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Heart transplantation is the main treatment of end-stage heart failure. With the advancement of heart transplantation and rational use of postoperative immunosuppressants, the survival rate of recipients has been gradually enhanced. However, a variety of central nervous system complications may still occur following heart transplantation, including immunosuppressant-associated neurotoxicity, epilepsy, stroke, encephalopathy, central nervous system infection and de novo malignant tumors in the central nervous system. These complications will severely affect the quality of life of heart transplant recipients. Consequently, prompt imaging diagnosis plays a significant role in the prevention and treatment of central nervous system complications. In this article, main imaging manifestations of central nervous system complications after heart transplantation were reviewed, aiming to provide reference for prompt diagnosis and differential diagnosis of complications, guide clinical treatment and management, and improve the long-term prognosis of the recipients.
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Objective: To investigate the clinical characteristics and diagnosis and treatment process of a patient with invasive mucinous adenocarcinoma (IMAs) of lung, and to improve the clinician's understanding of IMAs. Methods: The general materials, imaging manifestations and treatment plan of a patient with IMAs were collected, and the related literature review was conducted. Results: A 42-year-old female patient was admitted to hospital due to cough and expectoration, the CT examination results showed the bilateral lung patchy shadows∗ the patient was suspected of having pneumonia. After anti-infective treatment, the patient' s symptoms did not improve. The pathological findings of transbronchial lung biopsy (TBLB) and the examination of exfoliated cells of pleural fluid all showed inflammation, and the pathological result of percutaneous biopsy was IMAs. The result of gene detection was 2-point mutation in exon of KRAS. After chemotherapy with paclitaxel plus carboplatin combined with bevacizumab, the symptoms of the patients were improved significantly, and the changes of imaging manifestations were obvious. Conclusion: IMAs is a special pathological type of lung adenocarcinomas (ADCs) with various imaging manifestations and specific gene expression. The treatment principles are different from those of the other types of ADCs.
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Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was –28 to –84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.
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Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was –28 to –84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.
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<p><b>Background:</b>Rosai-Dorfman disease (RDD) is typically characterized by painless bilateral and symmetrical cervical lymphadenopathy, with associated fever and leukocytosis. The aim of the current study was to summarize the clinical features and imaging characteristics of RDD, in an effort to improve its diagnostic accuracy.</p><p><b>Methods</b>The study was analyzed from 32 patients between January 2011 and December 2017; of these, 16 patients had pathologically diagnosed RDD, eight had pathologically diagnosed meningioma, and eight pathologically diagnosed lymphoma. All patients underwent computed tomography and magnetic resonance imaging (MRI). Clinical features and imaging characteristics of RDD were analyzed retrospectively. The mean apparent diffusion coefficient (ADC) values of lesions at different sites were measured, and one-way analysis of variance and the least significant difference t-test were used to compare the differences between groups and draw receiver operating characteristic curves. The tumors were excised for biopsy and analyzed using immunohistochemistry.</p><p><b>Results:</b>The mean ADCs were (0.81 ± 0.10) × 10mm/s for intercranial RDD, (0.73 ± 0.05) × 10mm/s for nasopharyngeal RDD, (0.74 ± 0.11) × 10mm/s for bone RDD, and (0.71 ± 0.04) × 10mm/s for soft-tissue RDD. The optimum ADC to distinguish intracranial RDD from lymphoma was 0.79 × 10mm/s (62.5% sensitivity and 100% specificity) and to distinguish meningioma from intracranial RDD was 0.92 × 10mm/s (62.5% sensitivity and 100% specificity). Levels of C-reactive protein, erythrocyte sediment rate and D-dimer were significantly elevated (81%, 87%, and 75%, respectively). On immunohistochemistry, RDD was positive for both S-100 and CD68 proteins but negative for CD1a.</p><p><b>Conclusions:</b>Conventional MRI, combined with diffusion-weighted imaging and ADC mapping, is an important diagnostic tool in evaluating RDD patients. An accurate diagnosis of RDD should consider the clinical features, imaging characteristics, and the pathological findings.</p>
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Objective: To investigate the diagnostic value of automatic breast volume system (ABVS) for breast carcinoma in clinical practice so as to use these reliable data to provide imaging reference for further therapy. Methods: 300 patients with suspected breast cancer were selected and the postoperative pathological examinations were chosen as the golden standard to implement screening. At the same time, 2 radiologists were selected to carry out the grading diagnoses of breast imaging reporting and data system (BI-RADS) so as to observe the consistency between diagnoses of ABVS and pathological results. Results: 210 patients were diagnosed as breast tumor by the post-operative pathological examination, and these patients included 89 malignant tumor (29.67%, 89/300). In these malignant cases, there were 42 cases were infiltrative ductal carcinoma, and its rate was 47.19% (42/89). Besides, there were 121 cases were benign tumor (40.33%), and the rate of patients with fibrosum adenoma (78 cases) was the highest in the 121 cases (64.46%, 78/121). And the diagnostic consistency of them was preferably (K=0.724). The sensitivity and specificity of ABVS in diagnosing breast carcinoma were 92.86% and 85.56%, respectively. Its positive predictive value and negative predictive value were 93.75% and 83.70%, respectively. And the Youden index was 0.78. Conclusion: ABVS has relatively high sensitivity and specificity, and the screening test has good authenticity and reproducibility. Therefore, it can provide a reliable basis for clinical diagnosis and treatment.
