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Objective:To evaluate the role of brain-derived neurotrophic factor-antisense long-chain non-coding RNA (BDNF-AS) in amygdala in the development of neuropathic pain (NP) in rats.Methods:Healthy clean-grade male Sprague-Dawley rats, aged 2 months, weighing 200-260 g, were used to develop NP model via ligation of left L 5-6 spinal nerve, while control group was only subjected to the exposure of L 5-6 spinal nerve without ligation.This study was performed in two parts.Experiment Ⅰ Fifty-six rats were divided into 3 groups by the random number table method: sham operation group (Sham group, n=8), NP group ( n=24) and BDNF ( n=24). In BDNF group, exogenous BDNF was injected into bilateral amygdala at 1, 3, 6, 13 and 20 days after development of the model, with 100 pmol at each side.Eight rats were sacrificed at 7, 14 and 21 days after the model was developed in NP and BDNF groups and after the model was developed in Sham group, the brains were removed, and the amygdala was isolated for determination of the BDNF content (by enzyme-linked immunosorbent assay), the number of BDNF-positive cells (by immunohistochemistry), and expression of BDNF-AS (by real-time quantitative polymerase chain reaction). Experiment Ⅱ Thirty-two rats were divided into 4 groups ( n=8 each) using the random number table method: Sham operation group, NP group, BDNF group and siRNA group.At 1, 3, 6, 13 and 20 days after development of the model, exogenous BDNF 100 pmol and siRNA-BDNF-AS 50 nmol were injected into the amygdala at each side in BDNF group and siRNA group, respectively.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before development of the model (T 0) and at 4, 7, 14 and 21 days after development of the model (T 1-4). After the last behavioral test was completed, the rats were sacrificed, and the spinal cord tissues were collected to measure the contents of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α). Results:Experiment Ⅰ Compared with Sham group, the content of BDNF and the number of BDNF positive cells were significantly decreased, and the expression of BDNF-AS was up-regulated at each time point after development of the model in group NP ( P<0.05). Compared with NP group, the content of BDNF and the number of BDNF positive cells were significantly increased, and the expression of BDNF-AS was down-regulated at each time point after development of the model in group NP ( P<0.05). Experiment Ⅱ Compared with Sham group, MWT was significantly decreased and TWL was shortened at T 1-4, and the contents of IL-1β, IL-6 and TNF-α were increased in NP, BDNF and siRNA groups ( P<0.05). Compared with NP group, MWT was significantly increased and TWL was prolonged at T 1-4, and the contents of IL-1β, IL-6 and TNF-α were decreased in BDNF and siRNA groups ( P<0.05). Conclusions:The mechanism underlying the development of NP may be related to the up-regulation of BDNF-AS expression in amygdala, inhibition of BDNF synthesis and promotion of inflammatory responses in the spinal cord of rats.
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Objective To analyze histomorphometrical characteristics of the bone and bone marrow tissues of the lumbar vertebrae in rabbits with fluoride treatment,and its correlation with signal intensity of MRI.Methods Forty New Zealand albino rabbits aged three months old were randomly divided into fluoride exposure of 30 cases and control of 10 cases,male and female,half each.One hundred milligrams of sodium fluoride were added to the municipal water each liter (fluoride content 100 mg/L) as drinking waterto fluorine for 180 days.Twenty-four of 30 cases with fluoride exposure had complete data (male10 casesand female14 cases).The same municipal water was used as control drinking water (fluoride content < 0.9 mg/L).Eight of 10 cases with control had complete data (male andfemale in half).Twenty-four cases with fluoride treatment and complete data were classified into sensitive and resistant type according to the MRI signal intensity of the lumbar vertebra.Histomorphometrics of the vertebra and its correlation with the MRI signal intensity,and sensitivity in early diagnosis of osteofluorosis and feasibility of susceptibility to osteofluorosis detected with MRI were analyzed.Results Theratios of trabecular bone volume (BV),hematopoietic cell volume (HV) and fluid volume (FV) in bone marrow tissue to total cavernous tissue volume (TT) in group with fluoride treatment were 18.3%±2.6%,45.2%±6.0% and 10.4%±5.7% respectively.These were 14.5%±2.8%,36.3%±7.3% and 6.2%±2.1% in control group respectively.These parameters in fluoride group were significantly increased compared to control group.The ratio 26.0%± 8.0% of adipocyte volume (AV) to TV in fluoride group was significantly lower than that 43.3%±5.6% in control group.Two of 24 cases with fluoride exposure (8.3%,2/24) were sensitive and the remaining 22 (91.7%,22/24) were in resistance.The valuesof BV/TT,HV/TV and FV/TV were considered to be sensitive,resistant and control from large to small,while AV/TV value were opposite.A comparison resuhs of signal intensity in MRI showed that vertebra T1WI contrast to noise ratio (CNR) in the sensitive was the minimum (3.0±0.8),followed by resistance (21.3±3.8) andmaximum in the control (28.3±3.1),but CNR of FsT2WIwas opposite.There were positive associations between T1WI and AV/TV,FV/TV and BV/TV,and between FsT2WI and FV/TV and BV/ TV.There were inverse associationsbetween FsT2WI and AV/TV.Theoptimal threshold value of the vertebra T1WI CNR was 23.2 or lessin early diagnosis of skeletal fluorosis,with sensitivity of 83.3% and specificity of 100%.FsT2WI was 5.7 or more,with sensitivity of 45.8% and specificity of 100%.Conclusion The pathogenesis of osteofluorosis is relative to changes in bone marrow microenvironment and cells number in bone marrow tissue,and is correlated to MRI signal intensity.
