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1.
Hepatol Res ; 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31883216

RESUMO

BACKGROUND & AIMS: Controlled attenuation parameter (CAP) measured by vibration-controlled transient elastography (VCTE, FibroScan(®)) allows repeatable and reliable assessment of liver steatosis for screening of patients at risk of non-alcoholic steatohepatitis (NASH) development among asymptomatic individuals at community level. However, this has never been compared to another quantitative method, such as magnetic resonance imaging-based proton density fat fraction (MRI-PDFF), among Chinese health check-up population. METHODS: A multicenter prospective study was conducted in Chinese subjects undergoing regular health check-up. Steatosis grading by MRI-PDFF was used as the reference to evaluate the diagnostic performance of CAP. RESULTS: 173 subjects were included with mean age of 45 ± 11 years and BMI was 25.8 ± 4.0 kg/m2 . A linear correlation was found between CAP and log10-transformed MRI-PDFF results (Pearson's coefficient = 0.772, P < 0.001). The areas under receiver operating characteristic (AUROCs) curve for distinguishing ≥S1 and ≥S2 steatosis were 0.88 (95% confidence interval (CI): 0.83 - 0.93) and 0.89 (95% CI: 0.83 - 0.95) respectively. When optimized for ≥90% sensitivity, the CAP cutoff for staging ≥S1 steatosis was 244 dB/m. CAP could classify patients with ≥S1 steatosis with similar performance as ultrasound examination. CONCLUSIONS: As a noninvasive and quantitative method, CAP is very adapted for population screening at community level. With the integration of liver stiffness and CAP results in risk stratification scores for NASH, VCTE can be useful in regular health check-up.

2.
J Cancer ; 10(26): 6594-6598, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777588

RESUMO

Purpose: To investigate the accuracy of magnetic resonance imaging (MRI) in preoperative staging diagnosis for rectal cancer with multidisciplinary team (MDT) discussion. Methods: The retrospective study included 377 patients of rectal cancer with preoperative MRI staging from February 2015 to April 2018, in which 137 patients (36 received MDT discussion) received neoadjuvant therapy, 240 did not (97 received MDT discussion) and direct surgery was given. With postoperative pathological stage as the standard, the accuracy of MRI in preoperative staging for rectal cancer with MDT discussion was compared with non-MDT. Results: For direct surgery group, 21 out 97 (21.6%) patients changed their therapy strategy due to the change of the stage assessment after MDT. The accuracy of MRI for the diagnosis of preoperative N stage with MDT was significantly higher than those without MDT (56.2% vs. 42.1%, P=0.021). And for those without lymph node metastasis, the accuracy of MRI was higher after MDT (61.2% vs. 37.8%, P=0.009). For neoadjuvant therapy group, 7 out of 36 (19.4%) patients altered their therapy after MDT because of the changed stage. MDT improved the accuracy of restaging N stage with MRI (70.0% vs. 33.3%, P=0.003). The accuracy of MRI in staging T stage seemed not improved after MDT in both groups. Conclusions: In conclusion, MDT discussion increased the accuracy of MRI in preoperative staging diagnosis for rectal cancer. This mode could give a more accurate clinical stage of patients, which was in favor of choosing a preferable therapy strategy.

3.
Bioresour Technol ; 256: 333-341, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29459320

RESUMO

Illumina MiSeq sequencing and phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) were applied to study the dynamic changes and effects of microbial community structures as well as the metabolic function of bacterial community in maize straw composting process. Results showed that humic acid contents in loosely combined humus (HA1) and stably combined humus (HA2) increased after composting and Staphylococcus, Cellulosimicrobium and Ochrobactrum possibly participated in the transformation of the process. The bacterial communities differed in different stages of the composting. Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were reported the dominant phyla throughout the process and the relative abundance of the dominant phyla varied significantly (p < 0.05) over time. Moreover, the total phosphorus (TP) had the greatest influence on the microbial community structure among C/N ratio, available phosphorus (AP) and humic substances. Metabolism, cellular processes and environmental information processing might be the primary functions of microbial community during the composting.


