Dynamic contrast-enhanced CT and clinical features of sarcomatoid hepatocellular carcinoma.

PURPOSE: To investigate the dynamic contrast-enhanced computed tomography (CECT) features and clinical characteristics of sarcomatoid hepatocellular carcinoma (S-HCC). METHODS: We retrospectively reviewed the CECT data and clinical findings of 13 patients (11 male and 2 female, with an average age of 58.6 ± 11.2 years) with pathologically proven S-HCC, including 9 patients with surgical resection and 4 patients with biopsy examination. All patients underwent CECT scans. Two radiologists reviewed and evaluated general features, CECT features and extratumoral features of each lesions based on a consensus. RESULTS: Among the thirteen tumors, a mean size of 66.7 mm was observed, ranging in diameter from 30 to 146 mm. Seven of thirteen patients had hepatitis B virus (HBV) infection and an elevation of alpha-fetoprotein (AFP) level. Most of cases located in the right lobe of liver (84.6%, 11/13). Nine of thirteen tumors showed lobulated or wavy contours and infiltrative morphology, while eight tumors presented with unclear margin. The tumor textures were mainly heterogeneous for ischemia or necrosis, with solid components dominantly in all cases. Eight of thirteen tumors exhibited "slow-in and and slow-out" dynamic enhancement pattern in CECT, with a enhancement peak in the portal venous phase. Portal vein or hepatic thrombus, adjacent organs invasion and lymph node metastasis were observed in two patients, respectively. Four of thirteen lesions occurred intrahepatic metastasis and hepatic surface retraction respectively. CONCLUSION: S-HCC gengerally seen in elderly male with HBV infection and elevated AFP level. The CT manifestations including: large diameter, frequently hepatic right lobe involvement, lobular or wavy contours, ill-defined margins, infiltrative morphology, obvious heterogeneity and dynamic enhancement pattern of "slow-in and and slow-out" , contributed to the diagnosis of S-HCC. These tumors usually occurred hepatic surface retraction and intrahepatic metastasis.

Diagnostic value of MRI-DWI signal intensity value combined with serum PGI, PGII and CA199 in early gastric cancer.

To explore the diagnostic value of MRI-DWI signal intensity value combined with serum PGI. PGII and CA199 in early gastric cancer. Sixty cases of gastric cancer patients admitted to our hospital from December 2019 to December 2020 were selected as the gastric cancer group and 80 cases of healthy volunteers who underwent physical examination in our hospital during the same period were selected as the healthy group. All the 60 patients underwent MRI-DWI examination, and the pathological diagnosis results were regarded as the gold standard. MRI-DWI images, MRI-DWI signal intensity values of patients with different degrees of gastric cancer differentiation. Serum PGI, PGII and CA199 levels of subjects in the two groups were compared. AUC was used to evaluate the diagnostic value of MRI-DWI signal intensity value combined with serum PGI, PG II and CA199 for early gastric cancer. In the healthy group, T1W1 showed relatively uniform low signal intensity. While T2WI showed no significant increase in signal intensity. In the gastric cancer group. There was diffuse gastric wall thickening, local thickening or mass formation; T1WI and WATS showed slightly lower signal intensity in the lesion area. T2WI, FLAIR and B-TFE showed slightly uneven or moderately increased signal intensity. DWI showed limited diffusion, and the signal intensity increased uniformly or more uniformly, and the range of increase was clear. The signal intensity of MRI-DWI was 89.12 ± 8.14 in patients with low differentiation, 82.17 ± 6.35 in patients with moderate differentiation, and 74.52 ± 4.53 in patients with high differentiation. There were significant differences in the signal intensity of MRI-DWI among the three groups, and the difference was statistically significant (F=12.214, P <0.05). Serum PGI levels of subjects in the gastric cancer group were significantly lower than those in the healthy group, and the levels of PGII and CA199 were significantly higher than that in the healthy group, with statistical significance (P <0.05). The AUC, sensitivity and specificity of MRI-DWI signal intensity value and serum PGI, PGII and CA199 combined indexes in the diagnosis of gastric cancer were significantly higher than those of the independent indexes, with statistical significance (P <0.05). Conclusion: MRI-DWI signal strength value, serum PGI, PGII and CA199 levels are closely related to the occurrence and development of early gastric cancer. The combined detection and diagnosis efficiency is higher, which is helpful to improve the detection rate of early gastric cancer and is worthy of extensive clinical application.

