Galectin from Trichinella spiralis alleviates DSS-induced colitis in mice by regulating the intestinal microbiota.

According to numerous reports, Trichinella spiralis (T. spiralis) and its antigens can reduce intestinal inflammation by modulating regulatory immunological responses in the host to maintain immune homeostasis. Galectin has been identified as a protein that is produced by T. spiralis, and its characterization revealed this protein has possible immune regulatory activity. However, whether recombinant T. spiralis galectin (rTs-gal) can cure dextran sulfate sodium (DSS)-induced colitis remains unknown. Here, the ability of rTs-gal to ameliorate experimental colitis in mice with inflammatory bowel disease (IBD) as well as the potential underlying mechanism were investigated. The disease activity index (DAI), colon shortening, inflammatory cell infiltration, and histological damage were used as indicators to monitor clinical symptoms of colitis. The results revealed that the administration of rTs-gal ameliorated these symptoms. According to Western blotting and ELISA results, rTs-gal may suppress the excessive inflammatory response-mediated induction of TLR4, MyD88, and NF-κB expression in the colon. Mice with colitis exhibit disruptions in the gut flora, including an increase in gram-negative bacteria, which in turn can result in increased lipopolysaccharide (LPS) production. However, injection of rTs-gal may inhibit changes in the gut microbiota, for example, by reducing the prevalence of Helicobacter and Bacteroides, which produce LPS. The findings of the present study revealed that rTs-gal may inhibit signalling pathways that involve enteric bacteria-derived LPS, TLR4, and NF-κB in mice with DSS-induced colitis and attenuate DSS-induced colitis in animals by modulating the gut microbiota. These findings shed additional light on the immunological processes underlying the beneficial effects of helminth-derived proteins in medicine.

Bacterial cellulose production by a strain of Komagataeibacter rhaeticus isolated from residual loquat.

In this study, loquat extract was selected as a promising substrate for bacterial cellulose (BC) production. A new BC-producing bacterial strain was isolated from residual loquat and identified as Komagataeibacter rhaeticus. BC production with different carbon sources and with loquat extract was investigated. Among all tested carbon sources, glucose was demonstrated to be the best substrate for BC production by K. rhaeticus, with up to 7.89 g/L dry BC obtained under the optimal initial pH (5.5) and temperature (28 °C) with 10 days of fermentation. The total sugar and individual sugars were investigated in different loquat extracts, in which fructose, glucose, and sucrose were the three main sugars. When loquat extract was prepared with a solid‒liquid (S-L) ratio of 2:1, the concentrations of glucose, fructose, and sucrose were 7.91 g/L, 9.31 g/L, and 2.84 g/L, respectively. The BC production obtained from loquat extract was higher than that of other carbon sources except glucose, and 6.69 g/L dry BC was obtained from loquat extract with an S-L ratio of 2:1. After BC production, all sugars substantially decreased, with the utilization of glucose, fructose, and sucrose reaching 93.9%, 87.9%, and 100%, respectively. These results suggested that the different sugars in loquat extract were all carbon sources participating in BC production by K. rhaeticus. Structural and physicochemical properties were investigated by SEM, TGA, XRD, and FT-IR spectroscopy. The results showed that the structural, chemical group, and water holding capacity of BC obtained from loquat extract were similar to those of BC obtained from glucose, but the crystallinity and thermal stability of BC were higher than those of BC from mannose and lactose but lower than those of BC from glucose and fructose. KEY POINTS: • A new BC-producing strain was isolated and identified as Komagataeibacter rhaeticus. • Loquat extract is an alternative substrate for BC production. • The BC obtained from loquat extract owns advanced physicochemical properties.

Predicting Overall Survival in Patients with Nonmetastatic Gastric Signet Ring Cell Carcinoma: A Machine Learning Approach.

