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1.
Clin Case Rep ; 9(10): e04899, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34631083

RESUMO

Myxoid liposarcoma (MLS) is a common subtype of liposarcoma in children and adolescents and can occur anywhere in the body. Cardiac metastases from MLS are very rare. We report a rare case of postoperative recurrence of MLS in the left thigh with ectopic and metachronous pericardial metastases. Cardiac metastases from MLS are rare, the prognosis is poor, and long-term follow-up of patients after discharge is necessary.

2.
Front Oncol ; 11: 740732, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604085

RESUMO

Objective: To build and assess a pre-treatment dual-energy CT-based clinical-radiomics nomogram for the individualized prediction of clinical response to systemic chemotherapy in advanced gastric cancer (AGC). Methods: A total of 69 pathologically confirmed AGC patients who underwent dual-energy CT before systemic chemotherapy were enrolled from two centers in this retrospective study. Treatment response was determined with follow-up CT according to the RECIST standard. Quantitative radiomics metrics of the primary lesion were extracted from three sets of monochromatic images (40, 70, and 100 keV) at venous phase. Univariate analysis and least absolute shrinkage and selection operator (LASSO) were used to select the most relevant radiomics features. Multivariable logistic regression was performed to establish a clinical model, three monochromatic radiomics models, and a combined multi-energy model. ROC analysis and DeLong test were used to evaluate and compare the predictive performance among models. A clinical-radiomics nomogram was developed; moreover, its discrimination, calibration, and clinical usefulness were assessed. Result: Among the included patients, 24 responded to the systemic chemotherapy. Clinical stage and the iodine concentration (IC) of the tumor were significant clinical predictors of chemotherapy response (all p < 0.05). The multi-energy radiomics model showed a higher predictive capability (AUC = 0.914) than two monochromatic radiomics models and the clinical model (AUC: 40 keV = 0.747, 70 keV = 0.793, clinical = 0.775); however, the predictive accuracy of the 100-keV model (AUC: 0.881) was not statistically different (p = 0.221). The clinical-radiomics nomogram integrating the multi-energy radiomics signature with IC value and clinical stage showed good calibration and discrimination with an AUC of 0.934. Decision curve analysis proved the clinical usefulness of the nomogram and multi-energy radiomics model. Conclusion: The pre-treatment DECT-based clinical-radiomics nomogram showed good performance in predicting clinical response to systemic chemotherapy in AGC, which may contribute to clinical decision-making and improving patient survival.

3.
Medicine (Baltimore) ; 100(33): e26944, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414955

RESUMO

BACKGROUND: To explore the diagnostic value of computed tomography (CT) imaging for duodenal lipoma and the potential clinical significance of the findings. METHODS: Clinicopathological and CT data from 57 patients, who were diagnosed with duodenal lipoma at the first affiliated Hospital of Zhengzhou University (Zhengzhou, China) between June 2014 and March 2019, were retrospectively reviewed. Data collected included location and size of the tumor, morphological manifestations (shape, density, boundary), concomitant diseases, pathology and gastroscopy results, and follow-up. Follow-up was performed via telephone, and surgical patients were followed-up for recurrence, metastasis and tumor size, and morphological changes. The follow-up period was up to January 2019. RESULTS: Of the 57 patients with duodenal lipoma, contrast-enhanced scanning was performed in 7 cases. The tumor was located in the descending duodenum in 33 cases, the ascending in 4 cases, the horizontal in 16 cases, and the bulb in 4 cases. Mean tumor size was 13.0 ±â€Š5.8 mm. CT morphological features of the tumor were as follows: tumor shape, round, quasi-round, or oval (n = 42); long strip (n = 3); nodular (n = 2); triangular (n = 1); and irregular lobulated (n = 9). Among the 57 patients, tumor density was homogeneous in 52 cases, inhomogeneous in 4 cases, and nodular with calcification in 1 case. The tumor boundary was classified as clear and with no capsule. Diseases concomitant with the tumor were as follows: gastritis (n = 23), gastric adenocarcinoma (n = 1), and gastric lymphoma (n = 1). Esophageal disease was found in 16 cases, including reflux esophagitis (n = 12) and esophageal cancer (n = 4). There were 13 cases of gallbladder and biliary disease, including cholecystolithiasis and cholecystitis (n = 9), common bile duct disease (n = 2), colorectal cancer (n = 4), lung cancer (n = 2), duodenal carcinoma with obstruction (n = 1), and ureteral space narrowing (n = 1). CONCLUSION: CT was an effective, non-invasive method for diagnosis of duodenal lipoma. CT imaging could clearly discern location, size, shape, and nature of duodenal lipomas. Duodenal lipoma can be associated with digestive tract inflammatory diseases and tumors in different locations, and its diagnosis is potentially valuable for their prevention and treatment.


