First Report of Leaf Spot Disease on Avocado Caused by Bipolaris setariae in China.

Avocado (Persea americana), which is native to Latin America, is mostly planted in southwest China. In November 2021, leaf spot symptoms were observed in a nursery in Chongzuo (22.2019°N, 106.4723°E), Guangxi, China. Approximately 90% of avocado seedlings in the nursery were affected. Symptomatic plant fully expanded leaves showed small brown spots that ranged from 1 to 3 mm, with a yellow halo around (Fig.1). Lesions gradually expanded and became nearly round and dark brown. Finally, leaves withered or curled. For pathogen isolation, 15 symptomatic leaves were randomly sampled from different plants of the nursery, five leaves were selected and four samples size 4×4mm were taken from each leaf and were plated on potato glucose agar. Identical fungus colonies were observed in 80% of the samples, and no bacteria were isolated. Single conidial isolation was performed. After 4 days, the colony diameter reached 74.6 mm, colonies appeared gray, and developed aerial hyphae. Conidiophores were mostly solitary with a few clustered erect or slightly curved, knee shaped, and 3.89 to 5.24 µm wide. Conidia were 39.33 -96.88 × 9.96 - 15.59 µm, slightly curved, rarely straight, light brown to yellowish brown, fusoid or navicular, and truncated at the base with 4 to 10 septa. Based on morphological and cultural characteristics, the fungus was identified as Bipolaris sp. (Manamgoda et al. 2014). An isolate named MP211122 was grown on Sachs' ager at 27℃ under 12-h light/dark for 1 week and consistently with Adhikari et al. (2021) no sexual from was observed. To confirm the tentative identification, genomic DNA was extracted, ITS and GAPDH gene were amplified and sequenced using primers ITS1/ITS4 and GPD/GPD2, respectively (Tan et al. 2022). The ITS sequence (GenBank ON248469) shared 100% identity with B. setariae (MN215632.1), and the GAPDH sequence (ON642344) shared 99.82% identity with B. setariae (MF490833.1, MK144540.1) and B. yamadae (MK026428.1). A maximum likelihood phylogenetic analysis based on GAPDH and ITS sequences using MEGA 7.0 revealed that the isolate clustered with B. setariae with 100% bootstrap support(Fig. 2). Healthy 11-month old potted avocado seedlings from disease-free nursery were selected , the conidial suspension (1 × 105 conidia/mL) of MP211122 isolate was prepared by harvesting conidia from a 10-day-old culture on water agar. Conidia were sprayed onto young leaves of six potted plants. Three additional seedlings sprayed with sterile distilled water served as controls. All plants were covered with plastic bags for 3 days to maintain high humidity and then maintained in a greenhouse at 30℃ with a 12-h/12-h light/dark cycle. After 5 days, typical symptoms of small brown spots were observed on all inoculated leaves (Fig.3). All leaves on control plants remained asymptomatic. The reisolated fungus was morphologically identical to the original isolate used for inoculation, fulfilling Koch's postulates. This is the first report of B. setariae as a pathogen causing leaf spot on avocado in China. This information will facilitate further studies, monitoring and control of the disease as accurate identification of the causal agent is a primary requisite for designing management strategies.

A screening strategy for phenotypic detection of carbapenemase in the clinical laboratory.

Nosocomial infections caused by carbapenemase-producing Enterobacteriaceae have emerged as an important challenge worldwide and represent a great limitation for antimicrobial therapy. Detection of carbapenemase in Enterobacteriaceae species also remains challenging. Although the modified Hodge test is recommended, it lacks specificity and is unable to distinguish between carbapenemase types. Here, we demonstrated a screening strategy for the phenotypic detection of carbapenemases among Enterobacteriaceae isolates in the clinical laboratory by using ethylenediaminetetraacetic acid and phenylboronic acid. This strategy displayed an overall 100% sensitivity and 98.6% specificity for carbapenemase detection in Enterobacteriaceae, which was superior to that of the modified Hodge test (98.0% sensitivity and 84.3% specificity), and it also discriminated the carbapenemase phenotypes of KPC-2, VIM-1, and OXA-48.

