Objective To summarize and analyze the MRI imaging findings of advanced gastric cancer in order to improve the level of image diagnosis. Methods The plain and dynamic enhanced MRI findings in 8 volunteers and 30 patients with pathologically proven advanced gastric cancer were retrospectively analyzed. Results The stomach wall of advanced gastric cancer was inhomogeneous thickening with iso intensity or little hypo intensity signal on T1WI， and iso intensity or little hyper intensity signal on T2WI. Cases with serosal infiltration， the serous appearred indistinctly and rough. In some cases， the low signal zones between gastic wall and fat space were interrupted on T1WI out-of-phase image. Cases with adjacent organs invaded， the fat space was rough or disappeared. The lesions showed obvious irregular or hierarchy enhancement on MRI dynamic contrast scanning. Conclusions Inhomogeneous thickening of gastic wall with abnormal signal intensity， indistinctness or disappearance of fat space， irregular or hierarchy enhancement are very valuable as diagnostic signs in patients suspective of advanced gastric cancer.
ObjectiveTo introduce the role of three dementional computed tomograph (3D-CT) for patients underwent transcatheter aortic valve implantation (TAVI) procedure in perioperative evaluation. MethodsFrom April 2014 to June 2015, we retrospectively analyzed clinical data of 28 patients with severe aortic stenosis underwent successful TAVI procedure using new second-generation device, who were enrolled in this study including 12 males and 16 females at mean age of 72.8±4.5 years. We used 3D-CT to get the perioperative relative evaluation, including valve morphology and calcification degree, annular diameter, aoronary ostium height, ascending aorta, aortic sinus diameter, left ventricular-aortic angle, optimal intraoperative angiogram projection angle. Based on the evaluation by 3D-CT image, the prosthesis size, balloon size, best intraoperative imaging projection angle and approach of apex were then chosen. ResultsAll patients with severe aortic stenosis underwent successful TAVI procedure with mean logistic Euro-SCORE I:26.2%±7.9%. CT image revealed that mean aortic annular diameter was 24.6±1.8 mm with mean valve prosthesis size 25.8±1.1 mm and pre-dilation balloon size 23.1±1.2 mm and 76.8% patients were of tricuspid aortic valve with severe calcification and 25% patients were of asymmetric calcification. Optimal intraoperative angiogram image was achieved in 92.9% patients with the help of preoperative CT image. There was a statistic difference in mean transvalvular gradient after valve implantation (54.1±15.3 mm Hg vs. 13.1±8.5 mm Hg, P<0.05). And there was no mortality or severe complication postoperatively. Conclusion3D-CT image palys an important role during perioperative evaluation of TAVI procedure and it can be helpful for Chinese doctors to operate TAVI successfully.
目的 比较磁共振胰胆管成像（MRCP）三维质子加权快速自旋回波（SPACE）序列和半傅立叶采集单次激发快速自旋回波（HASTE）序列对胆囊管的显示情况，优选最佳的磁共振检查序列。 方法 2012年5月-2013年3月265例连续性患者同时采用SPACE序列和HASTE序列行MRCP检查，比较两种序列对胆囊管显示的图像质量和显示率，并进行统计学分析。 结果 SPACE序列对胆囊管显示的图像质量评分及显示率均优于HASTE序列 （P＜0.05）。 结论 SPACE序列是目前显示胆囊管较为理想的MRCP成像方法。
目的 观察蜂蜇伤致横纹肌溶解的MRI表现，探讨MRI对蜂蜇伤致横纹肌溶解症的诊断价值。 方法 收集2008年9月-2009年12月急诊科及肾内科蜂蜇伤患者4例。对其行蜇伤部位MR增强扫描，对其中1例患者行远离部位肢体扫描。总结MRI征象，评价MRI在蜂蜇伤所致横纹肌溶解临床诊治中的作用。 结果 蜇伤部位显示T1WI稍低，T2WI高信号影像，在T2WI加压脂影像中显示最为清晰，横纹肌损伤有局部随肌间隙扩散趋势，但远端无蜇伤肌肉受累。 结论 蜂蜇伤导致的横纹肌溶解可在MRI影像上得到直观反映。MRI具有良好的软组织对比度，能及时反映横纹肌受累范围及程度、治疗后恢复情况等，可为其临床诊治评估提供有利信息。
Objective To evaluate the clinical value of multi-detector row helical CT (MDCT) in Diagnosing the TN staging and typing of adenocarcinoma of esophagogastric junction. Methods From January 2008 to June 2011，149 consecutive cases with AEG confirmed surgery were examined by using MDCT scanner before surgery in West China Hospital，pathologic and operative finding diagnosis were correlated with that results of MDCT . Results The accuracies of MDCT for the T1, T2, T3, and T4 staging was 97.3%，91.3%，84.5%， and 89.3%，respectively， and for the typing of Ⅰ,Ⅱ, andⅢwas 84.6%, 63.8%, and 79.2%，respectively. The accuracies of MDCT to judge the metastasis of lymph node was 88.6%（132/149）. The feature of metastasis of lymph node with circular and fusion，significantly and obviously enhanced，ring and heterogeneous enhanced, which the positive rate of pathological metastasis was higher (P=0.000). Conclusions MDCT is an excellent diagnostic tool for the diagnosis of the TN staging and typing of AEG, which is useful for the selection of the surgical procedure and decision operation path.
