MSCT features of gastric schwannoma and misdiagnosis analysis / 实用放射学杂志

Objective To explore the MSCT features,diagnostic values and the misdiagnosis causes of gastric schwannomas.Methods T he CT images,pathological and clinical data of 9 misdiagnosis cases of gastric schwannomas were analyzed retrospectively,which were later confirmed by the operation and pathology.The study examined the CT findings in the following aspects:the lesion location, size,contour,border,growth pattern,enhanced pattern,hemorrhage,necrosis,calcification,and the presence and absence of perirenal lymph nodes.Results The gastric schwannomas were ovoid or round,with well-defined boundaries.Tumors were found in the gastric body in 6 cases(4 cases in the large gastric curvature and 2 in the small gastric curvature),the gastric antrum in 2 cases and the gastric fundus in 1 case.The largest lesion diameters ranged from 2.5 to 7.4 cm,with an average diameter of 3.2 cm.Extracavitary growth was found in 2 cases,intracavitary growth in 2 cases and both intracavitary and extracavitary growth in 5 cases.The density of the tumor was low and evenly distributed,without cystic change,necrosis or calcification.2 cases were found to have ulcer formation. Another 2 cases were found to have enlarged lymph nodes,which were pathologically confirmed to be reactive hyperplasia.In the CT contrast enhancement,mild homogeneous enhancement was found in 4 cases in the arterial phase,but no obvious enhancement was found in the other 5 cases.In the venous phase,all the cases were found to have moderate homogeneous enhancement.4 cases were found to have further enhancement in the delay phase.Conclusion The gastric schwannomas appears to be homogeneous soft tissue mass on the MSCT,with clear boundaries and low-density and without hemorrhagic necrosis or cystic lesions.MSCT examination can help to locate and characterize gastric schwannomas,and to observe the relationship between the tumor and the surrounding tissue structure.

Combined use of MRI and 1 H proton magnetic resonance spectroscopy on the detection of brain metabolites and different brain areas of volume in small for gestational age / 中国小儿急救医学

Objective By 1 H magnetic resonance spectroscopy( 1 H MRS) ,small for gestational age (SGA)and appropriate for gestational age(AGA) as the detection of brain metabolites and MRI plus soft-ware measurement in different brain areas of volume,investigate its cerebral metabolites and the changes of brain in different parts of the volume and significance. Methods Select 88 patients eligible infants, SGA group of 27 cases and AGA group of 21 cases of premature infants;SGA group of 22 cases and AGA group of 18 cases of term infants. Preterm infants with a gestational age of 32 to 36 weeks,term infants with a gesta-tional age of 37 to 41 weeks. Check time between 4 to 7 days old. Calculation of cerebrum volume,cerebellar volume and cerebrospinal fluid volume and intracranial volume,N-acetylaspartic acid(NAA),as 1H MRS area of metabolites measured right frontal choline compounds( Cho) and creatine compounds( Cr) wave,calcu-lation of Cho/Cr and NAA/Cho ratio of NAA/Cr. Results NAA/Cr,the cerebrum volume and intracranial volume of SGA in premature infants group,term infants group and mixed group were 0. 627 ± 0. 183,(2. 831 ±0. 199) ×105 mm3,(3. 178 ±0. 209) ×105 mm3;0. 706 ±0. 139,(3. 056 ±0. 217) ×105 mm3,(3. 411 ± 0. 212 ×105 mm3;0. 708 ± 0. 171,(2. 932 ± 0. 234) × 105 mm3,(3. 282 ± 0. 239) × 105 mm3,respective-ly. NAA/Cr,the cerebrum volume and intracranial volume of AGA in premature infants group,term infants group and mixed group were 0. 734 ± 0. 101,(2. 987 ± 0. 111) × 105 mm3,(3. 347 ± 0. 137) × 105 mm3;0. 805 ± 0. 106, ( 3. 228 ± 0. 284 ) × 105 mm3 , ( 3. 588 ± 0. 306 ) × 105 mm3; 0. 721 ± 0. 119, ( 3. 098 ± 0.240) ×105 mm3,(3.458 ±0.258) ×105 mm3,respectively. The data of SGA group were all lower than those in AGA group,which had significant difference(P0. 05,respectively). In the premature infants groups,the NAA/Cho of SGA group(0. 401 ± 0. 737) was lower than in the AGA group(0. 506 ± 0. 116), which had significant difference(P=0. 000). In the term infants groups,the NAA/Cho of SGA group(0. 483 ±0. 605) was lower than in the AGA group(0. 472 ± 0. 987),which had no significant difference(P =0. 653). In the AGA groups,NAA/Cr,NAA/Cho,cerebellar volume and cerebrospinal fluid volume of pre-mature infants group and term infants group had no significant difference ( P>0. 05 ) . Both of the cerebellar volume and cerebrospinal fluid volume between the premature infants AGA group and premature infants AGA group had no significant difference(P>0. 05). Conclusion Neurons in the brain,the cerebrum volume,the cranial cavity volume and NAA/Cr of SGA was significantly lower than those of AGA,but Cho/Cr,cerebel-lar volume and cerebrospinal fluid volume of SGA and AGA had no significant difference. NAA/Cr in the brain and the cerebrum volume of SGA may be associated with low volume of small nerve mental retarda-tion,worthy of further study.