Improving the efficiency of the modified Hodge test in KPC-producing Klebsiella pneumoniae isolates by incorporating an EDTA disk.

Carbapenemase-producing Klebsiella pneumoniae have emerged as an important pathogens in nosocomial infections with high mortality rate. Although the modified Hodge test (MHT) is recommended for phenotypic detection of carbapenemase-producing Enterobacteriaceae, high false-positive rates were reported for MHT results. The MHT has acceptable sensitivity (98.0 %), but it lacks specificity (73.6 %). In this study, we incorporated an EDTA disk test into the MHT (MHT-EDTA) to improve the efficiency in phenotypic detection of K. pneumoniae carbapenemase (KPC) of K. pneumoniae isolates. EDTA was used to lyse the cells of 123 carbapenem non-susceptible K. pneumoniae isolates to release the ß-lactamases. The MHT-EDTA achieved 100 % sensitivity and specificity for KPC detection among K. pneumoniae isolates as compared to growth patterns of the indicator organism E. coli (ATCC 25922). This method could be carried out as part of routine work to provide useful information for the clinical management of K. pneumoniae infection.

[Imaging features and clinicopathological manifestations of solitary fibrous tumors].

OBJECTIVE: To investigate the imaging features, clinical manifestations and pathological characteristics of solitary fibrous tumors (SFT). METHODS: The clinicopathological manifestations and medical imaging findings were analyzed retrospectively in 27 patients with surgically confirmed SFT. RESULTS: The SFTs originated from different parts of the body, including 18 in the chest, 4 in the abdomen, 1 in the lumboscral area, 3 in the pelvis, and 1 in the left shoulder. Twenty-three cases were found by CT scan, among which there were 16 benign diseases, presented with well-defined round or elliptic margins, with homogeneous attenuation and clearly surrounding; 6 malignant cases with unclear demarcations, invasive surrounding, heterogeneous attenuation due to calcification and/or irregular necrosis, and 1 junctional case with well-defined margins, which was enlarged during follow-up. There were 4 SFTs scanned by MRI with clear margin and homogeneous or heterogeneous signal intensity. All of the 4 cases were isointense or hyperintense to muscle on T1-weighted images, and were hyperintense on the T2-weighted images. All tumors showed heterogeneously intense enhancement with geographic pattern. Immunohistochemical staining showed that CD34-positive was 81.5%, vimentin (100.0%), CD99 (100.0%) and bcl-2 (96.3%), as well as negative CK (100.0%) and S-100 (96.3%). CONCLUSION: The location of SFT is varying. Though its clinical manifestations vary, the diagnosis is depended on pathology and immunohistochemistry. There are certain specific features related to SFTs on CT or MRI. These imaging techniques may serve to provide helpful information as to the location and vicinal anatomic structure of the tumor, which is of substantial importance for planning surgery.

[Diagnostic value of ADC and rADC of diffusion weighted imaging in malignant breast lesions].

OBJECTIVE: The aim of this study was to evaluate the value of diffusion weighted imaging (DWI) in the diagnosis of patients with breast diseases. METHODS: Fifty-three consecutive patients were scanned with GE signa HDx 1.5 T magnetic resonance system equipped with 8-channel breast coil. DWI was scanned by SE-EPI sequence in b values of 500 s/mm(2) and 800 s/mm(2), respectively. The apparent diffusion coefficients (ADC) of these lesions were measured. The mean apparent diffusion coefficients (ADC) of these lesions were calculated in b values of 500 s/mm(2) and 800 s/mm(2), respectively. These lesions' ADC value (rADC) was counted respectively and the result of the rADC was equal to the lesion's ADC divided by the ADC of the ipsilateral normal breast tissue. Threshold of ADC and rADC for differential diagnosis was acquired by ROC (receiver operating characteristic curve) analysis. Different imaging technologies were evaluated emphasizing their sensitivity, specificity and accuracy. RESULTS: Sixty-six lesions of 53 cases were confirmed by pathology, including 39 malignant lesions and 27 benign lesions. (1) b = 500 s/mm(2), the threshold of ADC value was 1.435 x 10(-3) mm(2)/s, with a sensitivity of 82.1% and a specificity of 81.5%. The threshold of rADC value was 0.62, with a sensitivity of 76.9% and a specificity of 100%. (2) b = 800 s/mm(2), the threshold of ADC value was 1.295 x 10(-3) mm(2)/s, with a sensitivity of 79.5% and a specificity of 81.5%. The threshold of rADC value was 0.71, with a sensitivity of 89.7% and specificity of 88.9%. (3) The area under the ROC curve was increased for the four diagnostic indicators (ADC(500), ADC(800), rADC(500), rADC(800)). CONCLUSION: DWI spends short time, and it doesn't need contrast material. ADC value and rADC value have a high sensitivity and specificity as a diagnostic indicator. DWI is helpful in improving the specificity of MR and may become one of valuable conventional procedures for breast tumor diagnosis.