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Objective The study the multislice spiral computed tomography (MSCT) characteristics of gastric glomus tumor. Methods The clinical data of 8 patients with gastric glomus tumor were retrospectively analyzed, and the MSCT characteristics were observed. Results Among 8 patients, 3 cases were male and 5 cases were female, and the age was 25-67 years. The diameter of lesions were 1.3-3.5 cm, and lesions situated in the antrum of the stomach. Gastric glomus tumor showed strong enhancement in the arterial phase, and prolonged enhancement during multiphasic scans. Conclusions Gastric glomus tumor has some characteristics in MSCT. The prolonged enhancement during multiphasic scans of the subepithelial lesion should be suspected of the gastric glomus tumor.
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Objective To assess the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of pancreatic neuroendocrine neoplasms (PNEN) and to analyze the factors influencing thepreoperative imaging diagnosis of PNEN.Methods From January 2016 to November 2016, patients with PNEN diagnosed by surgery and biopsy were collected. CT and MRI data of them were analyzed. The CT values or signal intensity of the lesions and the pancreatic parenchyma were measured and the contrast-to-noise ratio (CNR) of the lesion was calculated. Detecting sensitivity and diagnosis accuracy of CT and MRI were compared. Detecting sensitivity of different MRI sequences was also analyzed. Diagnosis accuracy of non-functional PNEN and functional PNEN was compared and analyzed. Lesion CNR was compared between arterial phase and portal venous phase of the contrast enhanced CT. The sensitivity, accuracy and constituent ratio were compared by nonparametric analysis. Independent sample t test and one-way analysis of variancewere performed for the quantitative parameters comparison. Results A total of 54 patients with 56 lesions of PNEN were included for two of whom had two lesions each. CT and MRI were both performed in 44 patients (46 lesions).Detecting sensitivity and diagnosis accuracy of CT were 97.8% (45/46) and87.0% (40/46), respectively. Detecting sensitivity of MRI were 97.8% (45/46) and89.1% (41/46), respectively. There was no significant difference in detecting sensitivity and diagnosis accuracy between CT and MRI (both P>0.05). The CNR of lesion in arterial phase was higher than that of portal venous phase(4.7±3.8 vs 3.4±2.5), and the difference was statistically significant (t=2.949, P<0.05). Detecting rates of T1 weighted imaging with fat suppression (T1WI-FS) image, T2 weighted imaging with fat suppression (T2WI-FS) image, diffusion weighted imagingand dynamic contrast enhanced T1WI-FS image were 90.0% (45/50), 88.0%(44/50), 86.0%(43/50), and 91.7% (44/48), respectively. There was no significant difference in detecting rate among these images sequences (Q=2.526, P=0.510). Tumor diameter in non-functional PNEN was significantly larger than that in functional PNEN ((2.9±1.6) cm vs (1.7±0.7) cm)(t=3.479,P<0.05). The overall diagnosis rate of non-functional PNEN with CT and MRI before operation was 70.8% (17/24), which was significantly lower than that of functional PNEN (100.0%, 31/31) (χ2=10.360,P=0.002).Conclusions CT and MRI are both sensitive in detectingPNEN, and they were two complementary modalities. CT image in arterial phase delineated the lesion better than that in portal venous phase. MRI images with different sequences can becomplementary and there is no significant difference in detecting sensitivity for PNEN among different sequences. CT and MRI play an equal rolein the diagnosis of PNEN before operation. Because of atypical CT and MRI findings, the diagnosis of non-functional PNEN is more difficult thanfunctional PNEN.
