摘要:目的:探讨血清CA153和BAKP在乳腺癌骨转移显像诊断中的应用。方法:对92例乳腺癌患者的核素骨显像结果、血清CA153和BAKP结果进行回顾性研究。结果:①血清CA15-3和B-AKP的值随着骨转移分期的增高而逐步升高,且差异显著(Plt;0. 01);②血清CA15-3和B-AKP与骨转移的数目呈正相关;③血清CA15-3gt;25 U/mL时,骨转移的阳性率为63.3%,血清CA15-3lt;25 U/mL时,骨转移的阴性预测值为94. 5%;血清B-AKPgt;20 U/L时,骨转移的阳性率为59. 6%时,骨转移的阴性预测值为73.5%;当血清CA15-3lt;25 U/mL同时B-AKPlt;20 U/L时,骨转移的阴性预测值为100%。结论:血清CA15-3和BAKP测定在乳腺癌骨显像诊断中具有重要的应用价值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.
【Abstract】ObjectiveTo evaluate the value of MR imaging with a contrast-enhanced multi-phasic isotropic volumetric interpolated breath-hold examination (VIBE) in diagnosis of primary liver carcinoma. MethodsThirty-two consecutive patients with surgical-pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two-dimensional (2D) T1WI and T2WI images were acquired before administration of Gd-DTPA for contrast enhancement. Then, contrast-enhanced multi-phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non-enhanced T1WI, enhanced T1WI and enhanced 3D-VIBE images (P＜0.05). The hepatic arterial anatomy of 30 patients （93.8%） and the portal venous structure of 31 patients （96.9%） were clearly depicted on enhanced 3D-VIBE images. Using MIP and MPR reconstruction techniques, the feeding arteries of 14 foci and draining vein of 12 foci were clearly displayed.ConclusionHigh-quality 3D-VIBE images are not only better than 2D images in lesion detection and characterization for primary liver carcinoma, but also able to provide much more information about hepatic vascular anatomy.
Coronary artery fractional flow reserve (FFR) is a critical physiological indicator for assessment of impaired blood flow caused by coronary artery stenosis. The wire-based invasive measurement of blood flow pressure gradient across stenosis is the gold standard for clinical measurement of FFR. However, it has the risk of vascular injury and requires the use of vasodilators, increasing the time and overall cost of interventional examination. Coronary imaging is playing an important role in clinical diagnosis of stenotic lesions, evaluation of severity of lesions, and planning of therapies. In recent years, the computation of FFR based on the physiological information of blood flow obtained from routinely collected coronary image data has become a research focus in this field. This technique reduces the cost of physiological assessment of coronary lesions and the use of pressure wires. It is beneficial to strengthen the physiological guidance in interventional therapy. In order to better understand this emerging technique, this paper highlights its implementation principle and diagnostic performance, analyzes practical problems and current challenges in clinical applications, and discusses possible future development.
Objective To analyze longitudinal motion of infarcted myocardium and ischemic myocardium with a new echocardiographic technology of velocity vector imaging (VVI), and to assess its accuracy. Methods From December2007 to January 2008, 6 patients suffered acute anterior myocardial infarction (MI group), 9 patients had myocardial ischemia (over 70% stenosis of anterior descending branch, MS group) and 16 healthy subjects (control group) were included. The long axis view and 2-chambers view of left ventricle at the apex of heart were acquired with Siemens Sequoia 512 ultrasound system. The longitudinal velocity, displacement, strain and strain rate were analyzed with off-l ine Syngo US workplace software. Results In normal myocardial group, longitudinal peak systol ic velocity (Vs) and peak displacement (D) decreased progressively from base level to apex level in anterior wall and anterior septum (P lt; 0.05), while peak strain (S) and peak systol ic strain rate (SRs) kept the same in three levels (P gt; 0.05). S and SRs significantly decreased in all segments of infarcted myocardium (P lt; 0.05), compared with normal and ischemic myocardium. In ischemic myocardium, only base and middle segmental S of anterior wall decreased (P lt; 0.05). A myocardial S lower than —6.94% in at least one ventricular segment showed best sensitivity (100%) and specificity (100%) for detecting an infarcted left ventricle. A myocardial SRs lower than —0.81% at least in one ventricular segment showed 100% sensitivity and 80% specificity, and lower than —0.46% showed 83% sensitivity and 100% specificity. Conclusion VVI is a useful tool for assessing myocardial regional function. Especially, S and SRs are useful predictors of the presence of regional dysfunction in infarcted myocardium.
OBJECTIVE: To study the effect of color doppler flow imaging(CDFI) technique in the design of axial pattern flap. METHODS: From April 1996 to June 1999, 10 patients with residual wound were adopted in this study. Among them, there were seven males and three females, the area of wounds ranged from 6 cm x 8 cm to 15 cm x 20 cm. Before operation, the axial pattern flaps were designed by traditional method, then CDFI technique with high frequency(5.0-7.5 MHz) was used for examining the major supply artery of the flap. At last, the modified flaps were transferred to cover the wounds. RESULTS: All the patients except one case completed the operation successfully. The cosmetic and function of the flaps were excellent. CONCLUSION: CDFI is a simple, direct and accurate method for detecting the supply artery of axial pattern flap. This technique should be popularized to avoid the blindness of flap design.