Background and Aims: Accurate prediction is essential for the survival of patients with nonmetastatic gastric signet ring cell carcinoma (GSRC) and medical decision-making. Current models rely on prespecified variables, limiting their performance and not being suitable for individual patients. Our study is aimed at developing a more precise model for predicting 1-, 3-, and 5-year overall survival (OS) in patients with nonmetastatic GSRC based on a machine learning approach. Methods: We selected 2127 GSRC patients diagnosed from 2004 to 2014 from the Surveillance, Epidemiology, and End Results (SEER) database and then randomly partitioned them into a training and validation cohort. We compared the performance of several machine learning-based models and finally chose the eXtreme gradient boosting (XGBoost) model as the optimal method to predict the OS in patients with nonmetastatic GSRC. The model was assessed using the receiver operating characteristic curve (ROC). Results: In the training cohort, for predicting OS rates at 1-, 3-, and 5-year, the AUCs of the XGBoost model were 0.842, 0.831, and 0.838, respectively, while in the testing cohort, the AUCs of 1-, 3-, and 5-year OS rates were 0.749, 0.823, and 0.829, respectively. Besides, the XGBoost model also performed better when compared with the American Joint Committee on Cancer (AJCC) stage. The performance for this model was stably maintained when stratified by age and ethnicity. Conclusion: The XGBoost-based model accurately predicts the 1-, 3-, and 5-year OS in patients with nonmetastatic GSRC. Machine learning is a promising way to predict the survival outcomes of tumor patients.

Quantitative Evaluation of Intravoxel Incoherent Motion and Diffusion Kurtosis Imaging in Assessment of Pathological Grade of Clear Cell Renal Cell Carcinoma.

RATIONALE AND OBJECTIVES: To evaluate the diagnostic value of intravoxel incoherent motion and diffusion kurtosis imaging parameters for clear cell renal cell carcinoma (ccRCC) grading. MATERIALS AND METHODS: A total of 60 patients with pathologically proven ccRCC who underwent intravoxel incoherent motion and diffusion kurtosis imaging were retrospectively evaluated. The standard apparent diffusion coefficient (ADC), true diffusivity (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), mean kurtosis (MK), and mean diffusivity (MD) maps were calculated and compared between high-grade and low-grade ccRCC using Mann-Whitney U test. Receiver-operating characteristic analysis was performed for all parameters. RESULTS: ADC, D and MD values were significantly lower for high-grade ccRCC compared to low-grade ccRCC (p < 0.05). MK values were significantly higher in high-grade ccRCC compared to low-grade ccRCC (p < 0.05). However, D* and f were not significantly difference between the two groups (p > 0.05). MD had the largest area under the curve (AUC = 0.888), followed by ADC (AUC = 0.796), D (AUC = 0.780), MK (AUC = 0.736), f (AUC = 0.582), and D*(AUC = 0.533). CONCLUSION: Diffusion-related parameters (D, ADC, MD, and MK) were able to significantly distinguish between low- and high-grade ccRCC. However, perfusion-related parameters (D* and f) were unable to separate high- and low-grade ccRCC. MD may be the most promising parameter for grading ccRCC in the clinic.

Differentiation between fat-poor angiomyolipoma and clear cell renal cell carcinoma: qualitative and quantitative analysis using arterial spin labeling MR imaging.