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Objective To explore the value of CT spectral imaging in the demonstration of pancreatic ductal adenocarcinoma (PDAC).Methods 113 patients were scanned by CT spectral,and gemstone spectral imaging (GSI) was performed in late arterial phase (AP) and portal venous phase (PP).All diagnosis were pathologically confirmed.The ROIs were placed on the lesion and on the pancreatic parenchyma.The ROI files including the CTmono values and the normalized CTmono values (normalized to pancreatic parenchyma) were saved.The works were performed three times repeatedly.CNR values ranged from 40 keV to 140 keV and the optimal keV in AP and PP were calculated.The differences of CTmono values, normalized CTmono values,and CNR were compared between the optimal keV and 70 keV(equivalent to conventional 120 kVp energy level).Paired t-test and Wilcoxon signed rank test were performed.P<0.05 was considered statistically significant.Results The optimal monochromatic energy of PDAC were 40 keV in both AP and PP.The optimal CNR values(mean±standard) were 2.31±1.02 and 2.38±1.02 in AP and PP,while the corresponding values of 70 keV were 2.08±0.98 and 2.12±0.96.The CNR of 40 keV was higher than that of 70 keV in both AP and PP.The CTmono values of PDAC were (58±13) HU and (71±19) HU at 70 keV and were (111±44) HU and (155±57) HU at 40 keV in AP and PP.The CTmono value in PP was higher than in AP.The median of normalized CTmono values of PDAC at 40 keV were 47.0% and 53.9% in AP and PP, and were lower than those of 70 keV,which were 57.7% and 61.8%.The differences of normalized CTmono values between 40 keV and 70 keV were significant.Conclusion CT spectral imaging manifests that PDAC is hypovascular both in AP and PP and is progressively enhanced form AP to PP.There is maximal conspicuity of tumor in AP, and the optimal monochromatic imaging can improve the conspicuity of PDAC lesion.
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Objective To explore the quantitative characteristics of pancreatic ductal adenocarcinoma(PDAC) in single-source dual energy spectral CT imaging. Methods From January 2013 to December 2014, 113 patients underwent dual phase contrast-enhanced gemstone spectral imaging(GSI) on Discovery CT 750 HD. All diagnoses were pathologically confirmed by surgery or biopsy. The spectral HU curves of PDAC were observed, the monochromatic CT values, the effective atomic number(Zef ), the iodine concentration(IC), water concentration(WC), and the corresponding normalized values(normalized monochromatic CT values, normalized Zef , normalized IC, normalized WC)of the lesion and the pancreatic parenchyma in late arterial phase(AP) and portal venous phase(PP) were recorded . The measurements were performed three times repeatedly. Paired t test (normal distribution) or Wilcoxon test (non-normal distribution) were used for analyzing the differences between the two phases and between PDAC and pancreatic parenchyma. Results The monochromatic CT values of PDAC in AP were lower than in PP at each energy level and the difference was more marked at lower energy. The normalized monochromatic CT values increased with the increase of energy level in both AP and PP and the difference was more distinct at lower energy. The Zef , IC and normalized IC of PDAC all had significant differences(P<0.05), while the WC, normalized Zef , and normalized WC had no difference between AP and PP. The Zef and IC of pancreatic parenchyma had significant differences(P<0.05), while the WC had no difference between AP and PP. The differences of Zef , IC, and WC between PDAC and pancreatic parenchyma were significant in both two phases (P<0.05). Conclusions Dual phase CT spectral imaging showed characteristic quantitative parameters of pancreatic ductal adenocarcinoma. The monochromatic CT values, Zef , and iodine concentration of PDAC were lower than those of pancreatic parenchyma in both AP and PP. The monochromatic CT values, Zef , and iodine concentration of PDAC in late arterial phase were lower than those in portal venous phase. The differences were all more distinct at lower energy.