Effects of the Co-occurrence of Anxiety and Attention-Deficit/Hyperactivity Disorder on Intrinsic Functional Network Centrality among Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) present with a high co-occurrence of anxiety and attention-deficit/hyperactivity disorder (ADHD). However, it remains unclear how the co-occurrence of anxiety and ADHD in children with ASD alters whole-brain functional networks. Here, we aimed to examine anxiety- and ADHD-related brain network centrality in children with ASD separately and their relationships with ASD symptoms. Clinical anxiety and ADHD levels in children with ASD, aged 6-13 years old, were assessed. Participants were categorized into four groups: ASD only (n = 28), ASD + anxiety (n = 19), ASD + ADHD (n = 25), and ASD + both anxiety and ADHD (n = 28). Subsequently, we compared voxel-wise network degree centrality (DC) among the four groups. We found that: (a) compared with ASD only, children with ASD + anxiety showed higher DC in the left middle temporal gyrus, right lingual gyrus, and left cuneus, and lower DC in the right precuneus; (b) children with ASD + ADHD presented higher DC in the right calcarine and left superior frontal gyrus (SFG) compared with ASD only; (c) children with ASD + both displayed higher DC in the right calcarine and lower centrality in the right middle occipital gyrus compared with ASD only; and (d) across all children with ASD, there was a positive correlation between DC of the right calcarine with nonverbal behavior scores, and DC of the left SFG was negatively correlated with social scores. Our findings suggest that the right calcarine, left SFG, and default mode network nodes play important roles in the co-occurrence of anxiety and ADHD among children with ASD. Autism Res 2019, 12: 1057-1068. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The co-occurrence of anxiety and attention-deficit/hyperactivity disorder (ADHD) has been shown to influence the brain function of children with ASD. In order to gain a better understanding of this, the present study compared degree centrality, the amount of effective brain functional connectivity that reflects the characteristics of brain networks, among four groups: ASD only, ASD + anxiety, ASD + ADHD, and ASD + both anxiety and ADHD. We found that some areas located in the language processing network and primary visual cortex were associated with the co-occurrence of ADHD, and some other areas located in the default mode network were associated with the co-occurrence of both anxiety and ADHD. These findings provide more knowledge about the neural basis underlying behavioral changes related to the co-occurrence of anxiety and ADHD in children with ASD.

[Gadolinium-loaded nanoparticle as a novel molecular imaging contrast agent for magnetic resonance imaging].

