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Objective To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma.Methods The retrospective and descriptive study was conducted.The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected.There were 40 males and 34 females,aged (46± 8)years,with a range from 32 to 82 years.Among the 74 patients,41 were simple mucinous adenocarcinoma,26 were partial mucinous adenocarcinoma,and 7 were focal or small foci mucinous adenocarcinoma.All patients underwent MRI plain scan and dynamic enhanced scan.Observation indicators:(1) morphology of rectal mucinous adenocarcinoma;(2) the lesion margin of rectal mucinous adenocarcinoma;(3)the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma;(4) internal enhancement features of rectal mucinous adenocarcinoma;(5) timesignal intensity curve of rectal mucinous adenocarcinoma.Measurement data with normal distribution were represented as Mean ±SD,and count data were described as absolute numbers.Results (1) Morphology of rectal mucinous adenocarcinoma:74 patients had different morphological changes.Among the 41 cases of simple mucinous adenocarcinoma,22 were oval,8 were round,and 11 were irregular.Among the 26 patients with partial mucinous adenocarcinoma,15 were oval,8 were round and 3 were irregular.Among the 7 patients with focal or small foci mucinous adenocarcinoma,2 were oval,1 was round and 4 were irregular.(2) The lesion margin of rectal mucinous adenocarcinoma:the lesion margin of 74 patients was mainly unclear and irregular.Among the 41 cases of simple mucinous adenocarcinoma,32 had unclear and irregular margin,7 had clear margin,and 2 had unclear margin combined with fissure.Among the 26 cases of partial mucinous adenocarcinoma,20 had unclear margin combined with fissure,5 had unclear margin and irregular margin,and 1 had clear margin.Among the 7 patients with focal or small foci mucinous adenocarcinoma,5 had unclear or irregular margin,1 had unclear or irregular margin,and 1 had clear margin.(3) The value of ADC of rectal mucinous adenocarcinoma:diffusion weighted imaging of 74 patients showed diffused limited changes.The average ADC value was (1.24 ± 0.23) × 10-3 mm2/s of 41 patients with simple mucinous adenocarcinoma,(0.91±0.42)× 10-3 mm2/s of 26 patients with partial mucinous adenocarcinoma,and (1.07±0.24)× 10-3 mm2/s of 7 patients with focal or small mucinous adenocarcinoma.(4) Internal enhancement features of rectal mucinous adenocarcinoma:74 patients showed delayed heterogeneous enhancement and marginal enhancement.Among 41 cases of simple mucinous adenocarcinoma,24 showed delayed heterogeneous enhancement,17 showed marginal enhancement,and none showed homogeneous enhancement.Among 26 patients with partial mucinous adenocarcinoma,20 showed marginal enhancement,6 showed homogeneous enhancement,and none showed heterogeneous enhancement.All the 7 cases of focal or small foci mucinous adenocarcinoma showed heterogeneous enhancement.(5) Timesignal intensity curve of rectal mucinous adenocarcinoma:74patients showed mainly outflow type in the timesignal intensity curve.Among the 41 cases of simple mucinous adenocarcinoma,22 presented progressive curve,12 presented platform type,and 7 presented outflow type.Among the 26 patients with partial mucinous adenocarcinoma,17 presented outflow type,8 presented platform type,and 1 presented progressive type.Among the 7 patients with focal and small forci mucinous adenocarcinoma,4 presented outflow type,2 presented platform type,and 1 presented progressive type.Conclusions MRI findings show different results for different types of rectal mucinous adenocarcinoma.A correct understanding of the MRI features of different types of rectal mucinous adenocarcinoma is helpful for the classification diagnosis of rectal mucinous adenocarcinoma.