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Objective To investigate the clinical value of coplanar template-assisted CT guided radioactive seeds implantation in the treatment of pancreatic carcinoma. Methods A total of 22 advanced pancreatic carcinoma patients underwent CT guided radioactive seeds implantation were retrospectively analyzed.Ten patients were treated with coplanar template-assisted with an average age of(65±10)years(48 to 77 years).Tweleve patients were treated without coplanar template assist with an average age of(68±13) years (47 to 84 years). The preoperative planning designs and postoperative dosimetry verifications were performed for all patients.The dose related parameters including D90,MPD,V100,V150and V200were compared between pre and post operation by t test. The operating time were also evaluated between the two groups. Results Overall the 22 patients were treated successfully without serious surgery-related complications. An average of 26 seeds were implanted in the coplanar template assisted implantation group,and 23 seeds were implanted in the non template-assisted implantation group. Preoperative V100in coplanar template group and non template group were(94.45 ± 1.32)% and(93.27 ± 1.37)% separately. Postoperative V100in both groups were(89.31 ± 2.58)% and(85.25 ± 4.35)% separately. Postoperative D90in both groups were (147.32±7.12)Gy and(149.25±4.86)Gy separately.Postoperative V150in both groups were(57.83±7.74)% and(63.97±7.75)% separately.Preoperative D90in both groups were(152.41±6.78)Gy and(153.30±7.79) Gy separately. Preoperative V150in both groups were(58.61 ± 14.11)% and(62.45 ± 6.49)% separately. Postoperative MPD in both groups were(87.64±10.60)Gy and(87.12±7.66)Gy separately.Postoperative V200in both groups were(34.12±7.67)%,(39.42±7.18)% separately.Preoperative MPD in both groups were (82.12±7.81)Gy and(83.43±4.86)Gy separately.Preoperative V200in both groups were(29.04±10.64)%, (36.11 ± 7.22)% separately. Compared with preoperative plans, the mean value of D90and V100decreased while the mean value of MPD and V200increased in postoperative verifications in both coplanar template assist CT guided radioactive seeds implantation group and non template-assisted group.However,there was no significant difference between pre and post operation except for V100(P<0.05). The operating time of coplanar template assist group and non template-assisted group were(44.3±12.4)min and(60.0±12.8)min respectively. The difference of operating time between two groups were statistically significant (P<0.05). Conclusion Compared with the treatment without template assist, coplanar template-assisted brachytherapy could be more accurate in preoperative plans optimization,and shorten the operation time and improve the patients'tolerance.
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Objective To investigate the clinical application value of 3D printing coplanar template in treating pancreatic cancer with 125I seed implantation.Methods Clinical data of 10 patients with pancreatic cancer,who received 3D printing coplanar template-guided 125I seed implantation during the period from January 2016 to June 2017,were retrospectively analyzed.According to preoperative CT scan results and treatment planning system findings,a 3D coplanar template was designed and printed,guided by which percutaneous puncture and 125I seed implantation were conducted.Dosimetric verification was performed after 125I seed implantation.Both preoperative and postoperative 90% dose of target volume (D90),90% target volume of prescription dose (V90),100% target volume of prescription dose (V100) and 150% target volume of prescription dose (V150) were calculated.The success rate of puncture location of 3D printing coplanar template-guided 125I seed implantation was calculated.The coincidence between preoperative dosimetric plan and postoperative dosimetric parameter was assessed,and the complications were recorded.Results Under the guidance of 3D coplanar template,percutaneous puncture and 125I seed implantation were successfully accomplished in all 10 patients with pancreatic cancer.The postoperative dosimetric parameter D90 was consistent with preoperative planning.No statistically significant difference in D90 existed between preoperative value and postoperative one (P>0.05).The postoperative V90,V100 and V150 were (94.3±2.4)%,(90.4±4.1)% and (62.1±13.4)% respectively,which were compliance with therapeutic dosimetry requirements.Local hematoma occurred in one patient after the treatment.Conclusion 3D printing coplanar template appears to be a safe and effective guiding tool,it is very helpful for precise implantation of 125I seeds in treating pancreatic cancer,and with the help of 3D printing coplanar template the postoperative dose parameters will be able to meet the preoperative planning requirements.
