Objective To determine the frequencies and patterns of gastrointestinal wall thickening at muti-slice computed tomography (MSCT) in patients with hepatic cirrhosis. Methods One hundred and nine patients with cirrhosis and 130 patients without cirrhosis for gastrointestinal wall thickening were retrospectively analyzed by the abdominal MSCT scans. The frequencies of wall thickening were determined in the cirrhosis patients and in those without cirrhosis. The segmental distribution, symmetry and enhancement pattern were evaluated in all patients with cirrhosis for gastrointestinal wall thickening. Results Gastrointestinal wall thickening was seen in 72 cases (66%) with cirrhosis patients and in 12 cases (9%) without cirrhosis patients (Plt;0.005). The jejunum and ascending colon were the most common sites of gastrointestinal wall thickening, which was involved in 32 and 31 patients respectively. The scans of 46 (64%) patients with gastrointestinal wall thickening showed multisegmental distribution. Gastrointestinal wall thickening was concentric and homogeneous in all patients with cirrhosis. Conclusion Gastrointestinal wall thickening is common in patients with hepatic cirrhosis. It frequently involves multiple segments. The jejunum and ascending colon are the most common sites of involvement. MSCT plays an invaluable role in diagnostic evaluation of bowel wall thickening in patients with hepatic cirrhosis.
Objective To systematically review the CT characteristic differences between pulmonary cryptococcosis (PC) and lung cancer presenting as solitary nodules. Methods PubMed, Embase, Web of Science, Cochrane Library, Wanfang, China National Knowledge Infrastructure and SinoMed were searched to collect case-control studies of the patients with PC and lung cancer presenting as solitary nodules on CT. The search period was from databases establishment to December 2023. We conducted a meta-analysis on the included studies. Results A total of 7 studies were included, 342 PC patients, and 370 lung cancer patients. The meta-analysis results showed that compared with lung cancer, PC patients were more likely to have the following characteristics in CT (P<0.05): nodules located in the lower lobe of the lung [odds ratio (OR)=1.91, 95% confidence interval (CI) (1.39, 2.62)], presence of bronchial inflation sign [OR=5.79, 95%CI (1.45, 23.21)], and halo sign [OR=6.64, 95%CI (2.87, 15.38)]. Compared with PC, lung cancer patients were more likely to have the following characteristics in CT (P<0.05): nodules located in the upper lobe of the lung [OR=0.52, 95%CI (0.35, 0.78)], presence of lobulation sign [OR=0.15, 95%CI (0.08, 0.27)], spiculation sign [OR=0.48, 95%CI (0.35, 0.65)], pleural indentation sign [OR=0.15, 95%CI (0.04, 0.50)], and vascular bundle sign [OR=0.20, 95%CI (0.05, 0.77)]. There was no statistically significant difference in CT between PC patients and lung cancer patients in terms of lesion size, relationship with pleura, vacuolar sign, cavity, and whether the broad base was connected to pleura (P>0.05). Conclusions For CT showing solitary nodules, PC nodules are more likely to be distributed in the lower lobe of the lungs, with bronchial inflation sign and halo sign. Lung cancer nodules are more likely to be distributed in the upper lobe of the lungs, with lobulation sign, spiculation sign, pleural indentation sign and vascular bundle sign.
ObjectiveTo analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP). MethodsEight patients with SPTP received triple phasic contrast-enhanced CT, and its consistency with pathological findings was analyzed. ResultsSPTP manifested as a solitary and exogenous mass, with a heterogeneous pattern composed of solid and polycystic parts. The shape of SPTP was spherical in four patients, oval in two patients, and shallow lobulation in another two patients. In contrast-enhanced phase images, the solid parts showed mild to moderate enhancement in both arterial and portal phases. Complete capsule was showed in seven patients, and nodules were found in the wall of mass in five patients. Hemorrhage was seen in two patients and calcification was showed in five patients. The dilation of pancreatic duct was found in one patient, liver metastases was showed in one patient, and the invasion of tumor to posterior gastric wall was found in one patient. Pseudopapillary structure, hemorrhage, necrosis, and cystic degeneration were showed in all patients by histological study. ConclusionSPTP has certain characteristic CT imaging manifestations consistent with histological features, which is helpful for the diagnosis and differential diagnosis of SPTP.
