Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series.

BACKGROUND: To evaluate the role of multi-slice spiral computed tomography (MSCT) angiography in the diagnosis of spontaneous isolated visceral artery dissection (SIVAD). METHODS: Twenty-seven patients with abdominal SIVAD were included in the study. The MSCT scans of the patients were subjected to various post-processing techniques to visualize the visceral artery wall. Clinical features including arterial dissection, thrombosis, dissection length, true/false lumen, and complications were recorded. RESULTS: Type I, IIa, and IIb SIVADs were observed in 11, 6, and 10 patients, respectively. Superior mesenteric artery (SMA) dissection was the most common (n = 16), followed by abdominal aortic dissection (n = 6), splenic artery dissection (n = 2), renal artery dissection (n = 2), and splenic artery dissection (n = 1). One patient with SMA dissection suffered small intestine ischemia, 1 with splenic artery dissection had splenic infarction, and 1 patient with left renal artery dissection experienced renal infarction. The false lumen was bigger than the true lumen in 20 patients, with 9 patients having thrombus. The true lumen was bigger than the false lumen in 7 patients. CONCLUSIONS: MSCT angiography is a valuable technique in the diagnosis and treatment of patients with SIVAD. Patients with abdominal pain suspected due to SIVAD should be examined with MSCT angiography for early detection of SIVAD.

A meta-analysis on the diagnostic value of diffusion-weighted imaging on ovarian cancer.

PURPOSE: This study systematically evaluated the potential influences of diffusion- weighted imaging (DWI) on the initial diagnosis, clinical decision making and diagnostic accuracy of ovarian cancer in the follow-up period. METHODS: Literature on the correlation between DWI and diagnosis of ovarian cancer were searched from PubMed, Embase, Cochrane Library, and Web of Science published before January 1, 2019. References in enrolled eligible literature were manually reviewed. Quality assessment on the diagnostic accuracy was performed using the QUADAS scale. Receiver operating characteristics (ROC) curve was depicted using STATA 12.0. Study heterogeneity and its sources were determined. Sensitivity (SEN), specificity (SPF), positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic odds ratio (DOR) of eligible studies were calculated for depicting forest plot and summary of ROC curve (SROC). The area under the curve (AUC) was calculated. RESULTS: A total of 15 articles involving 930 ovarian cancer cases and 832 control cases were enrolled. DWI was identified to exert a certain diagnostic value on ovarian cancer. The 95%CI of the merged SEN (91%, 95%CI=84-95%), SPF (85%, 95%CI=78-90%), +LR (6.18, 95%CI=4.17-9.15) and -LR (4.05, 95%CI=3.30-4.79) were calculated using the random-effects model due to the slight heterogeneity among these studies. AUC was 0.94 (95%CI=0.91-0.96). Subgroup analysis in Asian population obtained the following results: SEN was 85% (95%CI=78-91%), SPF 83% (95%CI=72-90%), +LR 0.18 (95%CI=0.11-0.27), -LR 3.34 (95%CI=2.60-4.09) and DOR 3.34 (95%CI=2.60-4.09); AUC was 0.91 (95%CI=0.88-0.93). In Caucasian population, SEN was 96% (95%CI=83-99%), SPF 89% (95%CI=84-93%), +LR 41.36 (95%CI=5.95-287.48), -LR 0.06 (95%CI=0.02-0.18) and DOR 5.31(95%CI=3.93-6.69); AUC was 0.94 (95%CI=0.91-0.96). CONCLUSIONS: This meta-analysis proved that DWI exerted a relatively high sensitivity and specificity in diagnosing ovarian cancer, especially in the Caucasian population. This conclusion still needs to be further verified in a multi-center study with a large sample size.