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Objective@#To investigate the application value of magnetic resonance imaging (MRI) in the classification diagnosis of rectal mucinous adenocarcinoma.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 74 patients with rectal mucinous adenocarcinoma who were admitted to Chongqing Traditional Chinese Medicine Hospital from July 2009 and February 2019 were collected. There were 40 males and 34 females, aged (46±8)years, with a range from 32 to 82 years. Among the 74 patients, 41 were simple mucinous adenocarcinoma, 26 were partial mucinous adenocarcinoma, and 7 were focal or small foci mucinous adenocarcinoma. All patients underwent MRI plain scan and dynamic enhanced scan. Observation indicators: (1) morphology of rectal mucinous adenocarcinoma; (2) the lesion margin of rectal mucinous adenocarcinoma; (3) the value of apparent diffusion coefficient (ADC) of rectal mucinous adenocarcinoma; (4) internal enhancement features of rectal mucinous adenocarcinoma; (5) timesignal intensity curve of rectal mucinous adenocarcinoma. Measurement data with normal distribution were represented as Mean±SD, and count data were described as absolute numbers.@*Results@#(1) Morphology of rectal mucinous adenocarcinoma: 74 patients had different morphological changes. Among the 41 cases of simple mucinous adenocarcinoma, 22 were oval, 8 were round, and 11 were irregular. Among the 26 patients with partial mucinous adenocarcinoma, 15 were oval, 8 were round and 3 were irregular. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 2 were oval, 1 was round and 4 were irregular. (2) The lesion margin of rectal mucinous adenocarcinoma: the lesion margin of 74 patients was mainly unclear and irregular. Among the 41 cases of simple mucinous adenocarcinoma, 32 had unclear and irregular margin, 7 had clear margin, and 2 had unclear margin combined with fissure. Among the 26 cases of partial mucinous adenocarcinoma, 20 had unclear margin combined with fissure, 5 had unclear margin and irregular margin, and 1 had clear margin. Among the 7 patients with focal or small foci mucinous adenocarcinoma, 5 had unclear or irregular margin, 1 had unclear or irregular margin, and 1 had clear margin. (3) The value of ADC of rectal mucinous adenocarcinoma: diffusion weighted imaging of 74 patients showed diffused limited changes. The average ADC value was (1.24±0.23)×10-3 mm2/s of 41 patients with simple mucinous adenocarcinoma, (0.91±0.42)×10-3 mm2/s of 26 patients with partial mucinous adenocarcinoma, and (1.07±0.24)×10-3 mm2/s of 7 patients with focal or small mucinous adenocarcinoma. (4) Internal enhancement features of rectal mucinous adenocarcinoma: 74 patients showed delayed heterogeneous enhancement and marginal enhancement. Among 41 cases of simple mucinous adenocarcinoma, 24 showed delayed heterogeneous enhancement, 17 showed marginal enhancement, and none showed homogeneous enhancement. Among 26 patients with partial mucinous adenocarcinoma, 20 showed marginal enhancement, 6 showed homogeneous enhancement, and none showed heterogeneous enhancement. All the 7 cases of focal or small foci mucinous adenocarcinoma showed heterogeneous enhancement. (5) Timesignal intensity curve of rectal mucinous adenocarcinoma: 74 patients showed mainly outflow type in the timesignal intensity curve. Among the 41 cases of simple mucinous adenocarcinoma, 22 presented progressive curve, 12 presented platform type, and 7 presented outflow type. Among the 26 patients with partial mucinous adenocarcinoma, 17 presented outflow type, 8 presented platform type, and 1 presented progressive type. Among the 7 patients with focal and small forci mucinous adenocarcinoma, 4 presented outflow type, 2 presented platform type, and 1 presented progressive type.@*Conclusions@#MRI findings show different results for different types of rectal mucinous adenocarcinoma. A correct understanding of the MRI features of different types of rectal mucinous adenocarcinoma is helpful for the classification diagnosis of rectal mucinous adenocarcinoma.
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Objective:To evaluate the safety and efficacy of high-intensity focused ultrasound (HIFU) ablation for the VX2 liver tumor near the hepatic main blood vessels of rabbits by using dosimetry and magnetic resonance imaging (MRI) and by analyzing path-ological changes and survival. Methods:Rabbits with VX2 liver tumor adjacent to the abdominal aorta were divided into the HIFU (n=32) and control groups (n=20). MRI-guided HIFU was employed for the ablation of the liver tumor in the HIFU group. The ablation vol-ume and the energy efficiency factor (EEF) of the 32 ablated rabbits were further analyzed. MRI and pathology were used to compare the changes in the tumor before and after HIFU. The survival of the animals in the HIFU and control groups was also determined. Re-sults: Both pathology and imaging showed that the rabbit liver VX2 tumor adjacent to the abdominal aorta was completely ablated, with an EEF of (25.72±11.40) J/mm3. The survival rate was significantly higher in the HIFU group than in the control group (P<0.05). Conclusion: HIFU ablation is safe and effective in rabbit VX2 liver tumor near the abdominal aorta. This approach significantly in-creases survival.
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Objective To explore the effect of oxytocin on uterine fibroids treated by ultrasound ablation. Methods Eighty-two single points in 29 uterine fibroids from 26 patients were sonicated with magnetic resonance imaging guided by high intensity focused ultrasound before and after using oxytocin. The required total energy, sonication time required to reach 60 ℃ and the acoustic energy for increasing 1 ℃ of temperature at the single point before and after using oxytocin were compared. Results Before intravenous infusion of oxytocin, the average total sonication energy required to reach 60 ℃ was (5320 ±910) J and it took (21 ±20) seconds for sonicating a single point, the energy required for increasing 1 ℃ was (255 ± 302) J. In contrast, after intravenous infusion of oxytocin, the average total sonication energy required to reach 60 ℃ was (2890 ±325) J, and it took (12 ±7) seconds for sonicating a single point, the energy required for increasing 1 ℃ was ( 126 ± 94 ) J. Those three index all reached statistical difference ( P = 0.002, P = 0.001, P= 0.002, respectively). Conclusion It seemed that Oxytocin could significantly decrease the energy required for ablating uterine fibroids, shorten treatment time and improve the treatment efficiency.