CT angiography features of the involved arterial branches of the spontaneous isolated superior mesenteric artery dissection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the CT angiography features of the involved arterial branches of the spontaneous isolated superior mesentery artery dissection(SISMAD).</p><p><b>METHODS</b>Clinical and CT angiogram data of 6 patients with SISMAD confirmed by dual source energy CT angiography were analyzed retrospectively. The CT angiography features and prognosis of patients were investigated.</p><p><b>RESULTS</b>Average age of 6 patients was(45.83±5.60) years old. Ten branches of jejunoileal artery were involved in 4 patients. All the dissections of the superior mesenteric arteries(SMA) were extended from its proximal to its end. Intramural hematoma was found in all the involved branches, which showed eccentric target sign in the transverse section and sandwich sign in the longitudinal axial section. In 7 branches of 3 patients, the involved branches originated from the false lumina of the SMA. In one patient, the intramural hematoma of the jejunoileal arteries was found to be completely absorbed in a repeated CT angiography one year late.</p><p><b>CONCLUSIONS</b>For the SISMAD, the involvement of the branches of the SMA may be associated with the extension of the dissection of the SMA. The inflation of the false lumina of the branches is worse than that of the SMA. With the improvement of the dissection of the SMA, the intramural hematoma of the branches can be absorbed. The conservative treatment may be the first choice for SISMAD without emergency.</p>

A study on hepatic perfusion parameter calculation / 生物医学工程学杂志

Hepatic perfusion parameters play an important role in detecting and diagnosing diffusion diseases of liver. Based on a hemodynamic model. In this study, we described a fast and accurate method to calculate the perfusion parameters. First, we used a dual-input one-compartment kinetics model to illustrate the distribution of the contrast agent concentration among the body. Then, we used the Gaussian function to fit the scatter concentration data of portal vein and aorta, to obtain a liver agent concentration on function of time. Finally, we solved the model parameters by using Levenberg-Marquardt algorithm, and calculated the perfusion parameters. The results showed that the method proposed in this study could calculate the parameters precisely, and had a prosperous future application possibility.

The treatment of liver tumor by CT-guided percutaneous radiofrequency ablation / 中国基层医药

Objective To evaluate the therapeutic effcacy with CT-guided percutaneous radiofrequency ablation(RFA)for the liver tumor.Methods 60 cases of patients with a total of 73 lesions were treated with radio-frequency ablation.The diameter of the lesions was 1.4～7.0cm.with a mean diameter of 4.2cm.The therapeutic efficacy was evaluated with enhanced CT scanning and AFP.Results 45 patients of 60 cases with lesions were full damaged,no blood flow Was found on enhanced CT scans.39 patients with significantly increased blood-AFP before treatment were decreased significantly after treatment,Complications occured in 11 patients,including refractory hiccup (n=2),epidermal scald(n=3),intrahepatic hemorrhage(n=2)and hepatic abscess(n=1).Conclusion The radiofrequency ablation was simple and effective treatment of liver tumor.The effect could be similar to that of surgical resection.