Assuntos
Compostagem , Zea mays , Filogenia , Solo , Microbiologia do Solo
4.
Shanghai Kou Qiang Yi Xue ; 26(4): 461-464, 2017 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-29199347

RESUMO

PURPOSE: To explore the factors affecting soft tissue infection after oral and maxillofacial debridement. METHODS: Fifty hundred patients with debridement were enrolled in this study from January 2013 to June 2016. The patients were divided into 2 groups according to soft tissue infection, 18 cases in infection group and 482 cases in non-infection group. Age, mean time to surgery, average length of stay, duration of antibiotics use, abbreviated injury scale (AIS), combined injuries, maxillofacial fractures, soft tissue injury, type of fracture, and history of diabetes were recorded and analyzed using SPSS 19.0 software package. RESULTS: The factors influencing soft tissue infection after oral and maxillofacial surgery were the aged, longer hospital stay, longer operation time, longer antibiotics use time, higher AIS score, Jaw bone injury and diabetes. CONCLUSIONS: The factors influencing soft tissue infection after oral and maxillofacial debridement are various. The aged, longer operation time, higher AIS score, jaw bone involvement lip and chin injury as well as diabetes might be the independent factors. Health care providers should give preventive measures to reduce the incidence of infection, according to specific factors.


Assuntos
Desbridamento , Traumatismos Maxilofaciais , Infecções dos Tecidos Moles , Humanos , Traumatismos Maxilofaciais/cirurgia , Estudos Retrospectivos , Lesões dos Tecidos Moles
5.
World J Surg Oncol ; 15(1): 148, 2017 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-28774330

RESUMO

BACKGROUND: For colorectal liver metastasis (CRLM) patients, hepatic resection is currently the sole cure offering the chance of long-term survival. Tumor shrinkage and planned liver remnant hypertrophy are the two key strategies for conversion of initially unresectable CRLM. First conducted in 2012, associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows rapid liver growth. As a means to induce hypertrophy, portal vein embolization (PVE) has been widely applied before extending hepatectomy. Recently, Peng et al. present a new approach of terminal branches portal vein embolization (TBPVE), offering an efficient way to amplify FLR and making chances for surgery in 2 weeks. CASE PRESENTATION: We reported a 61-year-old woman with synchronous hepatic metastasized carcinoma of the colon sigmoideum underwent TBPVE after 6 cycles of neoadjuvant therapy in order to perform a planned right trisectionectomy. Rapid liver remnant hypertrophy and remarkable tumor shrinkage were achieved, and laparoscopic sigmoidectomy and right trisectionectomy were successfully performed. The postsurgical course was uneventful and 7 months of recurrence-free survival have been witnessed. CONCLUSIONS: The dual tactics of tumor shrinkage and planned rapid liver remnant hypertrophy will make concerted efforts to further increase the clinical candidacy for curative resection, which are valuable for further investigation.


Assuntos
Carcinoma/terapia , Neoplasias Colorretais/terapia , Hepatectomia/métodos , Neoplasias Hepáticas/terapia , Regeneração Hepática , Fígado/fisiologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Antígeno Carcinoembrionário/sangue , Carcinoma/sangue , Carcinoma/diagnóstico por imagem , Carcinoma/secundário , Colo Sigmoide/diagnóstico por imagem , Colo Sigmoide/patologia , Colo Sigmoide/cirurgia , Colonoscopia , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Embolização Terapêutica , Feminino , Fluoruracila/uso terapêutico , Humanos , Hipertrofia , Laparoscopia , Leucovorina/uso terapêutico , Ligadura , Fígado/irrigação sanguínea , Fígado/diagnóstico por imagem , Fígado/cirurgia , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Veia Porta , Prognóstico , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/métodos
6.
Oncol Lett ; 13(6): 4459-4462, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28599446

RESUMO

The present study aimed to investigate the value of magnetic resonance imaging (MRI) in the diagnosis of giant cell tumor of the tendon sheath (GCTTS), including localized (L-) and diffuse (D-) types. A total of 38 patients with GCTTS, including 31 with L-GCTTS and 7 with D-GCTTS, diagnosed by surgery and pathology, were retrospectively analyzed. All patients underwent MRI examination. Of the 31 patients with L-GCTTS, the tumors were located in the hand and wrist (18 patients), the ankle and foot (10 cases), the knee joint (2 cases) and the temporomandibular joint (1 case). All 31 lesions were either located in relation to a tendon or were partially/completely enveloping it and all were well marginated. With respect to the 7 D-GCTTS patients, the tumors were located in the ankle and foot (6 cases) or the hand and wrist (1 cases). All 7 lesions presented as an aggressive soft tissue mass infiltrating the tendon sheath and adipose tissue around the joint. The characteristic internal signal of GCTTS, including L-GCTTS and D-GCTTS, was demonstrated by MRI examination. MRI is currently the optimal modality for preoperative assessment of tumor size, extent and invasion of adjacent joint and tenosynovial space.