Assuntos
Neoplasias Duodenais/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/patologia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Feminino , Humanos , Lipoma/diagnóstico , Lipoma/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
Medicine (Baltimore) ; 100(27): e25938, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232165

RESUMO

ABSTRACT: 2019 Novel Coronavirus (COVID-19) is a new acute infectious disease of respiratory system, posed a great threat to human health because of its strong infectivity and rapid progress. This study aimed to assess the severity of COVID-19 Pneumonia by analyzing the change of CT manifestations and body temperature.This retrospective review included 22 patients with COVID-19 pneumonia. The imaging manifestations and clinical features were observed and evaluated.Most of the infected patients were men (13/22, 59%). Fever (>38°C) (17/22, 77%) and cough (6/22, 27%) were the main symptoms. Leukocytes count decreased in 23% of patients and lymphocyte decreased in 41%. Twenty-one patients with pneumonia had abnormal findings on chest CT. The special CT manifestations were observed at the first CT examination when the lesions progressed, including a single ground glass nodule with uneven density, multiple ground glass opacities distributed in subpleural, and the ground glass opacities confined in superior lobe. The special CT manifestations were observed at the first CT examination when the lesions resolved, including ground glass opacities with homogeneous density. The lesion involved in the bilateral lungs and the absorption of the lesions mainly occurred in bilateral inferior lobes. Three patients had normalized body temperature increased more than 1°C within 1 to 2 days after admission. Ten patients fluctuated more than 1°C within 1 to 7 days after admission and the second CT scans showed the disease was at the progressive stage.Dynamic analysis of CT manifestations and body temperature have the potential to predict the severity of COVID-19 pneumonia.


Assuntos
Temperatura Corporal/fisiologia , COVID-19/diagnóstico , Pulmão/diagnóstico por imagem , Pandemias , SARS-CoV-2 , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/fisiopatologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
5.
Chin J Acad Radiol ; : 1-9, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34222797

RESUMO

Background: Coronary artery calcification (CAC) is an independent risk factor of major adverse cardiovascular events; however, the impact of CAC on in-hospital death and adverse clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective: To explore the association between CAC and in-hospital mortality and adverse events in patients with COVID-19. Methods: This multicenter retrospective cohort study enrolled 2067 laboratory-confirmed COVID-19 patients with definitive clinical outcomes (death or discharge) admitted from 22 tertiary hospitals in China between January 3, 2020 and April 2, 2020. Demographic, clinical, laboratory results, chest CT findings, and CAC on admission were collected. The primary outcome was in-hospital death and the secondary outcome was composed of in-hospital death, admission to intensive care unit (ICU), and requiring mechanical ventilation. Multivariable Cox regression analysis and Kaplan-Meier plots were used to explore the association between CAC and in-hospital death and adverse clinical outcomes. Results: The mean age was 50 years (SD,16) and 1097 (53.1%) were male. A total of 177 patients showed high CAC level, and compared with patients with low CAC, these patients were older (mean age: 49 vs. 69 years, P < 0.001) and more likely to be male (52.0% vs. 65.0%, P = 0.001). Comorbidities, including cardiovascular disease (CVD) ([33.3%, 59/177] vs. [4.7%, 89/1890], P < 0.001), presented more often among patients with high CAC, compared with patients with low CAC. As for laboratory results, patients with high CAC had higher rates of increased D-dimer, LDH, as well as CK-MB (all P < 0.05). The mean CT severity score in high CAC group was also higher than low CAC group (12.6 vs. 11.1, P = 0.005). In multivariable Cox regression model, patients with high CAC were at a higher risk of in-hospital death (hazard ratio [HR], 1.731; 95% CI 1.010-2.971, P = 0.046) and adverse clinical outcomes (HR, 1.611; 95% CL 1.087-2.387, P = 0.018). Conclusion: High CAC is a risk factor associated with in-hospital death and adverse clinical outcomes in patients with confirmed COVID-19, which highlights the importance of calcium load testing for hospitalized COVID-19 patients and calls for attention to patients with high CAC. Supplementary Information: The online version contains supplementary material available at 10.1007/s42058-021-00072-4.