Transcatheter uterine artery intervention for placenta increta / 中国介入影像与治疗学

Objective To investigate the method and clinical effect of interventional treatment on placenta increta.Methods Fifteen patients with placenta increta were treated interventionally through uterine artery.and Methotrexate 50-100 mg were superselectively infused.Then gel foam particulate or stripes were used for embolization of uterine artery.The therapeutic effect,prognosis and side effects were observed and analyzed.Results All patients underwent uterine artery embolization (UAE) .One week after UAE,curettage was successfully performed.No heavily hemorrhage nor hysterectomy occurred.Conclusion Transcatheter uterine artery intervention is simple,safe and effective with highly successful rate and has little side effects for the treatment of placenta increta.

Interventional therapy of pseudoaneurysms occurred after surgery / 介入放射学杂志

Objective To summarize the therapeutic results and experience of the interventional managements for pseudoaneurysms occurred after surgery. Methods Five pseudoaneurysms with different location that occurred after surgery in five patients were treated with different interventional managements. One patient suffered from a ruptured pseudoaneurysm of left common iliac artery, which was treated by obstructing the diseased artery with balloon via the abdominal aorta followed by the replacement of vascular prostheses. One patient had a pseudoaneurysm of right subclavian artery and endovascular covered stent was employed to isolate it. The remaining three patients were affected by pseudoaneurysm of terminal arteries and intraarterial embolization with gelfoam and/or steel coils was camed out. Results Complete closing of the pseudoaneurysm was obtained in all five patients and no therapy-related complications occurred. Conclusion Pseudoaneurysms occurred after surgery can be effectively treated with different interventional managements, it is worth popularizing this technique in clinical practice.

Diagnostic Vlaue of Diffusion Weighted Imaging with Background Body Signal Suppression in Tumors of Intestinal Tract / 实用放射学杂志

Objective To estimate the value of diffusion weighted imaging with background body signal suppression(DWIBS)in tumors of intestinal tract and metastasis.Methods 15 cass with tumors of intestinal tract underwent MRI and DWIBS examinations.Four of them underwent CT scan.Results All primary tumors were showed by conventional MR sequences and DWIBS.DWIBS showed that 4 cases had the invasion of placenta percreta,5 cases had transcoelomic metastasis in abdominal cavity and 5 cases had lymphatic metastasis,while the conventional MR sequences showed the invasion of placenta percreta in 10 cases,the invasion of fat interspace in 8 cases,transcoelomic metastasis in abdominal cavity in 3 cases and lymphatic metastasis in 3 cases.Conclusion DWIBS is better than the conventional MR sequences and CT in detecting the primary tumor of intestinal tract,transcoelomic metastasis in abdominal cavity and lymphatic metastasis.However,the conventional MR sequences and CT is better than DWIBS in detecting the invasion of placenta percreta and fat interspace.

Differential Diagnosis of Acute Vertebral Collapse Due to Osteoprosis or Metastasis Tumor in MRI / 中国医师杂志

Objective To analyze and sum up the MRI appearances of osteoporotic acute vertebral collapse(OAVC) or metastatic acute vertebral collapse(MAVC) and evaluate MRI value in both the differential diagnosis .Methods 30 cases of OAVC and 30 cases of MAVC were respectively collected at random according to clinical features,biochemical examinations,conventional radiograghy,and CT scan and all cases were studied with SE,T1-weighted images,gadolinium-enhanced T1-weighted images,and SE,T2-weighted images.Results 11 MRI apperances which were valuable in distinguishing OAVC from MAVC were summed up.Four images suggested that it was OAVC,one of which was specific:retropulsion of a bone fragment of collapsed vertebral body into the spinal canal.Seven images suggested MAVC,four of which were specific:dull-bell shaped body,destruction of pedicles,epidural mass,diffuse high or inhomogeneous signal intensity within the vertebral body on gadninium-enhenced T1-weighted images and T2-weighted images.Conclusion MRI is very useful in the differentiating OAVC from MAVC.