PURPOSE: To assess the diagnostic effectiveness of arterial spin labeling (ASL) MR imaging in differentiating fat-poor AML from clear cell renal cell carcinoma (ccRCC). METHODS: In this prospective study, 29 ccRCC patients and 9 fat-poor AML patients underwent routine anatomical MRI and ASL at 3T before surgery after signing written informed consent form. For each tumor, tumor blood flow (TBF) was measured in a region of interest (ROI) which was positioned to outline the edge of the target lesions on ASL perfusion maps. Additionally, the mean TBF values were obtained by standardizing the TBF using a blood flow measurement in the reference ROI. Moreover, a cluster containing more than 10 voxels was chosen from the renal cortex and medulla area in normal contralateral kidney as a reference ROI to calculate tumor-to-cortex ratio and tumor-to-medulla ratio. Independent sample t test was used to examine the alteration among the groups of fat-poor AML and ccRCC. ASL images were together analyzed by two radiologists to assess the following characteristics of the renal mass: predominant SI in the tumor on ASL images was lower than, as same as, or higher than SI of the cortex. For qualitative variables, Fisher's exact test was employed to compare the proportions of these two groups. The sensitivity, specificity ,and accuracy required for discrimination of fat-poor AML from ccRCC were quantified using receiver operating characteristic (ROC) curve. The corresponding optimal cutoff value was obtained for each parameter as well. RESULTS: The TBF value was significantly higher in ccRCC group than that in fat-poor AML (270.49 ± 78.88 ml/100 g/min vs. 146.68 ± 47.21 ml/100 g/min; P < 0.01). Both tumor-to-cortex and tumor-to-medulla ratios were notably higher in ccRCC group compared with those in fat-poor AML group (1.22 ± 0.26 vs. 0.74 ± 0.14, 3.13 ± 0.94 vs. 1.77 ± 0.55; P < 0.05). The values of area under the ROC curve (AUC) for TBF, tumor-to-cortex ratio, and tumor-to-medulla ratio were 0.931, 0.964, and 0.900, respectively. No significant difference in AUC values among these three measurements was observed. For qualitative variables, the SI of fat-poor AML was equal to or slightly lower than that of renal medulla and the SI of ccRCC was found to be higher than renal cortex in ASL. CONCLUSION: ASL MRI performs well in differentiating fat-poor AML from ccRCC in both qualitative and quantitative analyses.

Imaging of mixed epithelial and stromal tumor of the kidney: A case report and review of the literature.

BACKGROUND: Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported). They occur almost exclusively in postmenopausal women, with only seven cases reported in men. As this entity is very rare, little is known on its imaging features, especially magnetic resonance imaging (MRI) findings. In women, at MRI, the cystic component shows T1 hypointensity and T2 hyperintensity, while the solid component shows T1 hyperintensity and T2 hypointensity. CASE SUMMARY: We report the computed tomography (CT) and MRI findings of MESTK in a 19-year-old male adolescent. To our knowledge, this case report is the first report of MRI findings of MESTK in male adolescents. The patient was admitted to Subei People's Hospital (Jiangsu Province, China) in July 2017 after a renal mass on the left side was detected by ultrasound during a clinical examination. Blood tests were all normal. Non-enhanced CT showed a round, well-circumscribed complex mass, approximately 45 mm × 40 mm in size. MRI revealed a clear well-circumscribed mass with a mixed arrangement of solid and cystic components. On T2 weighted images, some hypointensities were found in the solid areas. After contrast enhancement, moderate or mild enhancement was found in the solid component, which increased with time. A radical left nephrectomy was performed. The pathology analysis revealed a mixed epithelial and stromal tumor. The patient had no imaging findings of recurrence or metastasis at 12 months following surgery. CONCLUSION: The possibility of MESTK should be considered in male adolescents. MRI can provide useful information for the preoperative diagnosis.

CT findings of sclerosing stromal tumor of the ovary: A report of two cases and review of the literature.

Sclerosing stromal tumor (SST) of the ovary, which was first described by Chalvardjian and Scully in 1973, is a rare ovarian neoplasm, occurring predominantly in young women. The most common clinical symptom in patients with SST is menstrual irregularities. Microscopically, the tumor is characterized by the presence of pseudo-lobulated cellular areas, with a prominent tendency to sclerosis, marked vascularity and pronounced variation in cellular size and shape. In the current study, 2 cases of SST of the ovary are presented. These cases were confirmed by imaging, surgical and histological examination. No adjuvant therapy was administered to the patients and the two patients were disease-free with no imaging findings of recurrence or metastasis 24 months following surgery.

Comparative study of CT appearances in renal oncocytoma and chromophobe renal cell carcinoma.