7.
Ultrasound Med Biol ; 42(7): 1431-40, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27072076

RESUMO

The aim of this study was to compare the accuracy of multi-detector computed tomography (MDCT) with double contrast-enhanced ultrasound (DCEUS), in which intravenous microbubbles are used alongside oral contrast-enhanced ultrasound, in determining the gross classification of patients with gastric carcinoma (GC). Altogether, 239 patients with GC proved by histology after endoscopic biopsy were included in this study. DCEUS and MDCT were performed pre-operatively. The diagnostic accuracies of DCEUS and MDCT in determining the gross classification were calculated and compared. The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT (84.9% vs. 79.9%, p < 0.001). There was no significant difference in accuracy between DCEUS and MDCT for Borrmann I and IV classifications of advanced gastric cancer (χ(2), p = 0.323 for Borrmann type I, p = 0.141 for Borrmann type IV). The accuracy of DCEUS for early GC and Borrmann II and III classifications of GC was higher than that of MDCT (χ(2), p = 0.000 for all). DCEUS may be regarded as a valuable complementary tool to MDCT in determining the gross appearance of gastric adenocarcinoma pre-operatively.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Aumento da Imagem/métodos , Tomografia Computadorizada Multidetectores/métodos , Cuidados Pré-Operatórios/métodos , Neoplasias Gástricas/diagnóstico por imagem , Ultrassonografia/métodos , Meios de Contraste , Feminino , Humanos , Masculino , Microbolhas , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Estômago/diagnóstico por imagem
8.
Int J Clin Exp Med ; 8(9): 15276-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26629014

RESUMO

OBJECTIVES: This work aims to assess the feasibility of perfusion CT in diagnosis of liver fibrosis in the early stage. MATERIALS AND METHODS: Solutions of carbon tetrachloride (CCL4) were injected into the peritoneum of 45 rabbits to establish rabbit models of liver fibrosis. Perfusion CT were performed at 4-, 8-, 12- and 16- week after injection. The parametric perfusion indices of blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI) on perfusion maps were measured. Liver samples were scored as F0, F1, F2, F3, F4 for fibrosis. RESULTS: In 50 rabbits, 23 rabbits survived. Of these survival rabbits, 5 rabbits were histopathologically scored as F0, 7 rabbits were F1, 8 rabbits were F2, and 3 rabbits were F3. For relatively small number of F3, multiple comparisons were made for F0 vs. F1, F1 vs. F2 and F0 vs. F2. A statistically significant difference was observed in PVP, BV, BF, ALP and HPI between F1 vs. F2 and F0 vs. F2, whereas a significant statistical difference was only achieved in PVP between F0 vs. F1. In the early stage of liver fibrosis PVP decreased with the progression of liver fibrosis, whereas HPI, ALP and BF increased with the progression of liver fibrosis. BV had no marked change. CONCLUSIONS: Perfusion CT is feasible in diagnosis of early stage of liver fibrosis. PVP appears to be the most promising parametric perfusion index.

9.
Medicine (Baltimore) ; 94(36): e1484, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26356712

RESUMO

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in gastrointestinal tracts; however, the synchronous or metachronous coexistence of GIST with additional primary malignancy is not common.Here, we present an unusual case of gastric GIST with metachronous primary lung adenocarcinoma diagnosed during his adjuvant treatment with oral receptor tyrosine kinase inhibitor imatinib mesylate (400 mg daily). After 6-month use of imatinib, the patient suffered from dry cough and dyspnea. Subsequent lung biopsy demonstrated adenocarcinoma with diffuse interstitial changes.Our research emphasizes the possibility of an additional primary tumor with GIST, and reminds the clinicians to strengthen the surveillance of the additional cancer during the follow-up of GIST patients.


