CT and MRI appearances of peripheral primitive neuroectodermal tumors / 实用放射学杂志

Objective To explore CT and MRI features of peripheral primitive neuroectodermal tumors (pPNET) .Methods CT and MRI findings were retrospectively analyzed in 9 cases with pPNET confirmed by pathology .Of them ,8 patients underwent CT imaging ,and 5 patients underwent MR imaging .Results The lesions occurred in head and neck in 2 cases ,chest in 3 cases ,scrotum in 1 case ,right scapular region in 1 case ,and lower extremity in 2 cases .The lesions were more solitary (7/9) with round ,lobular or irregular shape .The longest diameter was between 1 .6 cm -13 .8 cm ,and the median diameter was 6 .2 cm .8 cases had blurred boundary .On CT plain scanning ,the lesions were mixed density with predominant isodensity .On MR imaging ,the lesions were slightly T1 hypointensity and heterogeneous T2 hyperintensity .Enhancement patterns were varied ,and the common way was mild‐to‐moderate heterogeneous enhancement .3 cases of them were closely associated with bone ,and showed osteolytic bone destruction . Conclusion The CT and MRI features of pPNET has lack characteristics ,CT and MR imaging have some value for localization diagnosis .

Damage control using percutaneous transhepatic biliary drainage in acute cholangitis of severe type secondary to intrahepatic choledocholithiasis / 中华肝胆外科杂志

Objective To study the safety and efficacy of damage control using percutaneous transhepatic biliary drainage (PTBD) in acute cholangitis of severe type (ACST) secondary to intrahepatic choledocholithiasis.Methods The clinical data of 8 patients who received PTBD after hospital admission followed by conventional surgery for ACST when their general condition improved were retrospectively studied.Results All patients received PTBD successfully and the amount of bile drained was 100-400 ml in the first day.The general condition of these 8 patients became better after 24 h and the total bilirubin decreased for about 25-100 mmol/L after 48 h.Three patients with a platelet count of less than 20 × 109/L showed an improved count to more than 50 × 109/L 72 h after PTBD.All patients were operated at different times after the PTBD:2 received T-tube drainage,3 T-tube drainage combined with left hepatectomy,and 3 choledochojejunostomy.Seven patients recovered uneventfully,but 1 developed hepatic failure with the total billurubin rose to more than 200 μmol/L.He was discharged home with the PTBD tube.During the waiting time of 7 days to 3 months before surgery,the tubes were kept patent and no mortality or morbidity such as bleeding,bile leakage,and peritonitis occurred.Conclusions PTBD was a safe and efficacious procedure for patients who were in a serious condition with ACST secondary to intrahepatic choledocholithiasis.It was more likely to be successful as it is minimally invasive and therefore well-tolerented.It reduced the biliary pressure,relieved the ongoing sepsis,and was a good preparatory procedure before any conventional surgery.