Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.
Objective To review the value of imaging assessment for perioperative period of liver transplantation. Methods The related literatures in recent years were reviewed, and the applications of various kinds of radiological techniques in perioperative period of liver transplantation and radiological strategies of major complications after liver transplantation were summarized. Results Transplantation has become an effective option for treatment of patients with irreversible severe liver dysfunction. Radiological assessment supplies prompt and accurate information for clinic to increase the success rate and reduce the complications. So it plays an irreplaceable role. Conclusions Radiology assessment is important for screening donors and recipients before liver transplantation， following up and monitoring the complications. The doctor of imaging department could grasp the different imaging appearance in perioperative period of liver transplantation.
Objective To discuss the CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms (GI-NENs). Method The clinical and CT materials of 33 cases of GI-NENs who treated in our hospital from Jan. 2013 to Dec. 2015 were retrospectively analyzed. Results Of the 33 cases, 25 males and 8 females were enrolled. The median age was 62-year old (27–78 years), and the age at diagnosis mainly focused in the 50–70 years period. GI-NENs situation: 12 cases in the stomach, 11 cases in the rectum, 3 cases in the esophagus and colon respectively, 2 cases in the duodenum and appendix respectively. The main clinical symptoms included: abdominal pain in 13 cases, dysphagia and obstruction in 9 cases, hematemesis and hematochezia in 8 cases, abdominal distention in 5 cases, stool and bowel habits change in 5 cases, subxyphoid pain in 3 cases, belching in 2 cases, diarrhea in 1 case, protrusion of the neoplasm when defecation in 1 case, obstructive jaundice in 1 case. Seven cases of G1 grade, 6 cases of G2 grade, 15 cases of G3 grade, and 5 cases of mixed adenoneuroendocrine carcinomas were found according to pathologic grading. The immunohistochemical marker: synaptophsin was positive in 31 cases, cytokeratin A was positive in 23 cases, and cytokeratin was positive in 9 cases. The CT appearances of GI-NENs were mainly thickening of the walls and formation of nodules or masses in local area. Moderately homogeneous enhancement (in 20 cases) and irregularly heterogeneous enhancement (in 13 cases) were both commonly seen. In addition, 13 cases of lymphadenophathy, 6 cases of liver metastasis, and 3 cases of lung metastasis were also detected by CT. Conclusions GI-NENs have a preference for elderly male. The most common site of onset is the stomach. Its clinical symptoms and CT appearances are nonspecific, however, the enhancement pattern of the tumors has a certain characteristic.
Objective To introduce the current value of multi-detector row CT (MDCT) and magnetic resonance imaging (MRI) techniques on evaluation of diffuse hepatic parenchymal diseases.Methods By literature review, the application and recent advances of various kinds of MDCT and MR imaging techniques in evaluating diffuse hepatic parenchymal diseases were summarized. Results There were three kinds of diffuse liver parenchyma diseases, which were the diseases of storage, vascular and inflammatory. The morphology changes of diffuse liver parenchyma diseases could be demonstrated well by MDCT. MRI, especially MR functional imaging could reflect the morphology changes, and cellular metabolic activity of the liver, which provided qualitative and quantitative information for the diagnosis and evaluation of therapeutic effect on diffuse liver parenchyma diseases. Conclusion MR imaging techniques, especially those functional techniques, developed rapidly and had practical value in both the diagnosis and severity assessment of hepatic fibrosis.
肠道是人体容易发生疾病的部位之一，肠外局部或全身性疾病也易累及肠道。无论肠道原发疾病还是肠外疾病累及肠道，肠壁增厚都是一种常见而重要的病理改变。钡餐、钡灌肠和纤维内镜是常用的检查手段，但它们只能显示肠腔内及黏膜面的情况； 灰阶超声和多普勒超声可发现肠壁及肠外异常，但敏感性和准确率低，且受操作者经验影响较大。随着影像检查技术的不断进步，CT用于肠道疾病的诊断已日益普遍，多层螺旋CT快速薄层扫描和强大的图像后处理能力使其成为显示肠壁及相关肠外病变的主要手段［1］。虽然很多疾病可造成肠壁增厚，但正确认识肠壁增厚的CT表现特征，包括部位、范围、程度、密度、强化方式和相关肠外异常征象有助于疾病的诊断和鉴别诊断［2，3］。现通过复习肠壁增厚的相关文献，介绍肠壁增厚的基本CT征象，归纳引起肠壁增厚的常见疾病及其表现，并提出CT在诊断肠壁增厚中存在的问题……
ObjectiveTo investigate the radiological appearances of postoperative complications after living donor liver transplantation for patients with hepatocellular carcinoma under multi-detector row spiral computed tomography (MDCT) and magnetic resonance imaging (MRI) examination. MethodsThirty-nine imaging data in 20 patients with hepatocellular carcinoma after living donor liver transplantation from January 2008 to June 2010 in the West China Hospital were included and analyzed by two radiologists respectively. The relations between the types of complications and radiological appearances were especially recorded. ResultsAll the cases experienced complications to different extent. Common surgical complications occured in 20 cases, including pertitoneal fluid collection (14 cases), pneumoperitoneum (2 cases), swelling of peritoneum, omentum, and mesentery (1 case), abdominal wall swelling (2 cases), pleural effusion (9 cases), and pericardial fluid collection (2 cases). Hepatic vascular complications involved hepatic artery in 3 cases, portal vein in 5 cases. Biliary complications presented in 7 cases, including anastomotic stenosis of biliary duct (6 cases) and bile leak (1 case). Graft parenchymal complications included intrahepatic lymph retention (11 cases), infarction (3 cases), and infection (2 cases). Intrahepatic recurrence in 5 cases, intraperitoneal metastasis in 3 csses and pulmonary metastasis in 2 cases. ConclusionMDCT and MRI have important diagnostic values for postoperative complications after living donor liver transplantation for patients with hepatocellular carcinoma.
