total volume and trabecular num-ber were increased,while trabecular separation was significantly decreased in two prednisone groups.Com-pared with CIA group,there was no significant change in biomechanical properties in two prednisone groups. Conclusions Treatment with prednisone for 3 months can ameliorate the damage of trabecular microstructure of the femur in CIA rats,but it has no effect on biome-chanical properties and bone mineral density.