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Objective To analyze histomorphometrical characteristics of bone and bone marrow tissue in the vertebral lamina of patients with osteofluorosis, and to explore the influencing factors on signal intensity in MRI. Methods Spinal MRI of 109 patients (57 men, 52 women;age range 32-80 years;mean age 52 years) with osteofluorosis from December 2001 to May 2012 was analyzed retrospectively, including 48 patients in cervical segment, 31 in thoracic segment and 30 in lumbar segment. 36 pa?tients (16 men, 20 women;mean age 51 years;age range 34-68 years) had undergone laminectomy and the vertebral lamina speci?mens were collected. The cervical MRI of 48 patients with matching gender and age (26 men, 22 women;mean age 51 years, age range 34-71 years) was selected as control group, who were from areas where fluorosis is not endemic. All patients were divided in?to vertebra low, medium and high signal groups according to T1WI of MRI. The vertebra signal to noise ratio measure and stan?dardization of signal intensity were performed. Osteosclerosis, osteoporosis and normal bone were differentiated under spinal X?ray plain film. Combined with histomorphometric analysis of vertebra lamina in 36 patients, correlation between MRI signal intensity, histomorphometric parameters of the vertebra lamina and influencing factors on signal intensity were studied. Results 77 pa?tients (70.6%, 77/109) had osteosclerosis indicated by appearance of spine under X?ray, 29 (26.6%, 29/109) osteoporosis and 3 (2.8%, 3/109) normal bone. T1WI of MRI showed 25 cases had low signal vertebra, 52 medium signal and 32 high signal. The ver? tebra SNR in patients with osteofluorosis was lower on T1WI, T2WI and short time inversion recovery (STIR) sequences, compared with control group. Those with a low versus high signal on T1WI had 6.04 times the odds of osteosclerosis (OR=6.04, 95%CI 2.44-14.91, P<0.001). Histomorphometry of vertebral lamina in 36 patients with osteofluorosis was performed, revealing that not only the trabecular bone volume had changed, but also did the adipocyte volume and hemopoietic cell volume in the bone marrow tis?sues. Compared with normal reference values, trabecular bone volume was significantly increased (47.7%± 13.3% vs. 14.7%± 4.3%) (P<0.001);adipocyte volume was significantly decreased (12.3%±9.1%vs. 50.5%±8.7%);hematopoietic cell volume was decreased (40.0%±7.0%vs. 42.5%±8.5%) (P=0.038). There were inverse associations between trabecular bone volume and adipo?cyte volume (r=-0.869, P<0.001), and between trabecular bone volume and T1WI (r=-0.851, P<0.001) found by Pearson correla?tion test. In contrast, there were positive associations between T1WI and adipocyte volume (r=0.927, P<0.001). Conclusion The vertebra T1WI signal intensity is decreased in patients with osteofluorosis, resulting from increase of trabecular bone volume and re?duction of adipocyte volume. The vertebra STIR signal intensity is decreased, mainly caused by increase of trabecular bone volume.
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Objective To discuss the application of spectral CT imaging in evaluating the early therapeutic response of 125I seed interstitial brachytherapy for pancreatic carcinoma in experimental nude mice.Methods BxPC-3 human pancreatic cancer cell xenografts were subcutaneously inoculated at the dorsal part of the limbs in 16 BABL/c nude mice. When the tumor developed to the size of 1-1.5 cm, the tumor-bearing mice were randomly divided into the study group (n=8,receiving implantation of 125I seeds of 1.0 mCi) and the control group (n=8,receiving implantation of ghost shell particles of 0 mCi). Two weeks after the procedure, plain spectral CT scan as well as enhanced multiphase (10 s, 25 s and 60 s) spectral CT scan were performed to obtain multi-phasic image series. The contrast-to-noise ratio (CNR) and iodine concentration (IC) inside the lesions were determined, and the normalized iodine concentrations (nIC) of tumor were thus obtained. Immunohistochemical staining of tumor was used to measure microvessel density (MVD) within the tumor;the correlation between nIC and MVD was analyzed. Results The lesion's nICs measured on each of three phases (10 s,25 s and 60 s) in the study group were lower than those in the control group, the differences were statistically significant (P<0.05). MVD count in the study group was lower than that in the control group, the difference was statistically significant (t=5.957,P<0.01). A parallel linear correlation existed between nIC obtained from each phase of three phases and MVD count (r=0.63,P<0.000 1;r=0.51,P=0.002;and r=0.48,P=0.001 7 for 10 s, 25 s and 60 s phases respectively). Conclusion Spectral CT imaging is an effective method for evaluating the therapeutic effect of 125I seed interstitial brachytherapy for pancreatic carcinoma of experimental mice.