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Objective To explore the relationship between therapeutic dosage of ultrasound ablation in treatment of uterine fibroids and imaging characteristics of bloody supply of uterine fibroids by color Doppler ultrasound imaging. Methods One hundred and forty-two patients with 168 fibroids were treated by ultrasound ablation. Before treatment, bloody supply of fibroids were classified into grade 0 -4 by ultrasonography. Three patients lost follow-up with contrast MRI exam within 1 month after treatment, so 165 fibroids were enrolled in this study. Bloody supplies were 9 fibroids in grade 0, 34 fibroids in grade 1, 35 fibroids in grade 2, 55 fibroids in grade 3 and 32 fibroids in grade 4. After 1 month treatment, the treated area without blood supply and ratio of ablation were measured by contrast MRI to evaluate the efficacy of thermal ablation and compare status of blood supple based different therapeutic dosage. According to International Reditherapy for Society ( SIR ) standard, adverse effect and score of pain were evaluated. Results ( 1) Ratio of ablation based; ratios of ablation were 79% in grade 0, 89% in grade 1, 92% in grade 2, 86% in grade 3, 71% in grade 4. It reached statistical difference when blood supply of grade 0 compared with those of grade 2 and 3 (P ＜ 0. 05 ) and blood supply of grade 4 compared with those of grade 1, 2, 3 ( P ＜ 0. 05). (2) Factor of energy efficiency:factor of energy efficiency were 13.19 J/mm3 in degree 0, 9. 54 J/mm3 in degree 1, 12. 91 J/mm3 in degree 2, 17. 83 J/mm3 in degree 3 and 28. 10 J/mm in degree 4. Factor of energy of ablation in degree 4 was significantly higher than those in degree 1, 2 and 3 blood supply (P ＜ 0. 05). It exhibit the positive relationship between blood supply and factor of energy of ablation ( r = 0. 354 ,P ＜ 0. 01). ( 3 ) Score of pain and adverse effect: nearly 85% ( 120/142 ) patients could tolerate this treatment very well. Those scores of pain were in range of 0 to 4. All patients did not extend their hospitalization and C to F of SIR standard was not recorded. Conclusion blood supply of myoma measured by ultrasound could predict dosage of ultrasound ablation, it could help select indicated well patients.
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The present study was aimed to investigate the pathological changes after magnetic resonance imaging (MRI) guided high intensity focused ultrasound (MRgHIFU) therapy for ablating the liver tissue adjacent to goat portal vein. Fifty goats were involved in this study. Normal liver tissues at 0, 5, and 10 mm distance from portal vein, respectively, were ablated with MRgHIFU. Among the 50 tested subjects, 40 goats were sacrificed immediately after the operations, and the other 10 were sacrificed 7 days after the procedure for pathological examination of the targeted areas and the contiguous portal veins. Coagulation necrosis was observed in all the treated liver tissues. Collagen swelling (CS) and vessel wall fracture (VWF) emerged more frequently in the 0 mm group than that in the 5mm group: CS [0 mm group VS 5mm group = 27/40 (67.5%) VS 7/40 (17.5%), P < 0.05], VWF [0 mm group VS 5mm group = 8/40 (20%) VS 0/40 (0%), P < 0.05]. Seven days after ablation, no portal vein damages (CS and VWF) were observed under light microscope. The results indicated that MRgHIFU could be used to ablate the liver tissue adjacent to goat portal vein effectively, which may cause blood vessel damage when the focus is on the wall of blood vessels (0 mm). However, the pathological results indicated that these damages are reversible.
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Animals , Female , Male , Goats , High-Intensity Focused Ultrasound Ablation , Methods , Liver , Pathology , Magnetic Resonance Imaging , Portal Vein , PathologyABSTRACT
<p><b>UNLABELLED</b>Based on the T-map of MRI, this research sought to address the relationship between the simulated threshold thermal dose of coagulation and actual the coagulation on histological slides. The MR imaging guided HIFU system was used, the parameters of therapeutic transducer were: frequency--1 MHz, diameter--150 mm, and focal length--150 mm. In fresh beef liver tissue in vitro, sonications were delivered at a fixed depth of 20 mm and at varying powers. The temperature-sensitive MR images obtained during the sonications were used to estimate the temperature, and the thermal dosage of each voxel in the target region was calculated. The thermal dosage of each voxel was compared with the reference threshold thermal dosage, so as to calculate the boundary and area of the coagulated tissue. After the exposure, the tissue was dissected along the maximal section of the coagulation necrosis, and the area of the biological focal region was measured.</p><p><b>RESULTS</b>The occurrence of tissue damage correlated well with the equivalent thermal dose calculation based on the T-mapping of MRI, and they share the same variation tendency.</p><p><b>CONCLUSION</b>The equivalent thermal dose calculation based on the T-Map of MRI correlates well with the actual tissue damage, and so an index to predict the threshold for tissue damage in vivo is provided. This index offers improved online control over minimally invasive thermal treatments and increases the security of the therapy.</p>