Multi-slice spiral computed tomography diagnosis of juxta-papillary duodenal diverticulum and its relationship with biliopancreatic diseases.

BACKGROUND: Juxta-papillary duodenal diverticula (JPDD) are common but are usually asymptomatic, and they are often diagnosed by coincidence. OBJECTIVE: To analyse the anatomy and classification of JPDD and its relationship with biliary and pancreatic disorders, and to explore the diagnostic value of multi-slice spiral computed tomography (MSCT) in patients with JPDD. METHODS: The imaging data of patients with JPDD, which was obtained via abdominal computed tomography examination and confirmed via gastroscopy and/or upper gastrointestinal barium enema, in our hospital from 1 January 2019 to 31 December 2020 were retrospectively analysed. All patients were scanned using MSCT, and the imaging findings, classification and grading were analysed. RESULTS: A total of 119 duodenal diverticula were detected in 96 patients, including 73 single diverticula and 23 multiple diverticula. The imaging findings were mainly cystic lesions of the inner wall of the duodenum protruding to the outside of the cavity. The thin layer showed a narrow neck connected with the duodenal cavity, and the shape and size of the diverticula were different: 67 central-type cases and 29 peripheral-type cases. There were 50 cases of type I, 33 cases of type II, 19 cases of type III and six cases of type IV. Furthermore, there were seven small, 87 medium and 14 large diverticula. The differences in the location and size of the JPDD in MSCT grading were statistically significant (P< 0.05). CONCLUSION: The MSCT method has an important diagnostic value for the classification of JPDD, and MSCT images are helpful in the clinical evaluation of patients with JPDD and the selection of treatment options.

Diagnostic Value of Magnetic Resonance Diffusion-Weighted Imaging Combined with Routine Scanning in Body Tumors.

The aim of this study was to evaluate the value of whole body magnetic resonance diffusion-weighted imaging (WB-DWI) combined with routine scanning in the diagnosis of body tumors. Sixty-three patients with surgically and pathologically confirmed body tumors admitted to our hospital from October 2019 to October 2021 were scanned by WB-DWI using a 1.5TMR body coil. The images were reconstructed by a three-dimensional maximum intensity projection (3D-MIP) and black-white inversion technique. The lesions detected by WB-DWI were all plain MRI, and 35 cases were enhanced MRI. The number of lesions detected by WB-DWI and WB-DWI combined with routine scanning and the number of cases matching diagnosis were compared. The WB-DWI images of tumor lesions were analyzed, and the apparent diffusion coefficient (ADC) of the lesions was measured, and the ADC value of benign and malignant lesions was compared. There were 236 lesions in 63 patients with clinically confirmed tumors. 46 cases were diagnosed by WB-DWI, the diagnostic coincidence rate was 73.0%, and 207 lesions were detected. Fifty-eight cases were diagnosed by WB-DWI combined with routine scanning, the diagnostic coincidence rate was 92.1%, 236 lesions were detected. There were statistically significant differences in the number of lesions detected and the coincidence rate of tumor diagnosis between the two groups (P < 0.05). The average ADC value of malignant tumor ((1.04 ± 0.46) × 10-3 mm2/s) was lower than that of benign tumor ((2.53 ± 0.43) × 10-3 mm2/s), and the difference was statistically significant (P < 0.05). In conclusion, MR whole-body diffusion weighted imaging is safe, efficient, radiation-free, and highly sensitive, which is of great significance in the differential diagnosis of benign and malignant lesions. WB-DWI combined with MR routine scanning can further improve the detection rate of lesions and the coincidence rate of tumor diagnosis.

Characteristics and clinical value of 3D MR imaging in the diagnosis of pulmonary embolism.

The aim of the present study was to investigate the characteristics and value of 3D dynamic contrast-enhanced magnetic resonance pulmonary angiography (3D-DCE-MRPA) for the diagnosis of pulmonary embolism (PE). Among patients suspected with PE, 30 cases were scheduled for 3D-DCE-MRPA [magnetic resonance imaging (MRI) group], and 30 cases were examined using multislice computed tomographic pulmonary angiography (msCTPA) [computed tomography (CT) group]. Direct signs including location, number, morphology of emboli, and indirect signs such as pulmonary infarction, pneumonia and pleural effusion, were analyzed. Pulmonary artery enhancement was observed. Image quality was contrasted, branches of the pulmonary artery revealed, and differences in sensitivity, specificity and signal-to-noise ratio (SNR) were compared. The number and morphology of emboli in the two groups were compared, and there were no significant differences (P>0.05). In the MRI group, significantly more emboli were located in segmental and subsegmental bronchi (P<0.05). The indirect signs in the two groups were compared and the differences were not statistically significant (P>0.05). The difference in image quality between the two groups was not statistically significant (P>0.05). Levels 5 and 6 of the pulmonary artery branch were more evident in the MRI group compared to the CT group. The SNR and carrier-to-noise ratio in the MRI group were significantly higher than those in the CT group (P<0.05). Twenty-six cases of PE were diagnosed in the CT group, with a sensitivity of 90.5% and specificity of 86.7%. Twenty-five cases were diagnosed in the MRI group, with a sensitivity of 92.3% and specificity of 84.2%. In conclusion, 3D-DCE-MRPA surpassed msCTPA in revealing segmental and subsegmental pulmonary artery PE.