OBJECTIVE: To synthesize a novel gadolinium-loaded nanoparticle as a molecular imaging contrast agent for magnetic resonance imaging. METHODS: Gadolinium ion was incorporated within a silica nanoparticle. The size of this nanosized particle was determined by using transmission electron microscope. The spin-echo (SE) images of nine nanoparticle dilutions in vitro were obtained from a 1.5 T clinical scanner, compared with gadolinium diethylene triaminepenta acetate (Gd-DTPA). In vivo distribution of nanoparticle in Balb/c nude mice and Balb/c nude mice with nasopharyngeal carcinoma (NPC) xenografted CNE-2 tumors was studied at MR imaging, 30 sec, 5 min, 30 min, 1 h, 2 h, 4 h, and 24 h after intravenous administration. RESULTS: The gadolinium-loaded nanoparticle was short rod-shaped, and approximately 30 to 40 nm in diameter. The value of longitudinal relaxativity (r(1)) of gadolinium nanoparticle was much higher than that of Gd-DTPA. Thirty minutes after injection the gadolinium nanoparticle, the signal intensities of liver, kidney and xenografted tumor increased from 226 +/- 10, 283 +/- 7 and 195 +/- 5 to 352 +/- 12, 328 +/- 10 and 245 +/- 7, respectively. The dynamic MRI scanning showed that gadolinium nanoparticles were mainly distributed in liver after intravenous administration. Strong enhancement was also detected in CNE-2 xenografted tumors. CONCLUSION: A new gadolinium-loaded nanoparticle with high relaxativity was synthesized successfully, and might serve as a carrier for magnetic resonance molecular imaging.

[Molecular Research of Acid-Generating Microbial Communities in Abandoned Ores in the Waste Dump of an Iron Mine in Anhui Province].

The waste dump of an iron mine in Anhui Province has been abandoned for several decades. Pyrite in the exposed waste ores is oxidized by acidophiles and large amounts of metal ions and H2SO4 are released, resulting in the formation of an acid mine drainage (AMD) lake since 1970s. Besides the lake, there are also some small-scale AMD adjacent to the newly deposited waste ore. In order to study the acid generation potential of the waste ore and the related microbial communities, soil samples were taken from beside the AMD lake (1LL) and small-scale AMD (5J, 5Y, 6-1, 6-2, 6-3) and the physicochemical properties and microbial community of these samples were analyzed. The results reveal that all of samples were highly acidic and the pH of the 1LL sample was 2.77, while the other samples were even more acidic, at less than 2.6. The electrical conductivity (EC) (0.32 mS·cm-1) of the 1LL sample was obviously lower than the other samples (2.25-7.08 mS·cm-1), which indicates that the newly deposited waste ore contains higher ion concentrations. The Fe2+ concentration of the 1LL sample was only 0.80 mg·kg-1 but the other five samples were as high as 2.91-33.40 mg·kg-1. This suggests that most of the Fe2+ in the 1LL sample has been converted to Fe3+ after long-term oxidization. High-throughput sequencing results showed that most acidophiles in 1LL sample were Actinobacteria, Acidobacteria and Chloroflexi but the microbes in the remaining five samples were γ-Proteobacteria, Firmicutes and Nitrospira. The iron-sulfur oxidizing bacteria, such as Sulfobacillus, Leptospirillum, Acidithiobacillus, were scarce in the 1LL sample, while they highly abundant in the other five samples, which proves that the acid-generation process of the newly deposited waste ore is strong. However, the reduced iron and sulfur in the 1LL sample has nearly been depleted. Statistical analysis shows that the microbial composition of the 1LL sample is significantly different to that of the five newly deposited samples, illustrating that microbial community composition is remarkably influenced by physicochemical conditions.

Significant seasonal variations of microbial community in an acid mine drainage lake in Anhui Province, China.