BACKGROUND: Renal oncocytoma (RO) and chromophobe renal cell carcinoma (ChRCC) share histologic and some imaging features. PURPOSE: To investigate the multidetector computed tomography (MDCT) characteristics of these two tumor types. MATERIAL AND METHODS: Fifty-six patients with RO and 54 patients with ChRCC were studied retrospectively. MDCT was undertaken to investigate differences in tumor characteristics. RESULTS: Calcifications were visible in 24 (42.8%) patients with RO and in 11 (20.4%) patients with ChRCC (P = 0.011). 26 patients with RO had stellate scars as did 14 patients with ChRCC (P = 0.025). Spoken-wheel-like enhancement was visible in 41 patients with RO and in 11 with ChRCC (P < 0.001). Thirty-nine (69.6%) patients with RO and nine (16.7%) patients with ChRCC showed segmental inversion (P < 0.001). Two patients with RO had retroperitoneal lymph node enlargement as did 13 patients with ChRCC (P = 0.002). Combined evaluation of stellate scar, spoken-wheel-like enhancement, and segmental enhancement inversion features were found to have a sensitivity of 99.1% (106 of 107), a specificity of 100% (3 of 3), a positive predictive value of 100% (106 of 106), and a negative predictive value of 75% (3 of 4). The attenuation of RO tumors was greater than that of ChRCC tumors, normal renal parenchyma on unenhanced CT (P = 0.031). Enhancement was higher with RO than with ChRCC tumors in all phases (P = 0.021, < 0.001, and 0.007, respectively). CONCLUSION: CT imaging features such as stellate scar, spoken-wheel-like enhancement, and segmental enhancement inversion were more common in RO and they may help in differentiating RO from ChRCC.

Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report.

The present study reports a case of histologically proven hepatic epithelioid angiomyolipoma that was evaluated with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging and diffusion-weighted imaging. A 23-year-old female was admitted to the Northern Jiangsu People's Hospital (Yangzhou, Jiangsu, China) due to a 5.6-cm mass in the liver, and a right partial hepatectomy was performed. Magnetic resonance imaging (MRI) revealed a hypointense mass on T1-weighted imaging, and a hyperintense mass on T2-weighted and diffusion-weighted imaging, with a higher apparent diffusion coefficient value compared with normal liver parenchyma. On the dynamic Gd-EOB-DTPA-enhanced MRI scan, the lesion manifested as hypervascular with multiple filiform vessels and a pseudocapsule image, and in the hepatobiliary phase the lesion demonstrated a lack of contrast retention, thus appearing hypointense compared with the background liver. Pre-operatively, EMAL was diagnosed on the basis of these findings in the tumor. The optimum treatment is complete surgical excision and subsequent follow-up. The patient was healthy and free from recurrence at 6 months and 1 year post-surgery. Therefore, knowledge of EAML specific features on dynamic Gd-EOB-DTPA-enhanced and DWI scans may improve the diagnostic accuracy of hypervascular hepatic tumors and may facilitate treatment selection.

Comparative study of CT appearances in mucinous tubular and spindle cell carcinoma and collecting duct carcinoma of the kidney.

OBJECTIVE: To characterize the multidetector CT (MDCT) imaging characteristics of mucinous tubular and spindle cell carcinoma (MTSCC) and collecting duct carcinoma (CDC) of the kidney. METHODS: 21 patients with MTSCC and 18 patients with CDC were studied retrospectively. MDCT was undertaken to investigate differences in tumour characteristics. RESULTS: Five patients with MTSCC had calcifications as did nine patients with CDC (p = 0.108). In three patients with MTSCC and four patients with CDC, the tumours had a clear boundary (p = 0.682). No patient with MTSCC had retroperitoneal lymph node metastasis as did five patients with CDC (p = 0.015). 16 patients with MTSCC showed homogeneous enhancement, whereas 11 patients with CDC showed heterogeneous enhancement (p = 0.025). The attenuation value of CDC tumours was greater than that of MTSCC and normal renal parenchyma on an unenhanced CT (p = 0.027). MTSCC and CDC tumour enhancement was less than the normal renal cortex and medulla in all phases (p < 0.001). Tumour enhancement was greater for CDC than that for MTSCC in all phases (p = 0.011, p = 0.006 and p = 0.052). CONCLUSION: Unenhanced and dynamic MDCT may aid in diagnosis and differentiation of MTSCC and CDC of the kidney. ADVANCES IN KNOWLEDGE: This is the first series evaluating the imaging findings of MTSCC and CDC of which we are aware, and identification of such findings may improve diagnosis of these two rare tumours.

