OCT parameters as a predictor of the efficacy of Ranibizumab in the treatment of macular edema secondary to central retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the correlation between optical coherence tomography(OCT)parameters and central retinal vein occlusion of macular edema secondary(CRVO-ME), and compare the clinical efficacy of ranibizumab combined with laser photocoagulation and ranibizumab alone in the treatment of CRVO-ME.METHODS:There were 43 case with 43 eyes of patients in CRVO-ME diagnosed in our hospital from January 2020 to December 2020 included in the present study and divided into two groups, namely A and B. Patients in group A were treated with ranibizumab combined with laser photocoagulation, while patients in group B were treated with ranibizumab alone. The structure of outer retina and “SAVE” scores were observed and estimated using OCT and fluorescein angiography(FFA)examination before and after the treatment at 1, 3, 6, 12mo, and then analyzed their correlation with best corrected visual acuity(BCVA, LogMAR). The BCVA, central macular thickness(CMT), intraocular pressure and average number of drug injections were also compared between the two groups before and after treatment.RESULTS:At 12mo after treatment, the BCVA in the OCT baseline external limiting membrane(ELM)intact group and baseline ellipsoid zone(EZ)intact group before and after treatment were significantly improved than those of the fracture group(0.47±0.16 vs 0.21±0.15, P=0.013; 0.44±0.20 vs 0.25±0.17, P=0.008). There was no statistically significant difference in BCVA changes between baseline RPE fracture group and RPE intact group(P>0.05). The number of patients with “S” and “A” at 1 score decreased significantly at 12mo after treatment in both groups, the BCVA of patients with “V” and “E” at 0 score before treatment was significantly improved than those patients at 1 score(all P<0.05). The BCVA and CMT of patients after treatment in groups A and B were both significant improved compared with before treatment(P<0.05). There were no significant differences in the BCVA and CMT in the number of drug injections between the two groups(P>0.05). In addition, there were no severe complications such as secondary glaucoma and endophthalmitis in both groups.CONCLUSION: Baseline status of ELM and EZ, presence or absence of vitreoretinal abnormalities(V), and focal leakage(E)could suggest the treatment efficacy of CRVO-ME. Ranibizumab in the treatment of CRVO-ME demonstrates prominent efficacy and great safety, and there was no better effect was observed when combined with laser photocoagulation.

[Assessment of 64-slice spiral computed tomography angiography with image fusion for perigastric arteries anatomy].

OBJECTIVE: To evaluate the efficacy and clinical significance of 64-multislice spiral computed tomography angiography(MSCTA) with image fusion for the anatomy of perigastric arteries. METHODS: A total of 53 patients underwent abdominal 64-MSCTA, among whom 26 patients with gastric cancer underwent gastrectomy. Using volume rendering techniques, computed tomography angiography(CTA) of perigastric arteries and the stomach were reconstructed respectively, and then the images were fused together. The branching pattern of the celiac trunk and the origins and courses along the stomach of the 10 perigastric arteries were assessed. The accuracy, sensitivity, and specificity of 64-MSCTA were determined based on intraoperative findings. RESULTS: CTA clearly showed the celiac trunk. The most common branching pattern of the celiac trunk was Michels type I( in 46 patients(86.8%). The anatomy of perigastric arteries and stomach could be clearly demonstrated from any angle according to image fusion. The left gastric artery and the right gastroepiploic artery were shown in 100%, the left gastroepiploic artery 94.3%(50/53), the right gastric artery 83.0%(44/53), short gastric artery 58.5%(31/53), posterior gastric artery 49.1%(26/53), the replaced left hepatic artery 15.1%(8/53). The accessory left hepatic artery, accessory left gastric artery and replaced right hepatic artery were all identified in 7.5%(4/53) patients. The accuracy of preoperative CTA in term of correctly identifying perigastric arteries ranged from 84.6% to 100%, the sensitivity 82.6% to 100%, and the specificity was 100% for all the perigastric arteries. CONCLUSIONS: 64-MSCTA can clearly reveal individual perigastric arteries. The anatomy of the stomach and perigastric arteries can be shown in vivo by fused image, and can provide guidance for gastrectomy.