Assuntos
Adenocarcinoma , Carboplatina/administração & dosagem , Tumores do Estroma Gastrointestinal , Mesilato de Imatinib/administração & dosagem , Neoplasias Pulmonares , Pemetrexede/administração & dosagem , Neoplasias Gástricas , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/fisiopatologia , Adenocarcinoma de Pulmão , Antineoplásicos/administração & dosagem , Biópsia , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/fisiopatologia , Humanos , Achados Incidentais , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estômago/patologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
11.
Springerplus ; 4: 61, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25694861

RESUMO

INTRODUCTION: Whole lung lavage is the most effective method to treat pulmonary alveolar proteinosis (PAP), and most potential complications occur often during the lavage process, but few happen after lavage. Theoretically, pulmonary edema would be more common after whole lung lavage. However, no such case was reported in the literature. CASE DESCRIPTION: A 47-year-old Chinese male patient with PAP was referred to our hospital for whole lung lavage treatment. Although the clinical manifestations of PAP were improved, high fever was happened and multi-nodular consolidations in chest CT scan were occurred after whole lung lavage. Secondary lung infection was suspected, but the patient was not treated with antibiotics immediately. After therapies like liquid limitation, glucocorticoid administration and diuretic treatment, the patient was improved gradually. Namely, newly nodular consolidations were almost completely absorbed in three days, along with the complete recovery of body temperature and associated inflammatory biomarkers. The diagnosis of secondary infection was excluded, and the final diagnosis of lavage fluid-induced pulmonary edema was confirmed. DISCUSSION AND EVALUATION: No such case has been reported that lavage fluid-induced pulmonary edema is manifested by high fever and multi-consolidations in chest CT scan, which is similar to the secondary infection. CONCLUSIONS: For the first time, we described a rare complication of lavage fluid-induced pulmonary edema after whole lung lavage. As the obvious differences in treatments, it is very important for physicians to differentiate it from secondary infection.

12.
Ann Lab Med ; 34(1): 38-42, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24422194

RESUMO

BACKGROUND: The dramatic increase in use of the IgG test for toxoplasma, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV) [TORCH] has led to the requirement for a high-efficiency method that can be used in the clinical laboratory. This study aimed to compare the results of BGI-Array ELISA TORCH IgG (BGI-GBI, China) screening method to those of Virion/Serion TORCH IgG ELISA (Virion/Serion, Germany). METHODS: Serum specimens (n=400) submitted for routine IgG testing by Virion/Serion ELISA were also tested using the BGI-Array ELISA method. The agreements of these two kinds of method were analyzed by κ-coefficients calculation. RESULTS: Following repeat testing, the BGI-Array ELISA TORCH IgG assays demonstrated agreements of 99.5% (398/400 specimens), 98% (392/400 specimens), 99% (396/400 specimens), and 99.5% (398/400 specimens), respectively. The BGI-Array ELISA IgG assays provided results comparable to Virion/Serion ELISA results, with κ-coefficients showing near-perfect agreement for the HSV (κ=0.87), rubella (κ=0.92) and CMV (κ=0.93) and substantial agreement for the toxoplasma (κ=0.80) IgG assays. The use of the BGI-Array ELISA TORCH IgG assays could reduce the turnaround time (1.5 hr vs. 5 hr by Virion/Serion ELISA for 100 specimens) and were easy to use. CONCLUSIONS: BGI-Array ELISA TORCH IgG shows a good agreement with Virion/Serion ELISA methods and is suitable for clinical application.


Assuntos
Citomegalovirus/metabolismo , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G/análise , Vírus da Rubéola/metabolismo , Simplexvirus/metabolismo , Toxoplasma/metabolismo , Vírion/imunologia , Anticorpos Antivirais/sangue , Citomegalovirus/imunologia , Humanos , Imunoglobulina G/sangue , Infecções por Protozoários/diagnóstico , Kit de Reagentes para Diagnóstico , Vírus da Rubéola/imunologia , Sensibilidade e Especificidade , Simplexvirus/imunologia , Toxoplasma/imunologia , Vírion/metabolismo , Viroses/diagnóstico
13.
J Zhejiang Univ Sci B ; 13(3): 209-12, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22374613

RESUMO

OBJECTIVE: To assess the blood flow of the proper digital artery using digital subtraction angiography (DSA) in the early stage after replantation. METHODS: From January 2006 to October 2010, 27 anastomosed arteries in 27 replanted digits were included in the study. The patients included nine males and four females. The patients received DSA at 48 to 96 h after digital replantation. Based on DSA image, the blood flow was classified into normal, slow-running, and flow-stopping types. The patients with normal digital blood flow were given continuous routine treatments; the patients with slow-running flow were given the conservative treatments, such as release of the tight dressings, removal of stitches, keeping warm, the use of massage, and the use of anticoagulants and anti-inflammatory drugs; the patients with flow-stopping received immediate surgical re-exploration. RESULTS: In this series, 23 digits in 11 patients showed a normal blood flow, and these digits all survived. In one of 13 patients, two digits which displayed slow-running flow also survived after conservative treatments. In two of 13 patients, two digits showed flow stopping, with one surviving and one failing after re-exploration and arterial revision. CONCLUSIONS: The DSA can be used to assess the blood flow of the proper digital artery in the early stage after replantation. It provides essential information for salvaging the replanted finger.