[Role of immune deviation by toll-liked receptor's doping LPS in pathogenesis of allergic rhinitis].

OBJECTIVES: To investigate the role of TLR-NF-κB signaling pathway in pathogenesis of allergic rhinitis (AR) and the mechanism of TLR to modulate innate immunity and adaptive immunity. METHODS: One hundred rats were divided into 5 groups by simple randomization, normal group(group A), modle group(group B), AR+LPS20 group(group C), AR+LPS10 group(group D), AR+LPS5 group(group E). Model of AR in B group was established by intraperitoneal injection and nasal topic delivery of ovalbumin (OVA). A group was delivered of same volume physiological saline instated of OVA, C,D,E group were interfered by nasal delivery of LPS in different concentration (including LPS 20 µg, 10 µg, 5 µg per 100 µl). Changes of nasal mucosa tissues and inflammatory cell infiltration were observed by HE staining, while neutrophil and eosinophil counted under high power microscope.Expression of IL-4, IFN-γ, and IgE in nasal mucosa tissues were measured with immunohistochemical method.Realtime-PCR and Western-blot were used to evaluate the expression level of TLR-4 and NF-κB in nasal mucosa tissues.SPSS 13.0 software was used to analyze the data. RESULTS: Group B was observed to have developed AR injury of nasal mucosa. Eosinophil count and the expression of IL-4, IFN-γ, and IgE were significantly higher in B group than those in A group (all P < 0.05), neutrophil count was significantly higher in C, D, E groups than that in B group (all P < 0.05). RESULTS: of immunohistochemical staining showed that, expression level of IFN-γ, TLR-4 and NF-κB were significantly higher than group B (all P < 0.05), while IL-4 and IgE were significantly decreased than group B (all P < 0.05) . The protein expression of TLR-4 and NF-κB was 0.888 9 ± 0.032 9 and 0.913 3 ± 0.031 1 in group C, and 0.419 2 ± 0.038 0 and 0.447 8 ± 0.033 0 in group A, 0.616 1 ± 0.025 1 and 0.748 1 ± 0.034 3 in group B, the difference was significant(all P < 0.05). CONCLUSIONS: TLR plays an important role of modulation between innate immunity and adaptive immunity in the pathogenesis of AR. The higher concentration of TLR doping may activate the higher expression of NF-κB then intervene the development of AR with immune deviation.

Efficacy and safety of intensive statin therapy in Chinese patients with atherosclerotic intracranial arterial stenosis: a single-center, randomized, single-blind, parallel-group study with one-year follow-up.

OBJECTIVES: The purpose of this study is to validate the efficacy of intensive statin therapy for patients with atherosclerotic intracranial arterial stenosis (AICAS). METHODS: In this study, we performed a single-center, randomized, single-blind, parallel-group clinical trial. A total of 120 Chinese patients with AICAS were enrolled and randomly divided into three groups [low-dose atorvastatin therapy (LAT, 10mg/day), standard-dose atorvastatin therapy (SAT, 20mg/day), and intensive-dose atorvastatin therapy (IAT, 40mg/day) groups] in a 1:1:1 ratio. Evaluation variables, including changes in serum lipid profiles, degree of stenosis, and perfusion-related parameters derived from computed tomography perfusion (CTP) imaging from baseline to weeks 26 and 52, as well as the occurrence of cerebrovascular events during the study period, were used to compare the benefits of these three statin therapies. RESULTS: After 52 weeks of treatment, improvement of serum lipid profiles, degree of stenosis, and perfusion-related parameters were all significantly better in the IAT group. In addition, the cumulative probability of cerebrovascular events at 52 weeks was significantly lower in the IAT group than in the LAT group, although there was no statistical difference between the IAT group and the SAT group. The proportion of patients experiencing any adverse event was similar among the three treatment groups. Adverse events caused by IAT were generally mild; no serious adverse events occurred throughout the entire period of study. CONCLUSION: In conclusion, long-term use of IAT appears to be a safe and effective treatment at least for Chinese patients with AICAS.