Acid mine drainage (AMD),characterized by strong acidity and high metal concentrations, generates from the oxidative dissolution of metal sulfides, and acidophiles can accelerate the process significantly. Despite extensive research in microbial diversity and community composition, little is known about seasonal variations of microbial community structure (especially micro eukaryotes) in response to environmental conditions in AMD ecosystem. To this end, AMD samples were collected from Nanshan AMD lake, Anhui Province, China, over a full seasonal cycle from 2013 to 2014, and water chemistry and microbial composition were studied. pH of lake water was stable (∼3.0) across the sampling period, while the concentrations of ions varied dramatically. The highest metal concentrations in the lake were found for Mg and Al, not commonly found Fe. Unexpectedly, ultrahigh concentration of chlorophyll a was measured in the extremely acidic lake, reaching 226.43-280.95 µg/L in winter, even higher than those in most eutrophic freshwater lakes. Both prokaryotic and eukaryotic communities showed a strong seasonal variation. Among the prokaryotes, "Ferrovum", a chemolithotrophic iron-oxidizing bacterium was predominant in most sampling seasons, although it was a minor member prior to September, 2012. Fe2+ was the initial geochemical factor that drove the variation of the prokaryotic community. The eukaryotic community was simple but varied more drastically than the prokaryotic community. Photoautotrophic algae (primary producers) formed a food web with protozoa or flagellate (top consumers) across all four seasons, and temperature appeared to be responsible for the observed seasonal variation. Ochromonas and Chlamydomonas (responsible for high algal bloom in winter) occurred in autumn/summer and winter/spring seasons, respectively, because of their distinct growth temperatures. The closest phylogenetic relationship between Chlamydomonas species in the lake and those in Arctic and Alpine suggested that the native Chlamydomonas species may have been both acidophilic and psychrophilic after a long acclimation time in this extreme environment.

Surgical management of radiation-induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: report of 14 cases.

BACKGROUND: Radiation-induced temporal lobe necrosis is a rare and serious late complication in irradiated patients with nasopharyngeal carcinoma (NPC). Treatment of radiation-induced temporal lobe necrosis with surgery has been seldom thoroughly investigated. METHODS: We retrospectively analyzed the clinical data of 14 patients with radiation-induced temporal lobe necrosis treated with surgical intervention. RESULTS: Radiation-induced temporal lobe necrosis presented as obvious cystic formation or as heterogeneous enhanced nodule on MRI. Among 3 patients with (18)F-fluorodeoxyglucose ((18)F-FDG) PET-CT scan, increased uptake of (18)F-FDG was observed in 2 cases. Four patients were anesthestized nasotracheally and 1 was through tracheostomy during surgery because of other radiation complications, including trismus and skull base osteoradionecrosis. The temporal approach was applied in all cases, with the removal of bone flap in 11 patients. During follow-up, 1 patient died of exhaustion. CONCLUSIONS: Surgery benefits selected patients with NPC with radiation-induced temporal lobe necrosis. The goals of surgery are to relieve the increased intracranial pressure and to establish the accurate diagnosis.

[Correlation of multi-slice spiral CT features to clinicopathologic manifestations of gastrointestinal stromal tumor: a report of 49 cases].

BACKGROUND AND OBJECTIVE: Gastrointestinal stromal tumor (GIST) is one of the most common mesenchymal tumors of the digestive system. Imaging examination plays an important role in preoperative diagnosis and postoperative evaluation for it. This study was to describe the multi-slice spiral computed tomographic (MSCT) findings and pathologic features of GIST, and to analyze their correlation. METHODS: MSCT and pathologic reports of 49 patients with 53 pathologically confirmed GIST lesions were reviewed and compared. RESULTS: Of the 53 GIST lesions, 14 were at very low biological risk, 11 at low risk, ten at moderate risk and 18 at high risk; 36 (67.9%) were found in first visit by CT scans. On CT images, the GIST lesions with maximal diameter of > or =50 mm showed irregular shape, invasive growth, presence of cystic area and heterogeneous enhancement, and most of them were at high risk; the lesions with maximal diameter of <50 mm showed regular shape, expansive growth, and homogeneous enhancement, and most of them were at risk of moderate or below. No lymph node metastasis was found. Only three lesions showed S100-positive, which presented infiltration along the gastric wall or bowel ring on CT images. CONCLUSIONS: CT examination is helpful in risk prediction for GIST, but it is difficult to detect small lesions (< 2 cm) by CT scans. Due to the infiltrative growth of GIST with neural differentiation (S100-positive), it is difficult to distinguish GIST from gastric cancer on CT images.

[Comparison of CT findings between gastric cancer and gastric lymphoma].