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Objective To investigate changes of the interhemispheric coordination integrity in patients with hemi-parkinsonism using resting-state functional magnetic resonance imaging(rs-fMRI) homotopy technique called voxel-mirrored homotopic connectivity(VMHC).Methods Sixteen Parkinson disease(PD) patients with right body side motor symptom onset(RPD),15 patients with left side onset(LPD),and 19 age-,gender-,and education-matched healthy controls(HC) were included in this study.rs-fMRI scanning and pre-processed the raw data were performed.Then by using analysis of variance(ANOVA) and two sample t tset,we performed VMHC analyses on rs-fMRI data of these participants(P<0.05,corrected with AlphaSim,clusters≥16 voxels).Exploratory linear correlations analyses were performed between the VMHC of regions showing significant group differences and the clinical features of LPD or RPD patients.Results Compared with HCs,patients with LPD had significantly reduced VMHC in visual regions,sensorimotor regions,and the cerebellar cortex(voxels size of 17-77,t=-5.06--3.42,P<0.05).Patients with RPD exhibited decreased VMHC in the prefrontal cortex and sensorimotor regions.Both LPD and RPD groups had increased VMHC in subcortical regions.When compared with the RPD group,the LPD group displayed decreased VMHC in the visual regions,sensorimotor regions(voxels=16 and 18; t=-3.68and-3.87,respectively,both P<0.05) and increased VMHC in the supramarginal gyrus(voxels=4,t=4.72,P<0.05);ROI-based correlation analyses indicated that the VMHC in the inferior occipital gyrus and the postcentral gyrus was negatively correlated with the BDI-Ⅱ scores in the LPD group(r=-0.58 and-0.59,respectively; both P<0.05),and positively correlated with the MMSE scores(r=0.56 and 0.52,respectively;both P<0.05).In the RPD group,a positive correlation was found for the VMHC in the supramarginal gyrus and the illness duration(r=0.56,P<0.05) and for the VMHC in the postcentral gyrus and the(mini-mental state exam) MMSE(r=0.53,P<0.05).Conclusions The differential pattern of deficits in the interhemispheric coordination integrity in hemi-parkinsonism reflected by VMHC may provide insights into the neurological pathophysiology underlying the asymmetry of symptom appearance in PD.
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Objective To compare the image quality and radiation dose of prospective electrocardiogram(ECG)-triggered high-pitch spiral scan,prospectively triggered sequential scan and retrospectively triggered spiral scanning mode by dual-source CT in the follow-up of coronary artery bypass graft(CABG).Methods Totally 90 patients with stable heart rate(≤65 beats per minute)after bypass surgery were randomized to undergo prospective high-pitch spiral scan in group A (n=30),prospective sequential scan in group B (n=30),and retrospective spiral scan in group C (n=30).The patency and image quality of the grafts were blindly evalua-ted by two independent readers.Moreover,radiation dose of the three modes were evaluated.Results Scanning time of group A was significantly shorter than that of group B and group C (P<0.05).The average image quality score had no significant difference among three groups(H=0.449,P=0.799).The effective radiation dose of group A,group B and group C were (2.64±1.21)mSv, (6.48±2.58)mSv and(18.95±7.16)mSv,which was significantly lower in group A(H=101.21,P=0.00).Conclusion In pa-tients with a stable HR of 65 beats per minute or less,high-pitch spiral CT scan provides similar image quality at lower radiation dose compared with sequential scan and retrospective spiral scan,which can be widely used as a non-invasive effective tool for the post-operative follow-up of CABG.
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Objective To retrospectively analyze imaging features of multi-slica computed tomography (MSCT) and clinical characteristics of male patients with pancreas solid pseudopapillary tumor (SPT) and compare with that of female patients.Methods From November 2000 to October 2012,clinical data of 18 male patients and 94 female patients underwent MSCT examination and pathological diagnosed as SPT were retrospectively analyzed.Clinical characteristics and imaging features of MSCT of male and female patients with SPT were analyzed,which included lesion location,size,shape,encapsulation,calcification,internal composition,density and enhancement pattern of tumors.Rank sum test or x2 test was performed for statistical analysis.Results The median age of male patients with SPT was significantly older than that of female patients (39.0 (15.0,67.0) years vs 27.5 (11.0,63.0) years; U=2.865,P =0.005).There were no significant differences in clinical manifestation,lesion location and composition ratio of benign and malignant tumors between male and female patients with SPT (all P>0.05).Imaging of MSCT indicated that the median maximum tumor diameter of male patients with SPT was significantly shorter than that of female patients (5.1 (1.0,11.6) cm vs 7.9 (2.5,18.7) cm; U=3.161,P=0.002).Solid tumors were more common in male patients compared with female patients (9/18 vs 5.3% (5/94) ; x2 =30.606,P<0.01).Conclusions The imaging features of male patients with SPT are different with those of females.For pancreas lesion in males,if imaging of MSCT shows more solid composition,small lesion and with typical enhancement patterns of SPT,the possibility of SPT should be considered.
