Objective To review the examination techniques and the current research progress of the magnetic resonance diffusion weighted-imaging (DWI) used in liver. Methods The recent and relevant literatures about the principles and the current study situation of liver DWI were scrutinized and analyzed retrospectively. In addition, the existing problems of liver DWI were discussed. Results DWI could demonstrate the normal and abnormal structure and function through measuring the diffusion motions of water molecule in the liver. With the improving technology and better understanding of diffusion dynamics, DWI has been used for the diagnosis and differential diagnosis for hepatic diseases. Conclusion DWI as a non-invasive examine method, may provide valuable functional information for clinical diagnosis and treatment.
【摘要】 目的 探讨肝脏血管平滑肌脂肪瘤（hepatic angiomyolipoma，HAML）的多层螺旋CT影像学表现特征及其与病理学基础的相关性，以进一步提高CT诊断的准确性。 方法 收集2008年11月-2010年12月经手术病理证实的16例HAML患者。所有患者均行螺旋CT平扫及动脉期、门脉期增强检查，重点观察HAML的分型及其相应CT表现及影像-病理的相关性。 结果 16例患者共20个病灶，19个为稍低密度病灶，其中11个病灶内可见明显的脂肪密度影；1个为稍高密度病灶。动脉期所有病灶均有不同程度的强化表现，15个病灶内可见到较明显条状及扭曲的血管影。门脉期15个病灶有持续强化。 结论 多层螺旋CT能准确反映HAML的分型及其病理特征，对临床表现不典型患者的诊断和鉴别诊断有较大诊断价值。【Abstract】 Objective To discuss the correlation between the features of multislice spiral CT results for hepatic angiomyolipoma (HAML) and their pathological basis, and to further improve the diagnostic accuracy through CT examination. Methods Sixteen HAML patients diagnosed pathologically between November 2008 and December 2010 in our hospital were enrolled in our study. All patients underwent multi-slice spiral CT scanning of pre-and post-contrast arterial phase, and portal venous phase. Focus was put on observation of HAML types and their corresponding manifestations, and the correlation between CT imaging and the pathologic basis. Results There were 20 lesions in the 16 patients. Among the 19 hypodense lesions, 11 were clearly seen with fat density shadow. One out of the 20 lesions showed as slightly hyperdense. On the arterial phase scanning, all lesions showed enhancement, and obvious vascular shadow could be seen in15 lesions. On the portal venous phase, 15 lesions continued to strengthen. Conclusions Multi-slice spiral CT can accurately reflect the classification of HAML and its pathological features. It has a great value in the diagnosis and differential diagnosis of patients without typical clinical manifestations.
目的 探讨结核性腹膜炎（TBP）及癌性腹膜炎（CP）的螺旋CT表现，提高其诊断及鉴别诊断水平。 方法 回顾分析2009年9月－2010年9月经手术病理、穿刺活检或综合手段证实的22例TBP和45例CP患者的CT影像资料，采用χ2检验比较各种CT征象在两种病变中的发生率，结合病理、临床结果进行分析。 结果 TBP组及CP组患者大量腹水所占比例差异有统计学意义（36.4%、75.6%，χ2=9.703，P=0.002）；两组壁腹膜、肠系膜增厚构成比差异有统计学意义，TBP组以壁层腹膜均匀增厚、肠系膜污迹样改变为主，CP组壁层腹膜以结节、块样增厚为主；两组大网膜厚度差异有统计学意义。 结论 以壁层腹膜改变为基础，综合大网膜、肠系膜及腹水改变CT征象对两种病变的诊断及鉴别诊断具有重要意义。
Objective To investigate the application of multi-detector row spiral CT （MDCT） and multi-planer reconstruction （MPR） in identify the anatomy detail of normal adult groin region. Methods We retrospectively collected the CT images of 50 adult subjects with normal groin anatomic structure underwent groin region thin-slice MDCT scans between July and December 2009, 30 males and 20 females, obtained the coronal and sagittal views by MPR, investigated the value of different plans in identifying anatomic detail. Results Bilateral inferior epigastric artery (100/100, 100%), spermatic cord (60/60, 100%), and round ligament of uterus (40/40, 100%) were well identified on all plans in all subjects. The bilateral “radiological femoral triangle” could be demonstrated on coronal views in all subjects (100/100, 100%). The bilateral inguinal ligament were visible on coronal view in all subjects (100/100, 100%) and on sagittal views in 34 subjects (68/100, 68%), but on axial views was identified in 3 male subjects (6/100, 6%). The bilateral inguinal canal and deep inguinal ring were reliably visible on coronal views in all subjects (100/100, 100%), and on sagittal views in 46 subjects (92/100, 92%). On coronal views, the widths of inguinal canal was (0.97±0.35) cm in left, (0.89±0.23) cm in right for males, and (0.62±0.11) cm in left, (0.71±0.11) cm in right for females. No significant difference was found between two sides (P=0.059 in males， P=0.067 in females), but there were significant differences between males and females (P=0.007 in left， P=0.009 in right). Transverse diameter of deep inguinal ring was (1.32±0.31) cm in left, (1.31±0.36) cm in right for males, and (1.07±0.35) cm in left, (1.07±0.30) cm in right for females. No significant difference was found between two sides (P=0.344 in males， P=0.638 in females), but there were significant differences between males and females (P=0.001 in left， P=0.002 in right). Conclusion MDCT with different plans plays an important role in identify the anatomic details of groin region, the coronal views especially.
Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.
Objective To evaluate the sensitivity and accuracy of SPIO-enhanced MR Imaging in the detection of focal hepatic lesions. Methods We searched MEDLINE (1966 to 2004), EMBSAE (1984 to 2004), The Cochrane Library (Issue 1, 2004), CBMdisc (Jan.1978 to Jul. 2004), CMCC (1994 to 2004), “Radiology”, “AJR” and “European Radiology” database. Data from pharmaceutical companies and our research were also added. Related journals published from 1985 to 2003 were handsearched. Participants were clinically suspected of focal hepatic lesions. The quality of studies was assessed, and descriptive systematic review was applied to evaluate the detection sensitivity and accuracy of the imaging modality. Results Ten studies (418 patients with 1 037 focal hepatic lesions) were included. Because the data of sensitivity and specificity could not be extracted from any of the 10 included studies, it was impossible to do the meta-analysis using SROC curve. The sensitivity of SPIO-enhanced MRI ranged from 66% to 100%; accuracy ranged from 76% to 97%. Conclusions At present, there is no evidence to ascertain that SPIO-enhanced MRI has a considerably high accuracy in the detection of focal hepatic lesions. More studies with good methodology are needed.
ObjectiveTo discuss multislice spiral CT (MSCT) features and pathologic basis of the cavernous hemangioma of mediastinum, and further improve the diagnostic accuracy with CT. MethodsWe collected 4 cases of cavernous hemangioma in mediastinum from November 2008 to November 2013. All patients underwent MSCT examination of plain scan and enhanced-contrast scan. The CT manifestations of cavernous hemangioma in mediastinum were observed. The correlation of the CT imaging findings with pathology features was analyzed retrospectively. ResultsTwo of the 4 lesions were located in the anterior mediastinum and the other 2 in the posterior mediastinum. On plain scan, 2 lesions showed homogeneous density, and 2 had heterogeneous density. Vessels could be observed in all lesions on enhanced-contrast CT imaging. ConclusionCavernous hemangioma in mediastinum is often located in the anterior and posterior mediastinum. Calcification and vessels in lesions are its imaging characteristics. Multislice spiral enhanced CT can accurately reflect the characteristics and pathological basis, providing more important information for diagnosis.
Objective To evaluate the value of MRI and MDCT in detecting both inferior vena cava tumor thrombus and vena cava wall invasion in renal cell carcinoma. Methods Databases including PubMed, EMbase, The Cochrane Library, MEDLINE (Ovid), CBM, CNKI, VIP and WanFang Data were searched from January 2000 to February 2012. Relevant studies were screened on the basis of the inclusion and exclusion criteria, and then quality assessment and data extraction were conducted. Then heterogeneity test and meta-analysis were conducted using RevMan 5 and Meta-disc 1.4. Results A total of 6 trials involving 244 patients and 246 cases of renal cell carcinoma were included. The results of meta-analysis showed that, for the MRI group and the MDCT group, the sensitivity was 0.963 and 0.952, the specificity was 0.969 and 0.979, the value of +LR was 9.759 and 15.57, the value of −LR was 0.091 and 0.108, and the dOR was 198.71 and 251.54, respectively. There were no significant differences in pooled effect-size among groups (Pgt;0.05). The area under curve (AUC) of summary ROC curve analysis as well as Q index of the MDCT group were 0.981 8 and 0.940 7, respectively. Conclusion There is no significant difference in the value of MRI and MDCT in detecting inferior vena cava tumor thrombus induced by renal cell carcinoma. More original studies on vena cava wall invasion by tumor thrombus should be conducted in the future due to the limitation of current materials.