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Objective To investigate spiral CT,PET/CT and clinical manifestations in non-HIV infectious penicilliposis marneffei lung disease, to improve diagnostic level of this disease.Methods Imaging manifestations of 6 cases of non-HIV infectious penicilliposis marneffei confirmed by bronchofiberscope lung biopsy and/or pus culture were analyzed retrospectively All cases underwent chest CT,two had brain MRI,and two had PET/CT scan before treatment.Imaging appearances were observed and combined with clinical dates and literatures.Results Unilateral lung lesion was detected in 1 case,bilateral lungs lesions in 5 cases.Multiple patchy consolidation,stripe shadow in bilateral lungs or right lung were found in 3 cases, multiple nodes in 2 cases, mass with nodes in 1 case.Among 6 cases, 2 had septa interlobulare thickness,1 had tracheal fistula,2 had pericardium and pleura involvement,4 had bone destruction,1 had the brainand liver involvement.6 cases showed multiple lymphadenectasis,amalgamation and necrosis in bilateral hilar,mediastinaand the neck.2 had abdominal cavity and or retroperitoneal lymphadenectasis.On PET/CT,2 cases showed high uptake,and the range of SUV value were 1.4-13.9.Initial misdiagnosis by imaging was found in 5 cases.6 patients recovered after anti fungus treatment.Conclusion Imaging appearances of non-HIV infectious penicilliposis marneffei mainly reveals as multiple patchy consolidation,nodes and mass in bilateral lungs, all accompany with lymphadenectasis, many with bone destruction,lack of specificity, which needs lesion biopsy and pus culture to make confirmed diagnosis.
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Objective To summarize the clinical and MRI features of ruptured intracranial dermoid cysts to improve its diagnosis.Methods Totally 6 patients with ruptured intracranial dermoid cyst confirmed pathologically from March 2005 to April 2016 had their clinical and MRI data analyzed and compared on lesion location,morphology,size,growth and MRI features.Results All the 6 patients had solitary cysts,of which,there were 3 ones in the parasellar region,2 ones in anterior cranial fossa and 1 case in posterior fossa fourth ventricle.MRI showed non-uniform signals in the 6 patients,of whom,4 ones had short T1,long T2 signals,2 ones had long T1,long T2 signals intermixed with short T1,short T2 dot signals.The 2 patients with long T1,long T2 signals had grainy appearance,one of whom showed fat-fluid level and had low signals such as short T1 signals of the fat droplet adjacent to the cerebral sulcus and fat saturation images.Enhancement scanning found 2 cases of minimal peripheral contrast enhancement,1 of whom showed epedyma enhancement.Conclusion The clinical and MRI features of ruptured intracranial dermoid cyst are characteristic,and MRI is of significance for its diagnosis and differential diagnosis.