6.
Front Oncol ; 11: 677814, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34079766

RESUMO

Purpose: It is challenging for traditional CT signs to predict invasiveness of pancreatic solid pseudopapillary neoplasm (pSPN). We aim to develop and evaluate CT-based radiomics signature to preoperatively predict invasive behavior in pSPN. Methods: Eighty-five patients who had pathologically confirmed pSPN and preoperative contrasted-enhanced CT imaging in our hospital were retrospectively analyzed (invasive: 24; non-invasive: 61). 1316 radiomics features were separately extracted from delineated 2D or 3D ROIs in arterial and venous phases. 200% (SMOTE) was used to generate balanced dataset (invasive: 72, non-invasive: 96) for each phase, which was for feature selection and modeling. The model was internally validated in the original dataset. Inter-observer consistency analysis, spearman correlation, univariate analysis, LASSO regression and backward stepwise logical regression were mainly applied to screen the features, and 6 logistic regression models were established based on multi-phase features from 2D or 3D segmentations. The ROC analysis and Delong's test were mainly used for model assessment and AUC comparison. Results: It retained 11, 8, 7 and 7 features to construct 3D-arterial, 3D-venous, 2D-arterial and 2D-venous model. Based on 3D ROIs, the arterial model (AUC: 0.914) performed better than venous (AUC: 0.815) and the arterial-venous combined model was slightly improved (AUC: 0.918). Based on 2D ROIs, the arterial model (AUC: 0.814) performed better than venous (AUC:0.768), while the arterial-venous combined model (AUC:0.893) performed better than any single-phase model. In addition, the 3D arterial model performed better than the best combined 2D model. The Delong's test showed that the significant difference of model AUC existed in arterial models in original dataset (p = 0.019) while not in arterial-venous combined model (p=0.49) as comparing 2D and 3D ROIs. Conclusion: The arterial radiomics model constructed by 3D-ROI feature is potential to predict the invasiveness of pSPN preoperatively.

7.
Medicine (Baltimore) ; 100(21): e25846, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032697

RESUMO

ABSTRACT: Composite hemangioendothelioma (CHE) is a rare vascular neoplasm of intermediate malignant potential. Only 52 cases have been reported in the English literature, and one case previously reported occurred in the spleen. The purpose of our study was to report a 65-year-old man diagnosed as CHE primary arising from the spleen with multiple metastases.Clinical and imaging features, laboratory tests, and pathological results about CHE were described in detail in this study.The patient presented with multiple lesions in bilateral lungs and spleen that had been incidentally detected by computed tomography (CT). Except for thrombocytopenia, other laboratory tests were not significant. The CT scan of the abdomen revealed multiple round-like and irregularly mixed density masses with unclear borders in enlarged spleen. And contrast enhancement showed mild heterogeneous enhancement. CT scan also showed widespread liver, ribs, lungs, and vertebral bodies metastases. This diagnosis was confirmed by histopathological examination. The patient underwent splenectomy and still survives with tumors after six months followed-up.Due to the lack of specificity of clinical features and laboratory tests, it is necessary to combine imaging features and pathological findings to make a correct diagnosis.


Assuntos
Hemangioendotelioma/diagnóstico , Neoplasias Complexas Mistas/diagnóstico , Baço/patologia , Neoplasias Esplênicas/diagnóstico , Idoso , Hemangioendotelioma/secundário , Hemangioendotelioma/cirurgia , Humanos , Masculino , Neoplasias Complexas Mistas/secundário , Neoplasias Complexas Mistas/cirurgia , Baço/diagnóstico por imagem , Esplenectomia , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
8.
World J Clin Cases ; 9(15): 3704-3710, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34046473