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BACKGROUND: Interstitial brachytherapy (IBT) has been introduced as treatment for unresectable pancreatic cancers to maximize local dose and minimize irradiation of surrounding normal tissue. MicroPET-CT systems provide excellent anatomic and molecular information. PURPOSE: To use 18F-FDG micro-positron emission tomography (PET)/computed tomography (CT) to evaluate the therapeutic effect of (125)I interstitial brachytherapy on transplantation tumor of human pancreatic carcinoma in Balb/c-nu mice. MATERIAL AND METHODS: Xenograft models were created by subcutaneous injection of Swl990 human pancreatic cancer cell suspensions into the immunodeficient Balb/c-nu mice. The study was randomly divided into three groups: control group (n = 6), empty seed implant group (n = 6), and (125)I seed implant group (n = 6), respectively. Before and 1 week after treatment, 18F-FDG microPET-CT scan was performed. In-vivo cell proliferation and apoptosis were monitored by thymidine kinase 1 (TK1) immunostaining and Dutp-biotin nick end labeling (TUNEL) assay. RESULTS: Our results showed that before treatment the SUVmax and SUVmean values among three groups had no significant statistical difference. One week after treatment the SUVmax and SUVmean in (125)I seed implant group were significantly lower than before, while for the empty seed group and control group there were no significant difference compared with before treatment. Immunohistochemical analysis of tumor tissue revealed significantly less TK1 positive cells in (125)I seed implant group than in empty seed group and control group. The index of apoptosis was slightly higher in (125)I seed implant group than in empty seed group and control group as evaluated by TUNEL assay. CONCLUSION: These results suggest that 18F-FDG microPET-CT may be useful as a non-invasive imaging modality to assess early response to (125)I seed brachytherapy in a pancreatic carcinoma Xenograft.
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Braquiterapia , Imagem Multimodal/métodos , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/radioterapia , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Análise de Variância , Animais , Humanos , Processamento de Imagem Assistida por Computador , Marcação In Situ das Extremidades Cortadas , Radioisótopos do Iodo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Distribuição Aleatória , Transplante HeterólogoRESUMO
This paper describes the design process and implementation process of electronic film system. The establishment of electronic film system allowed us to aggressively reduce film use and costs and to demonstrate a positive return.
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Sistemas Computadorizados de Registros Médicos , Sistemas de Informação em Radiologia , Filme para Raios XRESUMO
Objective To summarize the imaging features of intra-pancreatic accessory spleen (IPAS)with multidetector computed tomography (MDCT) and improve the awareness and correct diagnosis of IPAS.Methods MDCT images of seven consecutive patients with surgically and pathologically confirmed IPAS were reviewed retrospectively.The investigated features included the location,size,shape,margin,density,and enhancement of the lesions.Results Four patients were male and three were female with a mean age of 49 years old.All the lesions were located at the dorsal side of parenchyma under the capsule of pancreatic tail.Three lesions were in round-like shape,and 4 in oval shape and all were well-defined.All the lesions were mass-like without necrosis and calcification.The maximum diameter of lesion ranged from 0.9 ~ 1.8 cm with a mean value of 1.4 cm.Compared with pancreatic parenchyma,the density of lesions were homogeneous on unenhanced CT,in arterial phase,slightly increased heterogeneous density was observed in 3 patients,slightly increased homogeneous density was observed in 4 patients.All the lesions appeared as slightly increased homogeneous density in portal phase.The CT value in unenhanced phase ranged from 50 ~ 61 Hu with a mean number of 55 Hu; and it ranged from 80 ~ 110 Hu with a mean number of 97 Hu in arterial phase; and the corresponding value was from 99 ~ 120 Hu with a mean number of 102 Hu in portal phase.Among the three patients underwent MDCT angiography,neither artery nor vein was compressed or invaded,and there was no vessel connected with lesions.Conclusions IPAS has some MDCT characteristics.For small solid mass in pancreatic tail,if the density and enhancement pattern is similar to that of spleen,the diagnosis of IPAS should be considered.
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OBJECTIVE: This study was designed to compare the clinical effectiveness of intraluminal radioactive stent loaded with iodine-125 seeds implantation versus covered stent alone insertion in patients with malignant esophageal stricture. METHODS: We studied two groups of patients with malignant esophageal stricture. Group A comprised 28 patients (19 men and 9 women) who underwent intraluminal radioactive stent loaded with iodine-125 seeds implantation and were followed prospectively. Group B comprised 30 patients (18 men and 12 women) who had previously received covered stent alone insertion; these patients were evaluated retrospectively. There was no crossover between the two groups during follow-up. Informed consent was obtained from each patient, and our institutional review board approved the study. The dysphagia score, overall survival rates, complication rates, and reintervention rates were compared in the two groups. RESULTS: There were no significant differences between the two groups in terms of baseline characteristics. Stent placement was technically successful and well tolerated in all patients. The dysphagia score was improved in both groups after stent placement. The median survival was significantly longer in group A than in group B: 11 versus 4.9 months, respectively (P < 0.001). The complications of chest pain, esophageal reflux, and stent migration was more frequent in group B, but this difference did not reach statistical significance. There was no statistical difference in reintervention between two groups. CONCLUSIONS: Intraluminal radioactive stent loaded with iodine-125 seeds implantation was a feasible and practical management in treating malignant esophageal stricture and was superior to covered stent alone insertion, as measured by survival.