Comparative study of intestinal tuberculosis and primary small intestinal lymphoma.

AIM: To characterize the clinical, radiological, endoscopic and pathological features of intestinal tuberculosis (ITB) and primary small intestinal lymphoma (PSIL). METHODS: This was a retrospective study from February 2005 to October 2012 of patients with a diagnosis of ITB (n = 41) or PSIL (n = 37). All patients with ITB or PSIL underwent computed tomography (CT) and pathological examination. Thirty-five patients with ITB and 32 patients with PSIL underwent endoscopy. These patients were followed for a further 18 mo to ascertain that the diagnosis had not changed. Clinical, endoscopic, CT and pathological features were compared between ITB and PSIL patients. RESULTS: Night sweating, fever, pulmonary TB and ascites were discovered significantly more often in ITB than in PSIL patients (P < 0.05), however, abdominal mass, hematochezia and intestinal perforation were found significantly more frequently in PSIL than in ITB patients (P < 0.05). Ring-like and rodent-like ulcers occurred significantly more often in ITB than in PSIL patients (P < 0.05), however, enterorrhagia and raised lesions were significantly more frequent in PSIL than in ITB patients (P < 0.05). The rate of granuloma was significantly higher in ITB than in PSIL patients (87.8% vs 13.5%, χ(2) = 43.050, P < 0.05), and the incidence of confluent granulomas with caseous necrosis was significantly higher in ITB than in PSIL patients (47.2% vs 0.0%, χ(2) = 4.034, P < 0.05). Multi-segmental lesions, mural stratification, mural gas sign, and intestinal stricture were more frequent in ITB than in PSIL patients (P < 0.05), however, a single-layer thickening of bowel wall, single segmental lesions, and intussusception were more common in PSIL than in ITB patients (P < 0.05). Necrotic lymph nodes, comb sign and inflammatory mass were more frequent in ITB than in PSIL patients (P < 0.05). The bowel wall enhancement in ITB patients was greater than that in PSIL patients (P < 0.05), while the thickening and lymph node enlargement in PSIL patients were higher than those in ITB patients (P < 0.05). CONCLUSION: Combined evaluation of clinical, radiological, endoscopic and pathological features is the key to differentiation between ITB and PSIL.

The clinical and CT imaging features of metanephric adenoma.

BACKGROUND: Patients with metanephric adenoma have a good prognosis after undergoing total nephrectomy or local resection with kidney preservation. Accurate diagnosing is important for guiding clinical treatment. Only few previous case reports have been found focusing on the imaging findings of metanephric adenoma. PURPOSE: To evaluate the multislice computed tomography (MSCT) imaging characteristics of metanephric adenoma. MATERIAL AND METHODS: The imaging findings in eight patients with metanephric adenoma were studied retrospectively. MSCT was undertaken to investigate tumor location, size, attenuation, cystic or solid appearance, calcification, capsule sign, and enhancement pattern. RESULTS: Tumors (mean diameter, 3.3 ± 1.0 cm) were solitary (8/8), solid (7/8) with cystic components (2/8), no calcifications (7/8), had a poorly-defined margin (8/8), were centered in the renal medulla (7/8), compressed the renal pelvis (3/8), and none had retroperitoneal lymph node metastasis. The attenuation of metanephric adenoma tumors was less or equal compared to the renal cortex or medulla on unenhanced CT (30.6 ± 2.6 vs. 36.3 ± 4.6 vs. 33.2 ± 3.9, P > 0.05), while tumor enhancement after administration of an contrast agent was lower than that of normal renal cortex and medulla during all phases (P < 0.05). CONCLUSION: Metanephric adenoma tends to be a solitary, poorly defined margin, isodense or hypodense mass arising from the renal medulla with enhancement less than the cortex and medulla during all phases.