RESUMO

BACKGROUND: Giant cell tumor of soft tissue (GCT-ST) is an extremely rare low-grade soft tissue tumor that is originates in superficial tissue and rarely spreads deeper. GCT-ST has unpredictable behavior. It is mainly benign, but may sometimes become aggressive and potentially increase in size within a short period of time. CASE SUMMARY: A 17-year-old man was suspected of having a fracture, based on radiography following left shoulder trauma. One month later, the swelling of the left shoulder continued to increase and the pain was obvious. Computed tomography (CT) revealed a soft tissue mass with strip-like calcifications in the left shoulder. The mass invaded the adjacent humerus and showed an insect-like area of destruction at the edge of the cortical bone of the upper humerus. The marrow cavity of the upper humerus was enlarged, and a soft tissue density was seen in the medullary cavity. Thoracic CT revealed multiple small nodules beneath the pleura of both lungs. A bone scan demonstrated increased activity in the left shoulder joint and proximal humerus. The mass showed mixed moderate hypointensity and hyperintensity on T1-weighted images, and mixed hyperintensity on T2-weighted fat-saturated images. The final diagnosis of GCT-ST was confirmed by pathology. CONCLUSION: GCT-STs should be considered in the differential diagnosis of soft tissue tumors and monitored for large increases in size.

9.
Int J Cardiovasc Imaging ; 37(1): 285-290, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32812146

RESUMO

Epithelioid hemangioendothelioma (EHE) is a rare hemangioma that can occur anywhere in the body. It occurs most commonly in the liver and lungs, rarely from the heart, and the etiology or risk factors are unclear. So far, timely detection and radical resection is a more acceptable treatment. Reviewing the literature, few cases of cardiac EHE have been reported. We present a rare case of EHE of the right atrium invaded the superior vena cava.


Assuntos
Átrios do Coração/patologia , Neoplasias Cardíacas/patologia , Hemangioendotelioma Epitelioide/patologia , Veia Cava Superior/patologia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Hemangioendotelioma Epitelioide/diagnóstico por imagem , Hemangioendotelioma Epitelioide/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Resultado do Tratamento , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/cirurgia
10.
World Neurosurg ; 145: e224-e232, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33059078

RESUMO

OBJECTIVE: An optimized Enhanced Recovery After Surgery (ERAS) program is lacking for adolescent idiopathic scoliosis (AIS). The aim of the present study was to evaluate the impact and feasibility of an optimized ERAS pathway in patients with surgically treated AIS. METHODS: In total, 79 patients with AIS who underwent corrective surgery without 3-column osteotomy were recruited from Xijing Hospital of the Fourth Military Medical University between 2012 and 2018. Forty-four patients were treated according to a traditional protocol and 35 were managed using an optimized ERAS pathway, which was designed and implemented by a multidisciplinary team. The following data were collected and retrospectively analyzed, demographic characteristics, Cobb angle, curve type (Lenke), surgical duration, fusion level, correction rate, estimated blood loss, postoperative hemoglobin level, postoperative pain score, pain relief time, hemovac drainage, drainage removal time, first ambulation time, length of hospital stay, and postoperative complications. RESULTS: There was no significant difference between the traditional and ERAS groups with respect to demographic characteristics, Cobb angle, curve type (Lenke), fusion level, and correction rate. However, the ERAS group had a shorter surgical duration, less blood loss and hemovac drainage, a higher postoperative hemoglobin level, and earlier pain relief, ambulation, and discharge. The rates of postoperative nausea and vomiting were lower in the ERAS group than in the traditional group. CONCLUSIONS: The ERAS pathway is capable of improving the perioperative status of patients with AIS by offering stronger analgesia, faster ambulation, and earlier discharge.


Assuntos
Recuperação Pós-Cirúrgica Melhorada , Escoliose/cirurgia , Adolescente , Estudos de Coortes , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos
11.
World J Gastroenterol ; 26(31): 4680-4693, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32884225

RESUMO

BACKGROUND: The rare incidence of esophageal neuroendocrine carcinoma (NEC) and limited treatment experience result in insufficient clinical observations and unsuitable guidelines for its management. AIM: To investigate the prognostic value of pretreatment contrast-enhanced computed tomography (CT) characteristics in patients with esophageal NEC. METHODS: Seventy-seven esophageal NEC patients who received contrast-enhanced CT at two hospitals were enrolled in this study from June 2014 to December 2019. The clinical features and image characteristics were recorded accordingly. Univariate survival analysis was performed using the Kaplan-Meier method and log-rank test, and multivariate analysis was carried out with a Cox proportional hazards model. RESULTS: The multivariate analysis performed using the Cox proportional hazards model showed that N stage, adjuvant chemotherapy, and degree of enhancement were independent prognostic factors for overall survival (OS). Meanwhile, adjuvant chemotherapy was an independent prognostic factor for progression-free survival (PFS). The hazard ratios (HRs) of N stage, adjuvant chemotherapy, and degree of enhancement (mild vs moderate/marked) for OS were 0.426 (P = 0.024), 3.862 (P = 0.006), and 2.169/0.809 (P = 0.037), respectively. The HR of adjuvant chemotherapy for PFS was 6.432 (P < 0.001). Adjuvant chemotherapy was significantly associated with degree of enhancement (P = 0.018). CONCLUSION: Adjuvant chemotherapy is an independent prognostic factor for OS and PFS. Additionally, N stage and degree of enhancement are prognostic factors for OS in patients with esophageal NEC.