Magnetic resonance features of meningeal solitary fibrous tumors.

The aim of the present study was to investigate magnetic resonance (MR) features of meningeal solitary fibrous tumors (SFTs) in order to improve their recognition. The study retrospectively analyzed MR manifestations in 12 cases of meningeal SFTs confirmed by surgery. The lesions were analyzed in terms of the site of their growth, growth mode, morphology, size, changes in the MR signal and the edge of the focus. The tumors were malignant in 3 cases, benign in 7 cases and borderline in 2 cases. A total of 3 cases spanned the tentorium cerebelli, 3 spanned the falx and another case was close to the falx. Overall, 4 superficial tumors were accompanied by adjacent bony destruction. One case was located at the triangular area created by the right lateral ventricles. The tumors were all lobular, with a large diameter and more cystic areas in the center of the focus. The signals were often heterogeneous. The parenchyma in the tumors was significantly enhanced. For certain tumors, the signal was usually inhomogeneous and not uniform. The MR features of a SFT were often similar to other intracranial tumors and easily misdiagnosed. There were certain innate characteristics, for example, the tumor was often a solitary large soft-tissue mass with an irregular edge and a clear boundary, with a lobulated contour, and was widely involved with other tissues. The tumors often grew across either the falx or tentorium cerebelli. A significantly inhomogeneous signal was found and either a low or low-high mixed signal on T2-weighted images in particular. These features are useful for the differential diagnosis of SFTs and other tumors.

[CT manifestations of the thymic carcinoid and literature review].

OBJECTIVE: To investigate the CT manifestations of thymic carcinoid and assess the diagnostic value of CT for this disease. METHODS: CT and clinical findings of 5 patients (4 males and 1 female, average age 41 years) with histologically confirmed thymic carcinoid were retrospectively analyzed. RESULTS: The clinical findings of the 5 patients showed no specificity, and none of the patients presented with carcinoid syndrome. The tumors were relatively large (mean size on the largest planar of 11.7 cm x 7.6 cm) with heterogeneous density, and showed necrosis or cystic degeneration in the tumor. The lesions showed uneven enhancement in contrast-enhanced imaging and displayed linear enhancement of the blood vessels in the tumors in 3 cases with unclear tumor margins. The adjacent major vessels were displayed in 4 cases (the superior vena cava in 2 and brachiocephalic vein in 4 cases), and 5 showed mediastinal and/or root of the neck lymphatic metastasis. None of the cases have lung or other site metastasis. CONCLUSION: The CT findings of the thymic carcinoid have some characteristics, and can be helpful in the diagnosis.

[Correlation between magnetic resonance imaging findings and proliferating cell nuclear antigen expression in peripheral lung cancer].

OBJECTIVE: To study the correlation between magnetic resonance imaging (MRI) findings and proliferating cell nuclear antigen (PCNA) expression in peripheral lung cancer. METHODS: The expression of PCNA was detected by means of SABC immunohistochemistry in 45 cases of surgically and pathologically confirmed peripheral lung cancer. The correlation between PCNA expression in the tumors and the MRI findings was analyzed. RESULTS: PCNA expression was correlated to the differentiation, tumor size, lobulation, and mediastinal lymph node metastasis of the tumors (P<0.05), but not to the histological type, clinical stage, pleural retraction, spiculation, or signal feature. CONCLUSION: Correlations are found between MRI findings of lung cancer and abnormal expression of PCNA.

[Role of 16 slices spiral CT angiography with 3-dimensional CT and CT virtual endoscopy in detecting blood supply of lung carcinoma].