[Multi-slice spiral CT scan with lower dose for preoperative evaluation: living renal donor kidney morphology and the quantification of unilateral glomerular filtration rate].

OBJECTIVE: To explore the feasibility of multi-slice spiral computed tomography (CT) with a lower dose as one-off examination for the preoperative morphology evaluation and the quantification of unilateral renal glomerular filtration rate of living renal donors. METHODS: A total of 36 living renal donors at our hospital from May 2008 to June 2009 were examined by 64-slice spiral CT and single photon emission computed tomography (SPECT). Living renal donors were examined with a plain scan and three-phase enhancement CT scan. Also there were two inserted dynamic scans, one after the injection of contrast agent and the other between cortex and parenchymal phases. Image reconstructions were performed to observe renal parenchyma, renal vessels and collecting system. Comparisons were made with intra-operative findings. And the known Patlak equation was used simultaneously. The glomerular filtration rate (GFR) in a single kidney was calculated on CT and SPECT respectively. The GFRs of two groups were analyzed to investigate the Pearson correlation and simple linear regression between them. RESULTS: Twenty of 36 renal living donor kidneys underwent the operation, variations of morphology detected by CT were all corresponded with the operation. The GFR values estimated from CT were (42.4 ± 8.9) ml/min (left) and 43.2 ± 8.4) ml/min (right). While GFR of SPECT 47.4 ± 9.3) ml/min (left) and 48.2 ± 8.5) ml/min (right). Linear trend was found between the GFRs of CT and SPECT. Pearson's product-moment correlation coefficient r = 0.753 (left) (P < 0.01), r = 0.709 (right) (P < 0.01). These values indicated that the GFR from CT was positively correlated with the GFR from SPECT. CONCLUSION: During the preoperative evaluation, multi-slice spiral CT may provide both anatomic information and the GFR of living renal donors.

[Imaging features of lung carcinoma, pulmonary tuberculoma, and inflammatory pseudotumor on helical incremental dynamic CT scan--a report of 44 cases].

BACKGROUND & OBJECTIVE: Lung carcinoma, pulmonary tuberculoma, and inflammatory pesudotumor are the most common solitary pulmonary nodules (SPN). Computed tomography (CT) is the major diagnostic examination of them. Most recent reports focused on their morphologic features on CT. The differential diagnoses are still difficult. This study was to explore their imaging features on helical incremental dynamic CT scan according to the differences of their hematal supply, and get more information for the diagnosis and differential diagnosis. METHODS: Incremental dynamic CT scan was performed on 115 cases of solitary pulmonary nodule. Of the 44 cases proved by postoperative pathology, 30 were lung carcinoma, 7 were pulmonary tuberculoma, and 7 were inflammatory pesudotumor. RESULTS: Of the 30 cases of lung carcinoma, 7 were mildly enhanced, 14 were moderately enhanced, 5 were highly enhanced, 2 were remarkably enhanced, and 7 were not enhanced; 9 had peak enhancement began at 18-28 s after injection, 17 began at 30-39 s, and 4 began at 40-44 s, with an average time of 32 s. Of the 7 cases of tuberculoma, 5 were not enhanced, and 2 were cricoid enhanced. All the 7 cases of inflammatory pesudotumor were remarkably enhanced, with the peak enhancement value of over 100 Hu in all cases; the peak enhancements began at 26 s, 28 s, 30 s, 32 s, 33 s, 110 s, and 122 s, respectively, after injection. CONCLUSION: Helical incremental dynamic CT is helpful in differential diagnoses of lung carcinoma, pulmonary tuberculoma, and inflammatory pesudotumor.