ABSTRACT
PURPOSE: To explore the application value of multi-slice spiral CT (MSCT), magnetic resonance imaging (MRI) combined with gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer. METHODS: The subjects of study were 109 gastric cancer patients with T stages admitted to our hospital for diagnosis and treatment from December 2016 to December 2018. All the patients were examined with MSCT, MRI and gastric contrast-enhanced ultrasonography before operation to observe corresponding imaging results. T staging of gastric cancer patients was conducted according to the examination results, which was then compared with postoperative pathological staging. It was performed to analyze the accuracy of the three diagnostic methods and combined diagnosis of gastric cancer T staging. RESULTS: The sensitivity of MSCT in the diagnosis of T staging of gastric cancer was 60.00%, 67.74%, 72.22%, 76.47%, the specificity was 95.24%, 88.46%, 86.30%, 94.56% and the diagnostic coincidence rate was 87.16%, 82.57%, 81.65%, 91.74%; the sensitivity of MRI in the diagnosis of T staging of gastric cancer was 68.00%, 70.97%, 77.78%, 76.47%, the specificity was 92.86%, 88.46%, 91.78%, 95.65%, and the diagnostic coincidence rate was 87.16%, 83.49%, 87.16%, 92.66%; the sensitivity of gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer was 80.00%, 83.87%, 86.11%, 82.35%, the specificity was 97.62%, 92.31%, 91.78%, 97.83%, and the diagnostic coincidence rate was 93.58%, 89.91%, 89.91%, 95.41%; the sensitivity of combined MSCT, MRI and gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer was 88.00%, 93.55%, 97.22%, 94.12%; the specificity was 100%, 97.44%, 95.89%, 98.91%; and the diagnostic coincidence rate was 97.25%, 96.33%, 96.33%, 98.17%, respectively. Statistical analysis revealed that the sensitivity, specificity and diagnostic coincidence rate of combined detection of the three methods were significantly higher than those of single detection (P < 0.05). CONCLUSION: Combined use of MSCT, MRI and gastric contrast-enhanced ultrasonography can significantly improve the diagnostic sensitivity, specificity and diagnostic coincidence rate of T staging of gastric cancer. It may provide a certain reference value for guiding the selection of clinical therapeutic approaches and evaluation of curative effect.
Subject(s)
Magnetic Resonance Imaging/methods , Multidetector Computed Tomography/methods , Stomach Neoplasms/diagnostic imaging , Ultrasonography/methods , Adult , Aged , Contrast Media/administration & dosage , Female , Humans , Male , Middle Aged , Multimodal Imaging/methods , Neoplasm Staging/methods , Sensitivity and Specificity , Stomach Neoplasms/pathologyABSTRACT
Abstract The spleen is one of the most susceptible organs to primary tumours, metastasis, and a wide range of diseases of the hematopoietic system. Therefore, detailed assessment of the spleen is of great importance in veterinary medicine, especially in dogs, due to their economic and sentimental value, and as an experimental model in human medicine. Considering the recent advances in diagnostic imaging in companion animals, this review aims to describe the applicability of acoustic radiation force impulse (ARFI) elastography (qualitative and quantitative), Doppler, and contrast-enhanced ultrasonography for evaluating the spleen in dogs. The ARFI elastography is a recent ultrasound method that can provide reference values and aid in the diagnosis and evaluation of splenic abnormalities routinely encountered in veterinary practice. Conventional ultrasonography of the spleen combined with haemodynamic analysis by Doppler and contrast enhanced ultrasonography is an important tool in diagnosis and triage.
Resumen El bazo es uno de los órganos más propensos a desarrollar tumores, tanto primarios como metastásicos, y varias enfermedades que afectan el sistema hematopoyético. Es por eso que la evaluación clínica del mismo es de gran importancia en medicina veterinaria, principalmente en perros, debido a su valor económico, afectivo, y como modelo experimental en medicina humana. Considerando los recientes avances en imagenología diagnóstica, esta revisión tiene como objetivo describir el examen ecográfico del bazo en perros, utilizando la técnica de elastografía por impulso de fuerza de radiación acústica (ARFI) cuantitativa y cualitativa, Doppler y ultrasonido contrastado. La elastografía ARFI es un método reciente que puede proveer información básica sobre la conformación normal del órgano y, en un futuro próximo, ayudar en el diagnóstico de las enfermedades esplénicas. De modo similar, la ecografía convencional, Doppler y el ultrasonido contrastado son importantes herramientas en el diagnóstico y en el triaje.
Resumo O baço é um dos órgãos mais propensos a desenvolver tumores primários, metastáticos e afecções do sistema hematopoiético. Por isso, realizar uma avalição apurada neste órgão é de suma importância em medicina veterinária, particularmente em cães, devido à importância econômica, afetiva e de similaridade científica com o homem. Considerando os recentes avanços em diagnóstico por imagem, esta revisão visou descrever a aplicabilidade das novas técnicas ultrassonográficas para avaliação esplênica de caninos, utilizando a elastografia por impulso de força de radiação acústica (ARFI) qualitativa e quantitativa, Doppler e ultrassonografia por contraste com microbolhas. A elastografia ARFI é um método recente que pode fornecer dados de base para o baço e permitir a utilização futura desta técnica na avaliação de cães com doença esplênica. Similarmente, a ultrassonografia convencional, o método Doppler e a ultrassonografia contrastada são importantes ferramentas no diagnóstico e triagem.
ABSTRACT
BACKGROUND/OBJECTIVE: The early detection of focal hepatic lesions using ultrasound scanning is challenging, and this challenge becomes even greater in the presence of diffuse parenchymal disease. This study aimed to evaluate the diagnostic performance of elastography and contrast-enhanced ultrasonography (CEUS) in the early detection of hepatocellular lesions in an experimental rat model of nonalcoholic steatohepatitis (NASH). METHODS: B-mode and Doppler ultrasonography was performed weekly in 30 rats divided into a NASH group (n = 20) and a group without liver disease (n = 10). The animals underwent elastography and CEUS and were then euthanized. Liver nodules were assessed by histopathology. RESULTS: Doppler mapping results of lesions with vascularization were considered indicative of malignancy, with a sensitivity of 29% before and 71% after contrast injection. The specificity was 71% before and 96% after CEUS. Elastograms of positive lesions showed areas of high stiffness, which were indicative of malignancy. This malignancy was confirmed by the histologic evaluation, with a sensitivity of 90% and a specificity of 60%. After CEUS analysis, 4 nodules were identified that were not observed on B-mode ultrasonography. Early wash-in was significantly associated with malignancy (sensitivity of 88% and specificity of 67%). CONCLUSIONS: Both techniques allow for the correct diagnosis of well-differentiated to moderately differentiated hepatocellular carcinomas with good accuracy in an experimental rat model of NASH.