[Computed tomographic features of abdominal compartment syndrome complicated by severe acute pancreatitis].

OBJECTIVE: To explore the computed tomographic (CT) imaging features of abdominal compartment syndrome (ACS) complicated by severe acute pancreatitis (SAP) to improve the diagnosis of disease. METHODS: Thirty-six cases of ACS and 61 cases of non-ACS (NACS) complicated by SAP were studied retrospectively. And the meaningful CT features were studied. RESULTS: Among them, the ACS vascular complications of abdominal cavity and gastrointestinal bleeding were found significantly more in ACS than in NACS (P < 0.05). The ACS intestinal obstruction occurred significantly more often in ACS than in NACS (P < 0.05). The ACS inferior vena cava pressure, diaphragm elevation, round belly sign and marked seroperitoneum occurred significantly more often in ACS than in NACS (P < 0.05). The score of ACS with Balthazar was higher than that of NACS (P < 0.05). For CT signs associated with ACS, four or more associated with ACS CT characteristics, the diagnostic sensitivity was 96.5%. And the specificity, positive predictive value and negative predictive value were 100%, 100% and 87.5% respectively. And the surgical survival rate was significantly higher than the non-surgical survival (P < 0.05). CONCLUSION: A comprehensive analysis CT features of ACS is important for early diagnosis and guiding treatment.

[Assessment of the diagnostic value of CT and X-ray enterography for small intestinal Crohn disease].

OBJECTIVE: To investigate the value of CT and X-ray enterography in the diagnosis of small intestinal Crohn disease(CD). METHODS: Data of 39 CD cases confirmed by surgery and pathology who underwent CT and X-ray enterography were analyzed retrospectively. All the patients had complete CT data, 28 cases had X-ray intestinal barium meal data, and 18 had sinus tract enterography. RESULTS: CT enterography showed mural thickening(>4 mm) in 34(87.2%) patients, mural gas in 7(17.9%), mural edema in 7(17.9%), mural fat in 4(10.3%), increased enhancement of bowel wall(>10 HU) in 37(94.9%), multiple segmental lesions in 33(84.6%), single segmental lesions in 6(15.4%), mesenteric lymphadenopathy(>5 mm) in 13(33.3%), vascular bundle thickening in 9(23.1%), cellulitis in 12(30.8%), peritoneal abscess in 10(25.6%), phlegmon in 8(20.5%), incomplete intestinal obstruction in 14(35.9%), seroperitoneum in 22(56.4%), and fistulization in 4(10.3%). CT enterography did not demonstrate the change of mucosa such as strip ulcer or cobblestone. Among the 28 cases of small bowel X-ray enterography, 23 cases(82.1%) presented with multiple segmental lesions, 5(17.9%) with single segmental lesions, 18(64.3%) with strip ulcer, 16(57.1%) with cobblestones, 4(14.3%) with intestinal fistula, while no bowel wall and extraintestinal complication of CD disease was observed. Among the 18 cases of sinus tract enterography, 13 cases (72.2%) presented with intestinal fistula, 12(66.7%) with peritoneal abscess, 8(44.4%) with sinus tract. CONCLUSIONS: CT enterography can demonstrate exactly the diseased bowel wall and extraintestinal complication of CD disease, which is important to evaluate the extent of CD and guide the treatment, however strip ulcer and cobblestone sign cannot be demonstrated. The X-ray enterography is available to demonstrate the characteristic changes of CD such as trip ulcers and cobblestones, but is difficult to show the bowel wall and extraintestinal inflammatory mass and abscesses. The sinus tract enterography is easy to demonstrate the intestinal fistula and intra-abdominal abscess. Combination of these methods is more beneficial to guild the diagnosis and treatment.