Assuntos
Carcinoma Neuroendócrino , Tomografia Computadorizada por Raios X , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/terapia , Quimioterapia Adjuvante , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos
12.
Front Oncol ; 10: 1611, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32850465

RESUMO

Purpose: Gastric sarcomatoid carcinoma (GSC) is a very rare malignant tumor. The purpose of this study is to describe the clinical, computed tomography (CT), and pathologic features of GSC to increase awareness of this entity. Methods: The CT features and clinical data of five patients with pathologically documented GSC were retrospectively analyzed and compared with the corresponding data of gastric adenocarcinoma and lymphoma. Results: Among the 5 patients, 4 were male, and 1 was female. The median age was 59 years. Of the 5 cases of GSC, 3 were in the gastric fundus and cardia, 1 was in the gastric body, and 1 was in the gastric fundus. The gastric wall had local thickening in 4 cases and mass formation in 1 case, with stenosis and deformation of the adjacent gastric cavity. The long-axis diameter of the lesions ranged from 1.4 to 10.2 cm (mean, 4.97 cm) and was <10 cm in 4 cases and >10 cm in 1 case. The tumor showed predominantly inhomogeneous density, with radiodensity values ranging from 30 to 53 HU. In addition, ulcers with an irregular base and slightly raised borders were observed in 4 of 5 cases. After an injection of contrast material, heterogeneous (n = 4) or homogeneous (n = 1) enhancement was observed. After contrast medium injection, obvious enhancement was seen in 2 cases, and moderate enhancement was seen in 3 cases; the peak tumor signal was observed in the portal phase. Two of the patients demonstrated evidence of lymph node involvement, and in one patient, the boundary between the lesion and the left lobe of the liver was unclear, with low attenuation in the right lobe of the liver with circular enhancement. The remaining two patients showed no evidence of metastasis. Conclusion: Although GSC is extremely rare, it should be considered in the differential diagnosis of gastric adenocarcinoma and lymphoma. CT findings, combined with patient age and sex, can provide support for the diagnosis of GSC. However, the final diagnosis must be confirmed with histopathology.

13.
Cancer Imaging ; 20(1): 15, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024553

RESUMO

BACKGROUND: Mature cystic teratoma (MCT) with meningioma of the ovary is a very rare benign tumor. There is only 3 reports of this disease until June 2019. The aim of the present study was to describe a ovarian mature cystic teratoma containing meningioma and nests of neuroblasts in a 15-year-old girl. METHODS: The method used in the present study consists of description of the clinical history, image lab features, and pathological result. RESULTS: The patient complained of a 2-month history of irregular vaginal bleeding. Abdominal computed tomography (CT) showed a large oval cystic-solid mass with septations and fat density shadow, in abdomen pelvic cavity. The cystic part was the main component in the mass. The tumoral solid parts and its internal division could be seen intensified from slight to moderate on contrast-enhanced CT images compared with those on precontrast images, and the solid parts showed heterogeneous enhancement. Neighbouring intestinal tract and the uterus displaced by compression. The pathological examination confirmed the diagnosis. CONCLUSIONS: The clinical feature of ovarian mature cystic teratoma with meningioma includes a lack of specificity. Only meticulous recording of the gross features, histopathological examination including immunohistochemistry and supportive clinical and radiological findings to arrive at a correct diagnosis in case of unconventional tumours. If necessary, preoperative puncture can be performed.


Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Adolescente , Feminino , Humanos , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/patologia , Meningioma/complicações , Meningioma/patologia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/patologia , Teratoma/complicações , Teratoma/patologia , Tomografia Computadorizada por Raios X
14.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(6): 631-635, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31875442

RESUMO

OBJECTIVE: This study aimed to investigate the value of normalized iodine concentration (NIC), spectral attenuation curve slope (SACS), area under curve (AUC), and iodine concentration difference (ICD) generated from spectral CT in the assessment of parotid gland tumors. METHODS: Ninety-two patients with pathologically confirmed parotid gland tumors underwent arterial phase- and venous phase-enhanced CT in spectral CT. The patients were divided into the pleomor-phic adenoma group (group A), Warthin tumor group (group B), basal cell tumor group (group C), and malignant tumor group (group D). The SACS, AUC, NIC, ICD were measured and analyzed. Statistical analyses were performed by one-way ANOVA, and statistical significance was set at P<0.05. RESULTS: SACS(AP), AUC(AP), and NIC(AP) in group A were lower than those in other groups; SACS(VP) and AUC(VP) in group C were higher than those in other groups; NIC(AP) and NIC(VP) in group D were higher than those in other groups; and ICD in group B was a positive number. The difference in SACS(AP) and AUC(AP) in groups B and C, SACS(VP) and AUC(VP) in groups C and D, and ICD in groups A and C were not statistically significant. By contrast, the diffe-rence between the other groups was statistically significant (P<0.05). The difference in NIC(AP) between groups A and B and groups C and D and the difference in NIC(VP) between groups A and C, groups A and D, and groups B and C were statistically significant (P=0.005, 0.025, 0.002, 0.038, and 0.049, respectively). CONCLUSIONS: Multi-quantitative parameters from spectral CT might be helpful in differentiating various types of parotid gland tumors.


Assuntos
Iodo , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Humanos , Glândula Parótida
15.
J Comput Assist Tomogr ; 43(5): 721-728, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356519

RESUMO

OBJECTIVE: This study aimed to investigate the predictive and prognostic values of repeated spectral computed tomographic (CT) parameter changes for the prediction of treatment responses to the angiogenesis inhibitor AL3818 in hepatic tumors. METHODS: A total of 30 rabbits with VX2 hepatic tumors that underwent spectral contrast-enhanced abdominal CT before and during treatment were included in the study. The percent change (Δ, %) of the normalized iodine concentration (nIC) during the arterial phase (AP) and venous phase (VP) was used to predict the tumor response and to calculate the overall survival (OS). The threshold of the nIC for tumor response prediction and prognostic significance was determined by a receiver operating characteristic curve and Kaplan-Meier analysis. RESULTS: After treatment, there were 43% (13/30) responders and 57% (17/30) nonresponders. When ΔnICAP ≥ -13.10% was used as the threshold, the sensitivity and specificity for the prediction of tumor response were 82.41% and 92.31%, respectively. ΔnICVP resulted in 88.20% sensitivity and 76.92% specificity for cutoff values ≥10.78%. Kaplan-Meier analyses showed that high ΔnICAP and ΔnICVP were associated with improved OS. CONCLUSIONS: The current study shows the capability of the changes (Δ) in repeated spectral CT parameters to predict the tumor response during antiangiogenesis therapy in small hepatic tumors. ΔnICAP and ΔnICVP were predictors for treatment response and were associated with OS.


Assuntos
Inibidores da Angiogênese/farmacologia , Indóis/farmacologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Quinolinas/farmacologia , Tomografia Computadorizada por Raios X , Animais , Meios de Contraste , Modelos Animais de Doenças , Iohexol/análogos & derivados , Valor Preditivo dos Testes , Prognóstico , Coelhos , Interpretação de Imagem Radiográfica Assistida por Computador
16.
Medicine (Baltimore) ; 98(14): e14839, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946311