Comparative Study of Acute Cerebral Trauma Between CT and MRI / 实用放射学杂志

Objective To compare the advantages between CT and MRI examination and to evaluate the applied value of diffusion weighted imaging(DWI) in acute cerebral trauma.Methods 54 cases with cerebral trauma were undergone CT and MRI simultaneously,the advantages and disadvantages of both examination were analysed using self-comparative method. Results In showing subarachnoid hemorrhage, ultra-acute cerebral bleeding and bone fracture,CT was better than MRI,but cerebral contusion in 5 cases,laceration of white matter in 5 cases,acute white matter swelling in 2 cases and subdural haematoma in one case were misdiagnosed by CT.DWI was much better to show laceration of white matter and acute cerebral matter swelling than CT and conventional MRI.Conclusion In diagnosing acute cerebral bleeding and bone fracture, CT is better than MRI, for other diagnoses MRI better than CT. DWI should be applied to be a common scan method in diagnose of acute cerebral trauma.

Solitary Pulmonary Nodule:Dynamic Spiral CT Scan of Thin Collimation with Pathology Study / 实用放射学杂志

Objective To evaluate the diagnosis and differentiation of solitary pulmonary nodule (SPN) using dynamic spiral CT scan of thin collimation.Methods The thin collimation no-enhanced CT scan and contrast enhanced scan in 30 seconds,1 minute,1 minutes,2 minutes,5 minutes,10 minutes,and 15 minutes after administration of media 100 ml were performed in 38 cases. Results The mean enhanced CT numbers of lung cancer and inflammatory pseudotumor were much higher than that of tuberculosis(TB) and hamartoma and statistically significant in different time of enhancement;20 HU was the threshold for a positive test,the sensitivity was 100% and the specificity was 96%.In time-attenuation curve analysis,lung cancer reached peak enhancement about 2 minutes,inflammatory pseudotumor in 5 minutes and keep longer enhanced time than that of lung cancer.No marked enhancement in SPN of TB and harmatoma,but ring-shaped enhancement can be seen in some of TB.More valuable imaging signs were found with thin collimation scan and more accurate to measure the CT numbers than traditional scan.Conclusion Dynamic spiral CT scan of thin collimation is a very valuable method for diagnosis and differentiation of SPN.

Diagnosis of Caroli Disease by CT and MRI / 中国医师杂志

Objective To study the value of CT and MRI in diagnosis of Caroli disease. Methods CT and MR findings in 10 patients with histologically proved Caroli disease were retrospectively reviewed. All the patients underwent both liver plane CT and contrast-enhanced CT. Five of 10 patients underwent MR imaging with Flash 2D T_1WI(TR/TE 148/4ms), True Fisp T_2WI(TR/TE 5.8/2.9ms) and MRCP(TR/TE 1120/86ms) sequences. Results The imaging paremeters of Caroli disease were multiple saccular/columnar dilatation of intrahepatic biliary ducts and communication with each other, which only partly were depicted at CT, however, all imaging findings were depicted at MRI True Fisp and MRCP without contrast-enhanced scanning. Of 10 patients, 4 cases were type Ⅰ of Caroli disease with hepatolith, but without hepatic cirrhosis and portal hypertention; 6 cases type Ⅱ,all complicated with hepatic cirrhosis and portal hypertension. Of 6 patients with type Ⅱ Caroli disease, 4 cases had not hepatolith, and 2 cases had hepatolith. Of 10 patients, 3 cases had bilateral sponge kidney. Conclusion Caroli disease could be identified by CT or MRI, but MRI was superior to CT in depicting Caroli disease.