[Differential diagnosis of intestinal tuberculosis and primary small intestinal lymphoma using endoscopy and computerized tomography].

OBJECTIVE: To analyze the characteristics of intestinal tuberculosis(ITB) and primary small intestinal lymphoma(PSIL) in order to provide clue for the differential diagnosis. METHODS: Data of 24 cases of ITB and 23 cases of PSIL confirmed by surgery and pathology were retrospectively analyzed. The clinical features, endoscopic and CT scan were compared. All the patients had complete clinical and CT data. Twenty cases of ITB and 20 PSIL had complete endoscopic data. RESULTS: ITB was associated with significantly higher proportion of patients with fever(58.3% vs. 4.3%), night sweating(50.0% vs. 8.6%), pulmonary tuberculosis(54.2% vs. 4.3%) and ascites(54.2% vs. 21.7%) than PSIL(all P<0.05), and lower proportion of patients with abdominal mass (4.2% vs. 39.1%), hematochezia (8.3% vs. 47.8%), and perforation (0 vs. 39.1%)(all P<0.01). Endoscopic examination showed circumferential ulcer and rodent ulcer in 40% and 35% of the patients with ITB, and massive lesion and polypoid lesion in 55% of the patients with PSIL(P<0.05). Multi-segmental lesions, layered thickening, pneumatosis intestinalis, edematous ring, bowel lumen narrowing, hollow lymph nodes, and comb sign were more common in ITB(P<0.05), while single segmental lesions, eccentric thickening, and intussusception were more common in PSIL(P<0.05). The enhancement of intestinal wall of ITB were higher than that of PSIL(P<0.05), while the thickening and lymph nodes enlargement of PSIL were higher than that of ITB(P<0.05). CONCLUSION: The clinical characteristics differ between ITB and PSIL and the differential diagnosis can be made by combining endoscopy and CT.

WITHDRAWN: Comparative study of CT appearances in renal carcinoma associated with Xp11.2 translocation/TFE gene fusion and papillary renal cell carcinoma.

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[Multi-slice computed tomography diagnosis of collecting duct carcinoma].

OBJECTIVE: To explore the diagnostic features of collecting duct carcinoma (CDC). METHODS: A total of 7 CDC patients were retrospectively examined by multi-slice computed tomography (MSCT). The relevant diagnostic parameters were assessed. RESULTS: All lesions were located in renal medulla. Among them, infiltrations extended to renal calyx (n = 3) and cortex (n = 5). There were indistinct boundaries (capsule sign) on enhanced phase (n = 6) and pre-capsule (n = 1). On non-enhanced CT, CDC attenuation was greater than normal renal cortex or medulla (43.8 ± 5.3 vs 37.6 ± 5.1 or 32.6 ± 4.1, P < 0.05). The degree of enhancement was less than normal renal cortex and medulla during all enhanced phases (P < 0.05 or 0.01). Excellent consistency existed between CT appearances of CDC and pathological characteristics. CONCLUSION: Dynamic contrast enhanced-CT can show distinct imaging features of CDC correlated with pathological characteristics so as to allow a better differential diagnosis.

Osteoblastoma of the rib with CT and MR imaging: a case report and literature review.

Osteoblastoma is a rare bone tumor which is mostly found in the vertebral column and long bone. We describe a 59-year-old woman with osteoblastoma in the right fifth posterior segment of the rib, whose presenting symptoms were right back pain for two years and awakened at night. Chest computer tomography (CT) and thoracic spine magnetic resonance (MR) imaging findings included an expansile lesion of the right fifth rib and an ossified matrix. Surgical resection of the lesion confirmed a benign osteoblastoma. 12 months follow-up revealed disappearance of right back pain. Rib osteoblastoma in plain film has been described previously; however, to our knowledge this is the only case report emphasized in CT and MR imaging.