BACKGROUND & OBJECTIVE: It is difficult to discriminate progressive gastric cancer and gastric lymphoma by CT imaging, because incrassate gastric wall, lump in gastric cavity, confined gastric cavity, intumescent lymph node, and distant metastasis can be displayed in both of them. This study was to compare the CT findings between gastric cancer and gastric lymphoma to improve diagnosis of gastric tumors, especially for gastric lymphoma. METHODS: CT images of 27 patients with pathologically proved progressive gastric cancer and 25 patients with pathologically proved gastric lymphoma were reviewed. Tumor location, appearance, scope of involvement, gastric wall thickness, mucous membrane, mucosal fold, serosa membrane, necrosis, enhancement degree and uniformity, involvement of other organs, and abdominal lymph nodes were observed. RESULTS: White line sign was observed in 23 cases (85.2%) of gastric cancer, but not in the 25 cases of gastric lymphoma. The extent of white line sign in gastric cancers was larger in portal vein phase than in arterial phase. Enhancement degree outside the white line was higher in portal vein phase than in arterial phase in 13 cases (48.1%) of gastric cancer. The extent of involved gastric wall was smaller than 50% of the whole gastric wall in all the 27 cases of gastric cancer, while it was larger than 75% in 23 cases (85.2%) of gastric lymphoma. Gastric mucous membrane ulcer was found in all of the 27 cases (100%) of gastric cancer, while it was found in only 1 case (4.0%) of gastric lymphoma. Intumescent lymph nodes in two or more areas were found in 11 cases (40.0%) of gastric lymphoma, but not in gastric cancer. Intumescent lymph nodes in the retroperitoneal space below renal hilum were found in 8 cases (32%) of gastric lymphoma, but not in gastric cancer. CONCLUSION: There are some different CT features between gastric cancer and gastric lymphoma, such as white line sign, gastric mucous membrane ulcer, extent of involved gastric wall, location of intumescent lymph nodes surrounding the stomach and in retroperitoneal space below renal hilum, and so on, which could be helpful in differential diagnosis of these two diseases.

[Malignant epithelial parotid tumors: CT imaging and histopathologic correlation].

BACKGROUND & OBJECTIVE: Malignant epithelial parotid tumors have various histopathologic types. Computed tomography (CT) has been widely used to detect parotid masses. This study was to analyze CT features of malignant epithelial parotid tumors to evaluate the diagnostic value of CT in the characterization of malignant epithelial parotid tumors. METHODS: CT reports of 29 patients with malignant epithelial parotid tumors (8 at low grade and 21 at intermediate or high grade), confirmed by histopathology in Cancer Center of Sun Yat-sen University, were reviewed. The localization, contour, margin, enhancing type, homogeneity, infiltration into the adjacent structures, and lymph node metastasis detected by CT scan were compared with relevant pathologic results. RESULTS: Of the 8 cases at low grade, 4 were well-differentiated mucoepidermoid carcinoma, 3 were acinic cell carcinoma, and 1 was epithelial-myoepithelial carcinoma; 3 had sharp margin, 3 had partly unsharp margin, and 2 had unsharp margin; 5 had regular contour, and 3 had irregular contour; all were enhanced obviously; 2 showed homogeneous appearance, and 6 showed inhomogeneous appearance with low-density areas; none had adjacent infiltration; 3 had lymph node metastasis. Of the 21 cases at intermediate or high grade, 5 were poorly-differentiated squamous cell carcinoma, 8 were malignant pleomorphic adenoma, 2 were adenocarcinoma, 1 was lymph-epithelial carcinoma, 4 were mucoepidermoid carcinoma, and 1 was adenoidcystic carcinoma; 5 had sharp margin, 7 had partly unsharp margin, and 9 had unsharp margin; 10 had regular contour, and 11 had irregular contour; 17 were enhanced obviously, and the 4 cases of malignant pleomorphic adenoma were enhanced slightly; 9 showed homogeneous appearance, and 12 showed inhomogeneous appearance with low-density areas; 8 had adjacent infiltration (the fat space between tumor and the parotid bed disappeared); 6 had lymph node metastasis. CONCLUSIONS: To some extent, CT features of malignant epithelial parotid tumors are correlated to the differentiation of tumor cells. Moreover, tumor size and histologic subtype should be considered to make a more accurate imaging diagnosis.