Objective To investigate the CT imaging features of autoimmune pancreatitis (AIP) with report of 4 cases and literature review. Methods The CT imaging data of 4 AIP patients proved on the basis of clinical findings, laboratory tests, response to steroids therapy and follow-up observation were retrospectively collected. Plain CT and contrast-enhanced dual phase CT scan at arterial and portal venous phases were performed for all 4 patients. All imaging data were reviewed, focusing on the shape, size, parenchyma density and enhancement patterns of the pancreas, as well as the biliary and pancreatic ducts, peripancreatic fat, blood vessels, retroperitoneal spaces, lymph nodes, and other positive findings. Results Three patients showed diffuse swelling of the pancreas on CT and 1 had focal enlargement of pancreatic head. Swelled pancreas was hypodense on plain CT images, showed decreased enhancement on artery phase and moderate enhancement on portal venous phase images of contrast-enhanced CT. Capsule-like enhanced rim was found around swelled pancreas in 2 patients. Stricture of distal common bile duct was present in 2 patients, and ERCP showed irregular narrowing of the main pancreatic duct in 1 cases. After steroid therapy, all patients showed significant morphological improvement of the pancreas at follow-up CT examination. Conclusion CT scan reveals certain characteristic imaging findings of AIP, thus it is helpful for the diagnosis of AIP.
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer. Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years. Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer. There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels, on the degree of circumferential contiguity of tumor to vessel, on the degree of lumen stenosis, and on the degree of contiguity between tumor and vessels combined vascular caliber. Conclusion CT grading criteria are not uniform, each one has defects.
Objective To investigate differential points of clinical symptoms and pathology of solid-pseudopapillary tumor of the pancreas (SPTP) and islet cell tumor (ICT). Methods Fifteen cases of SPTP and twelve cases of ICT were studied in this retrospective research. Clinical symptom, pathologic feature and computed tomography (CT) image of patients with both tumors were analyzed, and the imaging features were compared with pathological results. Results The mean age of SPTP patients was 22.4 year-old. Twelve patients with SPTP presented a palpable abdominal mass as the initial symptom. It was observed that the tumor cells were located in a pseudopapillary pattern with a fibro-vascular core histologically. On the CT images, a mixture of solid and cystic structures could be seen in all the tumors. After taking enhanced CT scan, the solid portion was slightly enhanced in the arterial phase and the contrast intensity increased in the portal venous phase. On the other hand, the mean age of ICT patients was 39.3 year-old. The major symptom was due to the function of islet cell tumor, which was typical in 8 patients, presenting as Whipple triad. Histologically, cells demonstrated in trabecular, massive, acinar or solid patterns, and the blood supply of the tumor was abundant. On the CT images, most small tumors were difficulty to be detected. ICT could be markedly enhanced in the arterial phase and slightly enhanced in the portal venous phase on post-contrast CT scan. Conclusion Clinical symptom, pathologic feature and CT scanning are helpful to differentiate SPTP from ICT.
【Abstract】Objective To investigate the imaging features of malignant invasion of major intrahepatic ductal structures (the portal and hepatic venous vasculature, the bilie duct) by primary hepatocellular carcinoma (HCC) using multidetector-row spiral CT (MDCT). Methods We retrospectively analyzed 68 documented HCC patients with tumorous invasion of the major intrahepatic ductal structures who had undergone contrast-enhanced dual-phase MDCT scanning of the upper abdomen.The morphological changes of the portal and hepatic venous vasculature, the bile duct, and the liver parenchyma at both the hepatic arterial phase and portal venous phase images were carefully observed and recorded. Results Among the 68 patients, 47 patients had malignant invasion of the intrahepatic portal venous vessels with secondary tumor thrombus formation; 12 patients had tumor involvement of the hepatic veins and intraheptic segment of the inferior vena cava; Tumor invasion of the bile duct was seen in 9 patents. The direct CT signs of tumor invasion of intrahepatic venous vessels included: ①dilatation or enlargement of the involved vein with intraluminal softtissue “filling defect”； ②enhancement of the tumor thrombus at hepatic arterial phase, the so-called “venous arterialization” phenomenon. The indirect CT signs included: ①arterial-venous shunt, ②early and heterogeneous enhancement of the hepatic parenchyma adjacent to HCC focus, ③cavernous transformation of the portal vein. The CT signs suggesting tumor invasion of the bile duct included: ①dilation of the bile ducts near or proximal to HCC lesion, ②soft-tissue nodule or mass inside the bile ducts. Conclusion Invasion of major intrahepatic ductal structures by HCC will present corresponding CT imaging features. Contrast-enhanced MDCT dualphase scanning combined with appropriate image postprocessing techniques can better evaluate the malignant invasion of major intrahepatic ductal structures.