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Objective To summarize the clinical and MRI features of ruptured intracranial dermoid cysts to improve its diagnosis.Methods Totally 6 patients with ruptured intracranial dermoid cyst confirmed pathologically from March 2005 to April 2016 had their clinical and MRI data analyzed and compared on lesion location,morphology,size,growth and MRI features.Results All the 6 patients had solitary cysts,of which,there were 3 ones in the parasellar region,2 ones in anterior cranial fossa and 1 case in posterior fossa fourth ventricle.MRI showed non-uniform signals in the 6 patients,of whom,4 ones had short T1,long T2 signals,2 ones had long T1,long T2 signals intermixed with short T1,short T2 dot signals.The 2 patients with long T1,long T2 signals had grainy appearance,one of whom showed fat-fluid level and had low signals such as short T1 signals of the fat droplet adjacent to the cerebral sulcus and fat saturation images.Enhancement scanning found 2 cases of minimal peripheral contrast enhancement,1 of whom showed epedyma enhancement.Conclusion The clinical and MRI features of ruptured intracranial dermoid cyst are characteristic,and MRI is of significance for its diagnosis and differential diagnosis.
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Objective To study the relationship between the clinical imaging manifestations and the judgement of benign and malignant of solitary pulmonary nodules (SPN) .Methods A retrospective analysis of 146 patients with SPN which confirmed by pathological diagnosis .According to SPN diameter all SPN were divided into three groups ,the number of SPN which diameter smal-ler than 0 .8 cm were 16 case ,> 0 .8 - 1 .5 cm were 41 cases ,> 1 .5 - 3 .0 cm were 89 cases .Collect patients′ age ,sex ,smoking his-tory ,clinical symptoms and imaging data ,and analyze its relationship with pathological results .Results All the 146 patients were pathological diagnosis ,benign in 52 cases (35 .6% ) ,malignant in 94 cases (64 .4% ) .As the diameter increases ,the malignant rate increased .There was statistical significance in benign and malignant lesions with smoking history and clinical symptoms (P< 0 . 05) .Whether SPN boundary is clear ,have lobulation ,burr ,pleural indentation syndrome and vessel convergence in benign and ma-lignant lesions were statistically significant (P< 0 .05) .Conclusion The feature size and imaging performance of SPN has important reference value for the judgement of benign and malignant .The positive intervention to SPN have great significance on improve sur -vival rate of lung cancer .
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ObjectiveTo explore the imaging characteristics of rib bone benign-malignant tumor or tumorlike lesion.MethodsRetrospectively analyzed 57 cases of imaging data by confirmation of clinical surgical pathology,the chest photograph 45 cases,the chest CT check 37 cases.ResultsAccording to imaging findings and lesion involve in the amount of ribs divided into:cystic expansive bone destruction 26 cases,dissolve osseous bone destruction 20 cases,bone hyperplasia sclerosis 8 cases,osseous bumps 3 cases,single bone manifestation 32 cases,many bone manifestation 25 cases.ConclusionDissolve osseous bone destruction or companion soft organization lump or companion pathologic bone fracture were seen in most malignant tumor.Cystic expansive bone destruction was seen in most benign tumor or tumor-like lesion,the chest film combined CT check was contribute to raise diagnosis accuracy rate of rib tumor and tumor-like lesion.
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Objective To investigate the histologic basis of imaging manifestations on adrenal myelolipoma and evaluate the value of various imaging modalities in diagnosing the tumor.Methods The imaging manifestations and pathological features of 21 cases of adrenal myelolipoma proved by postsurgical pathology were retrospectively analysed.Results Histologically,the myelolipoma presented hematopoietic elements amidst fatty tissue and showed indefinite border.The myeloid tissue was well vascularized and were adherent closely to normal adrenal gland.Both CT and MRI detected a single mass with irregular plaque or streak of bone marrow tissues between fatty components.The capsule of the tumor was not apparent,but rarely it presented an irregular local “capsule”which was composed of adrenal tissue with compression surrounding the tumor.Enhanced-scan found foggy enhancement in fatty tissue and enhancement of bone marrow tissue which made myeloid plaque enlarged and the edge misted.Ultrasonography demonstrated highly echogenic fat-containing ball of adrenal,while intravenous urography only showed translocation and renal axis alteration of homolateral kidney.Conclusion CT scan appears to be the most accurate qualitative modality to demonstrate adrenal myelolipoma while coronal and sagittal section scanning on MRI can make its localization more exact.Ultrasonography is also an important way in detecting the mass whereas intravenous urography and abdominal plain film should not be used to be the qualitative criterion.