[CT features of parotid tumors: an analysis of 133 cases].

BACKGROUND & OBJECTIVE: Most parotid tumors grow slowly. It is difficult to evaluate their malignancy. This study was to analyze the CT features of parotid tumors. METHODS: CT images of 133 patients with 157 lesions of parotid tumors, confirmed by histopathology, were reviewed. The location, contour, margin, enhancing type, necrosis and liquefaction, and adjacent structure involvement were analyzed. RESULTS: Among the 157 lesions, 110 (70.1%) were benign tumors, 18 (11.5%) were borderline tumors, and 29 (18.5%) were malignant tumors; 80 (72.7%) benign lesions and 14 (77.8%) borderline lesions located in the superficial lobe, whereas 7 (24.1%) malignant lesions located in the deep lobe and 10 (34.5%) in both the superficial lobe and the deep lobe; 99 (90.0%) benign lesions had sharp margins, 8 (44.4%) borderline lesions had sharp margins and 10 (55.6%) had partly unsharp margins, 10 (34.5%) malignant lesions had partly unsharp margins and 11 (37.9%) had unsharp margins. Most benign lesions were round (68/110, 61.8%) or oval (23/110, 20.9%), while malignant lesions were often irregular (14/29, 48.3%). Eleven lesions, including 2 borderline tumors and 9 malignant tumors, involved the adjacent subcutaneous fat. All the lesions which involved the bed of parotid gland were malignant. No benign tumor involved adjacent structures. CONCLUSION: On CT images, a parotid tumor located in the superficial lobe, with a round or oval contour and sharp margin, is more likely to be a benign tumor; otherwise, it might be a malignant tumor.

[Helical double-phase CT scan imaging features of hepatocellular carcinoma and pathology of false-positive lesions].

BACKGROUND & OBJECTIVE: The helical double-phase CT scan imaging features of hepatocellular carcinoma (HCC) overlap those of other hepatic lesions. This study was to investigate the helical double-phase CT scan imaging features of HCC to improve diagnosis accuracy. METHODS: Double-phase CT data and pathologic data of 52 HCC patients, received resection in Cancer Center of Sun Yat-sen University from Dec. 2000 to Dec. 2002, were analyzed. The double-phase CT features of HCC lesions were summarized. The pathology of false-positive lesions was analyzed. RESULTS: CT scan showed 56 lesions in the 52 patients: 51 were cancer lesions, including 49 HCC lesions and 2 mixed lesions of HCC and cholangioma, 5 were false-positive lesions. Arterial phase of these HCC lesions showed obvious heterogeneous enhancement, and the portal vein phase showed heterogeneous low dense. Necrosis was seen in all massive lesions, but was seldom seen in nodular and small lesions. Most lesions had clear borders and amicula. The pathologic diagnoses of the 5 false-positive lesions were hepatic cirrhosis with hepatocellular nodular hyperplasia, regenerative nodule, hepatic cirrhosis, bile duct calculus companied with inflammatory reaction, and fibrosis hyperplasia. CONCLUSIONS: Helical double-phase CT scan can be used to diagnose typical HCC lesions. There are no obvious differences in helical double-phase CT scan between HCC lesions and false-positive lesions. The diagnosis of HCC must be based on clinical information, follow-up or biopsy.

[Diagnostic values of CT perfusion imaging in pulmonary masses].