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Braquiterapia/métodos , Neoplasias Esofágicas/complicações , Estenose Esofágica/terapia , Radioisótopos do Iodo/uso terapêutico , Stents , Idoso , Idoso de 80 Anos ou mais , Cateterismo/métodos , Transtornos de Deglutição/classificação , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/prevenção & controle , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Estenose Esofágica/diagnóstico por imagem , Estenose Esofágica/etiologia , Estenose Esofágica/mortalidade , Feminino , Seguimentos , Refluxo Gastroesofágico/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Dor/etiologia , Radiografia Intervencionista , Recidiva , Estudos Retrospectivos , Stents/efeitos adversos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
In this paper, by describing and comparing different implementations of electronic film combined with the actual application of the electronic film in the imaging department and the clinical departments. We elaborate electronic film for optimizing the imaging department workflow to improve service quality and patient satisfaction and other aspects of value.
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Diagnóstico por Imagem , Sistemas de Informação Hospitalar , Garantia da Qualidade dos Cuidados de Saúde , Inquéritos e Questionários , Filme para Raios XRESUMO
OBJECTIVE: To investigate the value of spectral CT imaging in the diagnosis and classification of liver cirrhosis during the arterial phase (AP) and portal venous phase (PVP). MATERIALS AND METHODS: Thirty-eight patients with liver cirrhosis (Child-Pugh class A/B/C: n = 10/14/14), and 43 patients with healthy livers, participated in this study. The researchers used abdominal spectral CT imaging during AP and PVP. Iodine concentration, derived from the iodine-based material-decomposition image and the iodine concentration ratio (ICratio) between AP and PVP, were obtained. Statistical analyses {two-sample t test, One-factor analysis of variance, and area under the receiver operating characteristic curve (A [z])} were performed. RESULTS: The mean normalized iodine concentration (NIC) (0.5 +/- 0.12) during PVP in the control group was significantly higher than that in the study group (0.4 +/- 0.10 on average, 0.4 +/- 0.08 for Class A, 0.4 +/- 0.15 for Class B, and 0.4 +/- 0.06 for Class C) (All p < 0.05). Within the cirrhotic liver group, the mean NIC for Class C during the AP (0.1 +/- 0.05) was significantly higher than NICs for Classes A (0.1 +/- 0.06) and B (0.1 +/- 0.03) (Both p < 0.05). The ICratio in the study group (0.4 +/- 0.15), especially for Class C (0.5 +/- 0.14), was higher than that in the control group (0.3 +/- 0.15) (p < 0.05).The combination of NIC and ICratio showed high sensitivity and specificity for differentiating healthy liver from cirrhotic liver, especially in Class C cirrhotic liver. CONCLUSION: Spectral CT Provides a quantitative method with which to analyze the cirrhotic liver, and shows the potential value in the classification of liver cirrhosis.
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Variância , Estudos de Casos e Controles , Meios de Contraste , Fígado/patologia , Cirrose Hepática/patologia , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos , Ácidos Tri-IodobenzoicosRESUMO
ObjectiveTo explore the characteristics multi-detector-row computed tomography (MDCT)findings of ACTH-independent macronodular adrenal hyperplasia ( AIMAH ).Methods The un-enhanced and contrast-enhanced MDCT features in 24 patients ( 14 males and 10 females) with clinically confirmed AIMAH were retrospectively assessed for the morphology and enhancement patterns.ResultsThe adrenal glands were involved bilaterally in all of the 24 cases( 100% ).24 patients had massively enlarged multinodular adrenal glands.Nodules were( 1.79 ± 1.02) cm (0.50 ~ 3.85 cm),which usually distorted and completely obscured the normal adrenal glands.The enlarged adrenal glands were still retained the adreniform contour,showed characteristic ginger-like.22 of the 24 ( 91.7 % ) hyperplastic nodular glands demonstrated mild homogeneous enhancement.Calcification was revealed in 1 adrenals ( 1/24,4.2% ).Conclusion MDCT reveals the characteristic morphology and CT attenuation in AIMAH.Combined with its clinical presentation and biochemical findings,AIMAH is able to be diagnosed with high specificity and accuracy on MDCT.