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 The purpose of this study is to compare the differences of opened collateral circulation status between hepatic portal hypertension (HPH) and pancreatogenic portal hypertension (PPH), to guide the clinical treatment. Methods From Nov. 2015 to Oct. 2017, data of 119 cases of computed tomography portography (CTP) from the Department of Radiology of Sichuan Provincial People’s Hospital and Department of Radiology of West China Hospital of Sichuan University were retrospective analyzed, and the patients were divided into 2 groups, namely the HPH group (77 patients) and PPH group (42 patients) according to different causes. The diameter of portal vein system (including trunk of portal vein, left gastric vein, splenic vein, superior mesenteric vein, and gastroepiploic vein) and the incidences of varicose veins (lower esophageal vein, gastric fundal vein, gastric body vein, Retzius vein varix, umbilical vein open, and splenorenal shunt), as well as the degree of varicose of lower esophageal vein, gastric fundal, and gastric body vein were compared. Results The diameter of portal vein in the HPH group was larger than that of the PPH group, but the diameter of gastroepiploic vein was smaller than that of the PPH group, and the differences were statistically significant (P<0.05). There was no significant difference in left gastric vein, splenic vein, and superior mesenteric vein between the 2 groups (P>0.05). Significant differences were found in varicose veins incidence of gastric and lower esophageal vein (P<0.05), the varicose veins incidence of gastric was lower and varicose veins incidence of lower esophageal vein was higher in the HPH group. Statistically significant differences were also found in the incidence of umbilical vein open, Retzius varicose veins and splenorenal shunt between the 2 groups (P<0.05), and the incidences were all higher in the HPH group. Conclusions There are differences in collateral circulation status between the HPH and PPH. Gastric fundal and lower esophageal vein varices are easy to appear simultaneously in HPH, while gastric fundal and body vien varices are mostly only occurred in PPH. Compared with HPH, the degree of gastric fundal and lower esophageal vein varices is more mild in PPH.
ObjectiveTo investigate the diagnostic value of spectral saturation inversion recovery, gradient-echo chemical shift MRI， and proton magnetic resonance spectroscopy in quantifying hepatic fat content. MethodsConventional T1-weighted and T2-weighted scanning (without fat saturation and with fat saturation)， gradient-echo T1W in-phase （IP） and opposedphase （OP） images and 1H-MRS were performed in 31 healthy volunteers and 22 patients who were candidates for liver surgery. Signal intensities of T1WI amp; T1WIFS (SInonfat1, SIfat1), T2WI amp; T2WI-FS (SInonfat2, SIfat2), and IP amp; OP (SIin, SIout) were measured respectively, the relative signal intensity one (RSI1), relative signal intensity two (RSI2)， and fat index (FI) were calculated. Peak values and the area under peak of 1H-MRS were measured, and the relative lipid content of liver cells (RLC ) were calculated. Twenty-two patients accepted liver resection and histological examination after MRI scanning, the proportion of fatty degenerative cells were calculated by image analysis software. Results①Hepatic steatosis group showed higher average values of RSI1, FI， and RLC to non-hepatic steatosis group (Plt;0.05), while there was no significant difference in RSI2 between two groups (Pgt;0.05). ②There was a statistical significant difference in RLC among different histopathological grades of hepatic steatosis, and RLC increased in parallel with histopathological grade (Plt;0.05).There was no significant difference in RSI2, RSI1, and FI among different histopathological grades, although the latter two had a tendency of increasing concomitant with histopathological grade (Pgt;0.05). ③The values of FI and RLC were positively correlated with the PFDC （r=0468, P=0.027； r＝0771， Plt;0.000 1）, while they were not in RSI1 and RSI2 (r=0.411, P=0.057； r=0.191, P=0.392). ConclusionsSPIR, Gradient-echo chemical shift MRI and 1H-MRS can help to differentiate patients with hepatic steatosis from normal persons, the latter also can help to classify hepatic steatosis. In quantifying hepatic fat content, 1H-MRS is superior to gradient-echo chemical shift MRI, while SPIR’s role is limited.