【Abstract】ObjectiveTo investigate the value of volumetric interpolated breathhold examination (3DVIBE) MRI sequence in the diagnosis of functional islet cell tumors of the pancreas. MethodsDedicated MRI scan was performed for 3 patients suspected to have functional islet cell tumors of the pancreas on clinical and laboratory basis. The MRI scan protocol included routine axial T1W and T2W, coronal true fast imaging with steady state procession (TrueFISP) and MRCP, gadoliniumenhanced 3DVIBE dynamic triphasic acquisitions and enhanced 2D GRE T1W scan. The three phases images of 3DVIBE sequence were acquired at 15 s, 40 s and 65 s after injection of contrast agent, corresponding to the early arterial, late arterial and portal venous phase respectively. The imaging features were compared with surgical and pathological findings. ResultsThe triphasic images of 3DVIBE sequence depicted clearly the morphology of small functional islet cell tumors of the pancreas and reflected accurately the characteristics of tumor blood supply, while other MRI sequences might miss these small lesions. ConclusionThinslice and fast dynamic MRI sequence, as exemplified by 3DVIBE sequence, is very useful in the detection and characterization of pancreatic functional islet cell tumors.
The development and progression of atherosclerosis and thrombosis are closely related to changes of hemodynamics parameters. Ultrasonic pulse wave Doppler technique is normally used for noninvasively blood flow imaging. However, this technique only provides one-dimensional velocity and depends on the angle between the ultrasound beam and the local velocity vector. In this study, ultrasonic particle image velocimetry method was used to assess whole field hemodynamic changes in normal blood vessels. By using the polynomial fitting method, we investigated the velocity gradient and assessed the shear in different blood flow velocity of 10 healthy rats. It was found that using four polynomial fitting could result in optimal measurement results. The results obtained by ultrasonic particle image velocimetry accorded with the results obtained using Doppler technique. The statistical average of cyclical vessel wall shear stress was positively related to the locational mean velocity. It is proven that ultrasonic particle image velocimetry method could be used to assess directly the real-time whole field hemodynamic changes in blood vessels and was non-invasively, and should be a good prosperous technique for monitoring complex blood flow in stenotic arteries.
ObjectiveThis review has summarized in detail the advances in computed tomography (CT) and magnetic resonance imaging (MRI) imaging in evaluating the efficacy of targeted therapy for gastrointestinal stromal tumor (GIST).MethodsTo summarize the image-related guidelines, consensus, international conference reports, and relevant knowledge of clinical research on the evaluation of the efficacy of GIST targeted therapy in recent years.ResultsThe CT and MRI manifestation after targeted treatment of GIST was closely related to pathological changes, including necrosis, cystic degeneration, and bleeding. CT was the preferred imaging method. Functional magnetic resonance imaging, such as diffusion weighted imaging (DWI), had made some progress. The main criteria for evaluating the efficacy of GIST targeted therapy were RECIST 1.1 and Choi criteria.ConclusionCT and MRI play an important role in evaluating the efficacy of targeted therapy for GIST.
With high morbidity, branch retinal vein occlusion (BRVO) is a common retinal vascular disease in the clinic. Although the classic characteristics of BRVO have been recognized for a long time, the traditional understanding of BRVO has been challenged along with development and application of new imaging technologies, including the reasonable classification and staging of the disease, and the vascular characteristics at the occlusive site via multimodal imaging, etc. Thus, re-summarizing and refining these features as well as further improving and optimizing traditional imaging evaluation, can not only deepen the correct acknowledge of the entity, but also find biomarkers of prognosis of visual function, which is helpful to establish better diagnosis and treatment strategy. In the meanwhile, it is necessary that clinical characteristics of BRVO on imaging and the reliability of these imaging techniques are worth correct understanding and objective assessment.
ObjectiveTo analyze and conclude CT and MRI imaging features of ectopic pancreas in gastrointestinal tract so as to improve the understanding of the features.MethodsThe clinical, imaging, and pathological data of 12 patients with ectopic pancreas in the gastrointestinal tract confirmed by the pathology in the Sichuan Provincial People’s Hospital from November 2016 to June 2019 were retrospectively analyzed. The characteristics of image presentation were summarized.Results① The anatomical distribution: all patients had a single lesion. Of the 12 cases, 6 cases located in the gastric body lesser curvature, 3 cases located in the gastric angle, 1 case located in the posterior wall of gastric antrum, 1 case occurred in the upper jejunum, and 1 case occurred in the terminal ileum; 8 cases located in the submucosa, 2 cases located in the submucosa and muscular layer simultaneously, 1 case located in the submucosa, muscular and serous layer simultaneously, and 1 case located in the muscular layer. ② Size of the lesions: the maxium dimensions of the lesions were all 3 cm or less, and the long axes of the lesions were parallel to the gastrointestinal tract wall in 10 cases. ③ The internal characteristics: the results of 9 of 11 cases showed the isodensity compared to main pancreas on the plain CT scan. The results of 8 patients with enhanced CT showed the moderate to obvious enhancement, with 2 cases showed the slightly enhanced flaky or tube-like foci. In the arterial phase and portal venous phase, 6 cases showed the isodensity compared to main pancreas respectively. The result of MRI in 1 patient showed the isointensity compared to main pancreas on the plain scan and obviously heterogeneous enhancement.ConclusionCT and MRI could provide some information about location, size, and internal density or intensity of ectopic pancreas, and could be helpful for diagnosis.