RESUMO

Epstein-Barr virus (EBV)-associated lymphoepithelioma-like gastric carcinoma (LELGC) is a rare primary stomach tumor, which has overlapping imaging features with mass forming gastric carcinoma (GC). The aim of our study was to present the computed tomography (CT) findings and clinical features of EBV-associated LELGC to increase awareness of this entity.The CT findings and clinical features of 4 patients with pathologically documented EBV-associated LELGC were retrospectively analyzed.Among the 4 patients, 3 were male, and 1 was female. The medium age was 51 years old. All cases were single lesions including 1 was in the gastric cardia, 1 was in the gastric body, and 2 were in the gastric antrum. A focal thickening of the gastric wall was conducted, with a large thickness-to-length ratio. The low-density stripe of the normal gastric wall abruptly terminated at the edge of the lesion. The CT images of 4 cases showed inhomogeneous density with the radiodensity values ranging from 25 to 48 HU. In addition, an ulcer was demonstrated with an irregular base and slightly raised borders in all cases. Enhancement after injection of contrast material was heterogeneous enhancement (n = 3) or homogeneous (n = 1). After enhancement, obvious enhancement was seen in 1 case, moderate enhancement was seen in 3 cases, with the peak value of the tumor in the portal phase. No evidence of lymph node involvement and distant invasion was observed.Although LELGC is quite rare, it should be considered in differential diagnosis of early GC, advanced GC, and lymphoma. The relatively typical CT appearance, combined the age and sex of patients, can suggest the diagnosis of LELGC.


Assuntos
Infecções por Vírus Epstein-Barr/complicações , Neoplasias Gástricas/diagnóstico por imagem , Estômago/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Conscientização , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Carcinoma/virologia , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/patologia , Feminino , Herpesvirus Humano 4/isolamento & purificação , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Linfoma/patologia , Linfoma/virologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estômago/patologia , Estômago/virologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/virologia
17.
Clin Chim Acta ; 487: 330-336, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30347182

RESUMO

BACKGROUND: Oxidative stress is related to brain injury after spontaneous intracerebral hemorrhage (ICH). Myeloperoxidase (MPO) is a potent oxidizing enzyme. We tested the hypothesis that serum MPO concentrations are increased after ICH and they correlate with stroke severity and outcome. METHODS: Serum MPO concentrations were measured in 128 ICH patients and 128 controls. Odds ratios of dependent variables, including early neurological deterioration, hematoma growth, 1-week mortality, 6-month mortality, 6-month unfavorable outcome (modified Rankin Scale score > 2) and 6-month overall survival, were calculated and adjusted for age, sex, hematoma volume, National Institutes of Health Stroke Scale (NIHSS) score and vascular risk factors. RESULTS: As compared to the controls, the patients had significantly increased serum MPO concentrations. MPO concentrations of the ICH patients were strongly correlated with hematoma volume and NIHSS scores. Serum MPO were independently associated with the above-mentioned study points. Its area under receiver operating characteristic curve was equivalent to those of hematoma volume and NIHSS score. Moreover, serum MPO significantly improved the discriminatory ability of hematoma and NIHSS in predicting 6-month mortality and unfavorable outcome. CONCLUSIONS: Serum MPO concentrations rise in ICH patients and there is a correlation between MPO concentrations and severity or prognosis.


Assuntos
Hemorragia Cerebral/sangue , Peroxidase/sangue , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
18.
World J Gastroenterol ; 24(36): 4197-4207, 2018 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-30271084

RESUMO

AIM: To evaluate the T stage of esophageal squamous cell carcinoma (ESCC) using preoperative low-dose esophageal insufflation computed tomography (EICT). METHODS: One hundred and twenty ESCC patients confirmed by surgery or esophagoscopy were divided into three groups. Groups B and C were injected with 300 mgI/kg contrast medium for automatic spectral imaging assist (GSI assist), while group A underwent a conventional 120 kVp computed tomography (CT) scan with a 450 mgI/kg contrast medium injection. EICT was performed in group C. Group A was reconstructed with filtered back projection, and groups B and C were reconstructed with 50% adaptive statistical iterative reconstruction. The contrast-to-noise ratio of lesion-to-mediastinal adipose tissue and the radiation dose were measured. Specific imaging features were observed, and T stage ESCCs were evaluated. RESULTS: The sensitivity and accuracy of the T1/2 stage were higher in group C than in groups A and B (sensitivity: 43.75% vs 31.82% and 33.33%; accuracy: 54.29% vs 46.67% and 52.50%, respectively). With regard to the T3 stage, the sensitivity and specificity in group C were higher than those in groups A and B (sensitivity: 56.25% vs 41.17% and 44.44%; specificity: 73.68% vs 67.86% and 63.64%, respectively). The diagnostic sensitivity, specificity and accuracy of the T4 stage were similar among all groups. There were no significant differences in volume CT dose index [(5.91 ± 2.57) mGy vs (3.24 ± 1.20) vs (3.65 ± 1.77) mGy], dose-length product [(167.10 ± 99.08) mGy•cm vs (113.24 ± 54.46) mGy•cm vs (117.98 ± 32.32) mGy•cm] and effective dose [(2.52 ± 1.39) vs (1.63 ± 0.76) vs (1.73 ± 0.44) mSv] among the groups (P > 0.05). However, groups B and C received similar effective doses but lower iodine loads than group A [(300 vs 450) mgI/kg]. CONCLUSION: EICT combined with GSI assist allows differential diagnosis between the T1/2 and T3 stages. The ability to differentially diagnose the T3 and T4 stages of medullary ESCC can be improved by quantitatively and qualitatively analyzing the adipose tissue in front of the vertebral body.