ObjectiveTo investigate the value of postoperative CT examination for evaluation of local complications in patients with low rectal carcinoma after total mesorectal excision with anal sphincter preservation. MethodsThe patients with low rectal carcinoma who received total mesorectal excision (TME) with anal sphincter preservation were examined using contrastenhanced CT in one year period from May 2009 to May 2010. Particular attention was paid to the presence of anastomotic leakage, local recurrence and status of lymph nodes. ResultsTotal of 82 patients (52 men, 30 women； mean age 57.8 years old； range 25.74 years old) were included in the study. Over a mean 10-month follow-up， 8 cases （9.8%） had clinically or surgically confirmed anastomotic leak, 6 cases （7.3%） had local recurrence around the anastomotic site， and 4 cases （4.9%） showed pelvic and distant metastatic lymphadenopathy. ConclusionPostoperative CT examination, including baseline and follow-up CT studies, is very useful for diagnosing anastomotic leakage, local tumor recurrence and lymphadenopathy.
ObjectiveTo explore the utility of magnetic resonance-T1ρ-weighted imaging (T1ρWI) in the diagnosis of human primary hepatic carcinoma. MethodsNine patients were prospectively collected from West China Hospital of Sichuan University during January 2014 and June 2014, who had liver lesion that identified by the ultrasound or CT examination, and then were verified as primary hepatic carcinoma with pathological biopsy. A routine T2WI, pre-and post-contrast T1WI, pre-and post-contrast T1ρWI were performed on a 3.0 T clinical imager. The tumor-to-normal-tissue contrast was compared between pre-contrast T1ρWI/post-contrast T1ρWI and other sequences respectively, to investigate the value of T1ρWI in the diagnosis of human primary hepatic carcinoma. ResultsThe tumor-to-normal-tissue contrast of pre-and post-contrast T1WI were lower than that of pre-contrast T1ρWI (t=3.532, P=0.008; t=3.666, P=0.006), while there was no statistical difference between T2WI and pre-contrast T1ρWI (t=-1.448, P=0.186). And compared with post-contrast T1ρWI, post-contrast T1WI had lower tumor-to-normal-tissue contrast (t=3.468, P=0.008). ConclusionsT1ρWI can provide a better image of human primary hepatic carcinoma, thus T1ρWI is expected to become a new and useful method in MR scanning. It also shows potential value who can be used as an artery imaging that without using contrast agents.
ObjectiveTo explore the characteristics of chest high-resolution CT in common-type coronavirus disease 2019 patients.MethodsA retrospective analysis was performed on 35 patients in the Fever Clinic of West China Hospital of Sichuan University from January 21 to February 23, 2020. According to the nucleic acid test results, the patients were divided into a nucleic acid positive group of 14 cases, and a nucleic acid negative group of 21 cases. The clinical characteristics and high-resolution CT results (including lesion distribution, morphology, density, paving stone sign, air bronchial sign, vascular thickening sign, pleural effusion and enlarged lymph nodes, etc.) of the patients in each group were compared.ResultsThere was no statistically significant difference in the ratio of males to females, age distribution, clinical symptoms, or absolute lymphocyte values between the nucleic acid positive group and the nucleic acid negative group (P>0.05). The difference in epidemiological history between the two groups was statistically significant (P<0.05). The proportions of abnormal lymphocytes and white blood cell counts in the nucleic acid negative group were higher than those in the nucleic acid positive group (66.7% vs. 28.6%, P=0.041; 42.9% vs. 7.1%, P=0.028). The proportion of air bronchial signs in the nucleic acid negative group was higher than that in the nucleic acid positive group (47.6% vs. 7.1%, P=0.023). There was no significant difference in other high-resolution CT imaging findings between the two groups (P>0.05).ConclusionsCommon-type coronavirus disease 2019 patients have certain positive findings on chest high-resolution CT imagings. In clinical practice, high-resolution CT and other factors can be combined to assist in the diagnosis of coronavirus disease 2019.
【Abstract】Objective To compare radiologists’ performance on combined unenhanced and feridexs-enhanced MR imaging （MRI） with their performance on helical CT enhanced, unenhanced MRI, and feridexs-enhanced MR alone imaging for the characteristics of local hepatic lesions. Methods MR images and CT scans obtained in 26 patients with 57 local hepatic lesions were analyzed with reviewer operator characteristic (ROC) curve analysis. The imaging of patient were divided into 4 groups including combined unenhanced and feridexs-enhanced MRI group, helical CT enhanced group, unenhanced MRI group, and feridexsenhanced MR alone group. Results The combined approach resulted in larger area under the ROC curve (Az=0.926 0) and accuracy (86.8%),P＜0.05，as compared with the others methods. There were no significant differences among the other three methods. Conclusion Feridexs-enhanced MRI was more accurate than enhanced helical CT scan in characterization of local hepatic lesion. The combined analysis of unenhanced and feridexs-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of feridexs-enhanced images alone.