Assuntos
Amputação Traumática/diagnóstico por imagem , Amputação Traumática/cirurgia , Angiografia Digital , Traumatismos dos Dedos/diagnóstico por imagem , Traumatismos dos Dedos/cirurgia , Reimplante , Adolescente , Adulto , Artérias/fisiopatologia , Velocidade do Fluxo Sanguíneo , Feminino , Dedos/irrigação sanguínea , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 39(2): 207-14, 2010 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-20387252

RESUMO

The accurate diagnosis and staging of hepatic fibrosis is crucial for treatment and prognosis of liver disease. The current gold standard is liver biopsy, but it cannot be used in population-based screening, and has well known drawbacks if used for monitoring of disease progression or treatment results. Functional MR, as a non-invasive method, is increasingly used in hepatic fibrosis and became the current hot spot. Most recently available functional MR imaging techniques including diffusion weighted imaging, perfusion weighted imaging and MR spectroscopy can detect cirrhosis or fibrosis reasonably accurately. However, to date only MR elastography has been able to stage fibrosis or diagnose mild disease. MR diffusion weighted appears next most promising.


Assuntos
Cirrose Hepática/diagnóstico , Imagem por Ressonância Magnética/métodos , Imagem de Difusão por Ressonância Magnética , Humanos , Cirrose Hepática/classificação , Espectroscopia de Ressonância Magnética
15.
Turk J Gastroenterol ; 20(4): 291-4, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20084576

RESUMO

Somatostatinomas are extremely rare endocrine tumors, and those with diameters above 2 cm are reported to increase the risk of metastasis significantly. We report a case of a large functional somatostatinoma in the pancreatic tail without metastases. A 46-year-old woman with a history of recurrent mild upper abdominal pain and diarrhea for 10 months was admitted to our hospital. Multiple-phase spiral computed tomography revealed a 10 cm x 8 cm, ill-defined, elliptic mass in the body and tail of the pancreas. There was a slightly heterogeneous enhancement on hepatic arterial phase and isodensity to the pancreatic parenchyma with small dotted necrosis within the middle region of the mass on hepatic portal venous and parenchymal phase, with patent splenic vein, dilated collaterals at the splenic hilum and no dilated pancreatic duct, resembling a diffuse infiltration tumor. To the best of our knowledge, this is the first description of multiple-phase spiral computed tomography findings of a functional somatostatinoma in the pancreatic tail and the largest thus far on reported computed tomography, with some differences compared with the previous reports.


Assuntos
Neoplasias Pancreáticas/diagnóstico por imagem , Somatostatinoma/diagnóstico por imagem , Tomografia Computadorizada Espiral , Feminino , Humanos , Pessoa de Meia-Idade , Necrose , Pancreatectomia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Somatostatinoma/patologia , Somatostatinoma/cirurgia
16.
Eur Radiol ; 18(10): 2196-205, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18463872

RESUMO

Primary hepatic sarcomas are rare tumors that are difficult to diagnose clinically. Different primary hepatic sarcomas may have different clinical, morphologic, and radiological features. In this pictorial review, we summarized computed tomography (CT) findings of some relatively common types of hepatic sarcomas, including angiosarcoma, epithelioid hemangioendothelioma (EHE), liposarcoma, undifferentiated embryonal sarcoma (UES), leiomyosarcoma, malignant fibrous histiocytoma (MFH), and carcinosarcoma (including cystadenocarcinosarcoma). To our knowledge, hepatic cystadenocarcinosarcoma has not been described in the English literature. The CT findings in our case are similar to that of cystadenocarcinoma, a huge, multilocular cystic mass with a large mural nodule and solid portion. The advent of CT has allowed earlier detection of primary hepatic sarcomas as well as more accurate diagnosis and characterization. In addition, we briefly discuss the MRI findings and diagnostic value of primary hepatic sarcomas.


Assuntos
Neoplasias Hepáticas/diagnóstico por imagem , Fígado/diagnóstico por imagem , Sarcoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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