BACKGROUND & OBJECTIVE: Blood flow patterns with CT perfusion imaging (CTPI) had been innovated to delineate abnormal hemodynamic lesions in the liver, brain, and kidney. This study was to evaluate the blood flow patterns of pulmonary masses by CTPI, and determine the value of CTPI in differential diagnosis among benign, malignant, and inflammatory masses. METHODS: Fifty-two patients with previously diagnosed pulmonary masses (37 with malignant masses, 7 with benign masses, and 8 with inflammatory masses) underwent dynamic CTPI. Time-density curves (TDC) of artery, vein, and pulmonary masses as well as mass perfusion images and parameters including perfusion volume (PV), peak height (PH), mean transit time (MTT) and blood volume (BV) were obtained by Phlips CT-perfusion software. RESULTS: The values of PV, PH, and BV were significantly higher in malignant masses and active inflammatory masses than in benign masses [(27.63+/-15.06) ml.min(-1).ml(-1) and (30.80+/-20.33) ml.min(-1).ml(-1) vs. (11.81+/-3.74) ml.min(-1).ml(-1), (28.46+/-12.07) Hu and (32.15+/-15.89) Hu vs. (10.41+/-3.77) Hu, (21.64+/-10.97) ml/100 g and (28.38+/-14.55) ml/100 g vs. (10.61+/-5.33) ml/100 g, P<0.01]. However, the differences of MTT among malignant, inflammatory, and benign masses were not significant [(28.39+/-21.66) s, (25.91+/-14.57) s, and (29.86+/-13.57) s, P=0.928]. No significant differences in the 4 parameters were found between malignant and inflammatory masses. When PV >20 ml.min(-1).ml(-1) and pH >15 Hu were set as a diagnostic threshold (excluded active inflammatory masses), the sensitivity, specificity, and accuracy were 91.9%, 100%, and 84.1%, respectively. CONCLUSION: CT perfusion imaging provides quantitative information about blood flow patterns of pulmonary masses and is an applicable diagnostic method for differentiating pulmonary masses.

[CT diagnosis of various subtypes of ameloblastoma in the maxillomandibular region].

BACKGROUND & OBJECTIVE: Based on biological behavior and histopathologic characteristics, ameloblastomas in the maxillomandibular region can be divided into several subtypes with different prognosis. This study was to explore the clinical and CT imaging features of solid or multicystic ameloblastoma (SMA), unicystic ameloblastoma (UA), and malignant ameloblastoma (MA), and thus to improve the CT diagnostic accuracy for these diseases. METHODS: Clinical and CT features of 25 histologically proven ameloblastomas in the maxillomandibular region, including 14 SMAs, 6 UAs, and 5 MAs were analyzed retrospectively. RESULTS: The median age of the patients initially diagnosed as SMA, UA, and MA were 33.5, 20.5, and 56 years, respectively. The mean maximal transverse diameters on CT images were 33 mm for SMA, 46 mm for UA, and 59 mm for MA. Of the 14 SMAs, 11 (79%) showed low to intermediate density as compared with muscles, 3 (21%) showed homogenous and intermediate density; 12 (86%) appeared as lobulate lesions; 10 (71%) had incomplete bone septa; 9 (64%) showed root resorption of the neighboring teeth; 13 (93%) showed cortical perforation; 6 (43%) had soft tissue masses; all SMAs showed well-defined margins. Of the 11 SMAs examined by enhanced studies, 9 (82%) showed strong enhancement. CT images of the 6 UAs showed homogenous and low density in comparison with muscles. Of the 6 UAs, 2 (33%) were lobulate, 4 (67%) were regularly round or oval; 1 (17%) had bone septa, 2 (33%) had root resorption of the neighboring teeth, 3 (50%) had cortical perforation. All UAs showed well-circumscribed margins without soft tissue masses. Three UAs were examined by enhanced studies and showed mild to moderate enhancement of the wall. Of the 5 MAs, 3 (60%) showed low to intermediate density as compared with muscles, 2 (40%) showed homogenous and intermediate density; 3 (60%) had bone septa; 3 (60%) showed root resorption or destruction of the neighboring teeth. All 5 MAs were lobulate with cortical perforation, soft tissue masses, and ill-defined margins. All 3 MAs examined by enhanced studies showed strong enhancement. CONCLUSIONS: SMAs are usually seen in middle-aged patients. CT images of SMAs frequently show lobulate lesions with strongly enhanced solid and cystic components. UA occurs mostly in young patients, and typically appears as cystic lesion with mild to moderate enhancement of the wall on CT images. MA often appears in old patients, and shows extensive bone destruction, soft tissue mass, ill-defined margin, and strong enhancement on CT images. Combined analysis of CT images and clinical data is helpful in differentiating these 3 subtypes of ameloblastoma.