ObjectiveTo explore the association between single nucleotide polymorphism (SNP) in the X-ray cross complementary repair gene-1 (XRCC1) rs1799782 locus and thyroid cancer.MethodsStudies investigating the association between SNP in the XRCC1 gene and thyroid cancer susceptibility were retrieved from the PubMed, Embase, Web of Science, CNKI (Chinese National Knowledge Infrastructure), Wanfang, and CBM (China Biology Medicine) databases (published date up to February 15, 2021). Eligible studies were screened according to inclusion/exclusion criteria and principles of quality evaluation. Meta-analysis was performed using Stata 14.0 software. Odds ratios with their corresponding 95% confidence intervals (95%CI) were pooled to assess the association between SNP in the XRCC1 gene rs1799782 locus and thyroid cancer susceptibility.ResultsTwelve articles were eligible for this meta-analysis. Meta-analysis results were shown as follows: No significant association was found between XRCC1 rs1799782 polymorphism and thyroid cancer in overall population [Dominant model: CT+TT vs CC, OR=1.07, 95%CI (0.84, 1.36). Recessive model: TT vs CT+CC, OR=1.48, 95%CI (0.95, 2.31). Allelic model: T vs C, OR=1.15, 95%CI (0.93, 1.43). Codominant model: TT vs CC: OR=1.44, 95%CI (0.83, 2.53); CT vs CC, OR=1.02, 95%CI (0.82, 1.28); TT vs CT, OR=1.40, 95%CI (0.98, 1.99)]. rs1799782 polymorphism was significantly associated with the risk of thyroid cancer in Chinese population [Dominant model: CT+TT vs CC, OR=1.38, 95%CI (1.11, 1.71). Recessive model : TT vs CT+CC, OR=1.97, 95%CI (1.55, 2.50); Allelic model: T vs C, OR=1.40, 95%CI (1.16, 1.68). Codominant model: TT vs CC, OR=2.12, 95%CI (1.66, 2.71); CT vs CC, OR=1.26, 95%CI (1.09, 1.47); TT vs CT, OR=1.70, 95%CI (1.31, 2.21)]. rs1799782 polymorphism was significantly associated with the risk of thyroid cancer in Asian population [Dominant model: CT+TT vs CC, OR=0.64, 95%CI (0.49, 0.83). Codominant model: TT vs CC: OR=0.50, 95%CI (0.33, 0.74); CT vs CC, OR=0.65, 95%CI (0.49, 0.86)].ConclusionsThere is no significant correlation between XRCC1 rs1799782 polymorphism and the risk of thyroid cancer in general population. The XRCC1 rs1799782 polymorphism may be associated with an increased thyroid cancer risk among Chinese, and a tendency for decreased thyroid cancer risk among Asians (Chinese excluded). The XRCC1 rs1799782 polymorphism is not associated with thyroid cancer susceptibility among Caucasians under all genetic models.
Objective To investigate the value of multislice spiral CT （MSCT） findings in the diagnosis of hepatic tuberculosis. Methods MSCT imaging data, including both plain and contrast-enhanced CT scan, of 14 patients with hepatic tuberculosis confirmed by surgery (5 patients), aspiration biopsy (4 patients), or clinic follow-up (5 patients) were collected for the study. MSCT findings were analyzed with correlation of pathological changes. Results Hepatic tuberculosis was classified into 2 types. ①The parenchymal type (12 patients), which was further divided into 4 subtypes: Miliary subtype (2 patients) showed multiple tiny hypodense dots with faint border and had no enhancement; Nodular subtype (5 patients) showed blurring border on plain CT scan, 2 patients had no enhancement, 2 had peripheral rim-like enhancement, and peripheral rim enhancement mixed with no enhancement in 1 patient; Abscess subtype (4 patients) showed central hypodense area with peripheral zone-like enhancement in 2 patients, or patchy like slight enhancement in 2 patients; Fabric and calcific subtype (1 patient) depicted enplaque calcification. ②The serohepatic type (2 patients) showed thickened hepatic capsule, sub-capsule nodules with slight enhancement, and local subcapsular fluid collection. Other signs included hepatomegaly, tuberculous lymphadenopathy, splenic tuberculosis, and tuberculosis of pancreas, adrenal glands, intestine and thorax. Conclusion MSCT plays an important role in diagnosis of hepatic tuberculosis, by reflecting underlying pathological changes.
ObjectiveTo investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery. MethodsThere were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery. ResultsThe 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000]. ConclusionsThe cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.