BACKGROUND & OBJECTIVE: Angiography, a common method in evaluating blood supply of lung carcinoma, is invasive and complicated, with low success rate for bronchial artery, and could not assure to show all supply blood vessels at a time. This study was to explore clinical value of 16 slices spiral CT angiography with 3-dimensional CT (3DCT) and CT virtual endoscopy (CTVE) in diagnosing and evaluating supply blood vessels and blood supply of lung carcinoma, so as to find a non-invasive, safe, simple and effective method in diagnosing blood supply of lung carcinoma. METHODS: A total of 72 patients with pathologically proved lung carcinoma underwent 16 slices spiral CT angiography with 3DCT. Volume rendering (VR), maximum intensity projection (MIP), and surface shaded display (SSD) of supply blood vessels of lung carcinoma were used as 3DCT models. CTVE of bronchial artery was performed in 25 patients. Color VR of tumor lesion was performed in all patients. RESULTS: Supply blood vessels were showed in 68 patients, 59 of them showed only bronchial artery, 5 showed intercostals arteries, and 4 showed mixed types, including bronchial artery, intercostals arteries, or branch arteries of subclavian artery. The bronchial artery entered into enlarged mediastinal lymph nodes in 4 patients. CTVE well displayed the orifice and lumen of bronchial arteries in the 25 patients. The extent of red color of tumor lesion on VR color image were divided into 4 types: no color (n=11), light red (n=17), moderate red (n=32), and heavy red (n=12); the added CT values of tumor lesion after enhanced CT were (6.16+/-2.23) Hu, (15.71+/-3.13) Hu, (25.47+/-2.71) Hu, and (44.31+/-19.68) Hu, respectively. The corresponding rate between enhanced type and distributive type of red color on color VR was 86.1%. CONCLUSIONS: The 16 slices spiral CT angiography with 3DCT and CTVE could show clearly supply blood vessels and blood supply of lung carcinoma. It is a non-invasive, simple and effective method in evaluating and diagnosing blood supply of lung carcinoma.

[CT findings of ischemic infarction in relation to neuronal damage in rabbits].

OBJECTIVE: To explore the early changes in CT findings of ischemic infarction in relation to neuronal damage in rabbits. METHODS: Thirty-two rabbits were divided into control group and experiment groups and scanned with CT 2, 4, 8, 12, 18, 24, and 36 h after ischemic cerebral infarction induced by PVA embolization of the middle cerebral artery (MCA), respectively. The brain specimen were stained with HE, Nissle and TUNEL techniques for pathological examination. RESULTS: In stage I (2-8 h after MCA occlusion) by CT staging, the neurons exhibited ischemic change followed by cell edema. A small number of TUNEL-positive cells were found in the basal ganglia and cortex. In stage II (12-18 h after MCA occlusion), neuronal swelling and lysis were observed with greater number of TUNEL-positive neurons in the basal ganglia and cortex. In stage III ( 24-36 h after MCA obstruction), cerebral edema became obvious and ischemic cores were distinct, with numerous necrotic neurons seen and destruction of the cell structure. Numerous TUNEL-positive cells were seen in the ischemic penumbra and cortex. CONCLUSION: The damaged neurons after ischemic cerebral infarction showed varied morphology including cell edema, apoptosis, necrosis, and necrosis-apoptosis continuum. CT manifestations are strongly associated with the progression of ischemia and the pathological changes.

[The value of three-phase pulmonary helical CT in diagnosing peripheral pulmonary cancer (diameter

OBJECTIVE: To evaluate the value of three-phase pulmonary helical CT in diagnosing peripheral pulmonary cancer (diameter

[Helical dual-phase CT scan in evaluating blood supply of primary heptocellular carcinoma after transcatheter hepatic artery chemoembolization with lipiodol].

OBJECTIVE: To evaluate the blood supply of low density viable area of primary heptocellular carcinoma after transcatheter hepatic artery chemoembolization using lipiodol (LP-TACE), by helical dual-phase CT scanning and three dimensional CT (3DCT). METHODS: Thirty-four patients with primary heptocellular carcinoma after LP-TACE were examined by hepatic helical dual-phase CT. 3DCT model of the maximum intensity projection (MIP), surface shaded display (SSD) reconstruction of the hepatic artery and portal vein were simultaneously done in 5 cases. RESULTS: Viable tumor areas of 34 cases of primary heptocellular carcinoma after LP-TACE were divided into four types: peripheral, lateral, central and diffused types. Enhanced tumor vessel or tissue in viable tumor area was found during hepatic dual-phase in 17 cases, during hepatic artery-phase only in 8 and hepatic portal vein-phase only in 3. The viable tumor areas were found to have blood supply from the hepatic vein in 2 cases. The viable tumor area unenhanced during hepatic dual-phase was found in 6 cases. In 5 cases, the relation between the viable tumor area and branches of hepatic artery and portal vein was showed by MIP and SSD of hepatic artery and portal vein. CONCLUSION: Hepatic helical dual-phase CT scan with 3DCT is effective in evaluating the blood supply of viable tumor areas and the therapeutic effect of primary heptocellular carcinoma after LP-TACE.