Assuntos
Neoplasias Esofágicas/diagnóstico por imagem , Carcinoma de Células Escamosas do Esôfago/diagnóstico por imagem , Esôfago/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste/administração & dosagem , Diagnóstico Diferencial , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/patologia , Esofagoscopia , Esôfago/patologia , Estudos de Viabilidade , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Insuflação/efeitos adversos , Insuflação/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Doses de Radiação , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/efeitos adversos
19.
Clin Chim Acta ; 486: 162-167, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30077639

RESUMO

BACKGROUND: Cyclophilin A is involved in brain injury. We investigated the relationship between serum cyclophilin A concentrations, hemorrhagic severity and clinical outcome in intracerebral hemorrhage (ICH). METHODS: We enrolled 105 ICH patients and 105 healthy individuals. Admission serum cyclophilin A concentrations were detected in ICH patients. Hemorrhagic severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and hematoma volume. Modified Rankin Scale score > 2 was defined as a poor outcome. RESULTS: Serum cyclophilin A concentrations were significantly higher in patients than in controls. There was a close correlation of serum cyclophilin A concentrations with NIHSS scores and hematoma volume. Serum cyclophilin A emerged as an independent predictor for 6-month mortality, overall survival and poor outcome. Moreover, it had a strong discriminatory ability for 6-month mortality and poor outcome. Furthermore, it could significantly improve the prognostic predictive ability of NIHSS scores or hematoma volume alone. CONCLUSIONS: Increasted serum cyclophilin A concentrations are highly associated with stroke severity and prognosis after hemorrhagic stroke.


Assuntos
Hemorragia Cerebral/sangue , Hemorragia Cerebral/diagnóstico , Ciclofilina A/sangue , Doença Aguda , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Taxa de Sobrevida
20.
Cancer Imaging ; 18(1): 26, 2018 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-30086800

RESUMO

BACKGROUND: Identifying gastric heterotopic pancreas and stromal tumors is difficult. Few studies have reported computed tomography (CT) findings for differentiating lesions less than 3 cm in diameter. In this study, we aimed to identify clinical characteristics and CT findings that can differentiate gastric heterotopic pancreatic lesions from stromal tumors less than 3 cm in diameter. METHODS: A total of 132 patients with pathologically confirmed gastric heterotopic pancreas (n = 66) and stromal tumors (n = 66) were included. Each group was divided into primary (n = 50) and validation cohort (n = 16). Clinical characteristics and CT findings were retrospectively reviewed. CT findings included location, border, contour, growth pattern, enhancement pattern and grade, the enhancement value of tumor, enhancement ratio of tumor, and enhancement ratio of tumor to pancreas in venous phase. The findings in the two groups were compared using the Pearson χ2 test or Student t-test. Receiver operating characteristic curves were used to determine areas under the curve and optimal cut-offs. RESULTS: Significant differences were observed between heterotopic pancreas and stromal tumors in the distribution of tumor location, border, contour (all P < 0.001), enhancement values (P < 0.001), enhancement ratios of tumors (P < 0.001), and enhancement ratios of tumors to pancreas (P < 0.001). No significant differences existed in growth pattern (P = 0.203). The area under the curve differed significantly between enhancement ratio of tumor to pancreas and enhancement ratio (P = 0.030). There were significant differences in above characteristics between two groups in validation cohort. CONCLUSIONS: Heterotopic pancreas has characteristic CT features differentiating it from stromal tumors.


Assuntos
Coristoma/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Pâncreas , Tomografia Computadorizada por Raios X , Adulto , Idoso , Coristoma/patologia , Diagnóstico Diferencial , Feminino , Tumores do Estroma Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-Idade
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