ObjectiveTo investigate clinical value of MRI examination in diagnosis of xanthogranulomatous cholecystitis (XGC), and to analyze pathologic correlation of various imaging findings. MethodsMRI imaging data of 7 patients with XGC proved by surgery and pathology who underwent entire MRI sequences examination in Sichuan Provincial People's Hospital from Jan. 2013 to Dec. 2015, were analyzed retrospectively. The thickness and contrast enhancement of gallbladder wall, gallbladder wall nodules, completeness of gallbladder mucosa lines, gallbladder stones, and the changes around the gallbladder were focused in every patient. ResultsIn 7 patients with XGC: gallbladder wall thickening occurred in all patients, in which 2 patients were local thickening, 5 patients were diffuse thickening; ‘hypodense band sign' was found by enhance scan in 4 patients; the multiple intramural nodules were presented in 5 patients, which were low signal intensity on T1WI image and high signal intensity on T2WI image; the mucosal lines were continuous in 6 patients and discontinuous in 1 patient; 6 patients combined with cholecystolithiasis. The fat layer around the gallbladder was found fuzz in 7 patients, liver and gallbladder boundaries were not clear in 7 patients; temporal enhancement of arterial phase in liver parenchyma was observed in all patients, and 1 patient combined with liver abscess. Hilar bile duct narrowed and intra-hepatic bile duct dilated in 2 patients, intra-hepatic and extra-hepatic bile duct slightly dilated in 2 patients (lower part of the choledochus stone was found in 1 patient), liver cyst was observed in 3 patients, single or double kidney cyst was observed in 4 patients; all patients were not found intraperitoneal or retroperitoneal swelling lymph nodes. ConclusionMRI examination can accurately describe various imaging features of XGC, so MRI has important value in diagnosis of XGC.
ObjectiveTo investigate the CT and MR imaging manifestation of solid-pseudopapillary neoplasm of pancreas (SPNP), deepen the understanding of imaging and clinical pathological characteristics of SPNP and improve the level of diagnosis. MethodsBetween Jan 2010 and Dec 2015, the CT and MR imaging data of seven patients with SPTP proved by surgery and histopathologically were analyzed retrospectively. The following imaging features were reviewed: tumor size, location, shape, margin, encapsulation, calcification, hemorrhage, solid-cystic ratio, pancreatic and bile duct dilatation, the manifestation of plain scan and dynamic pattern of enhancement. ResultsThe population comprised 7 women, the average age was 28.3 years oldwith a median tumor size of 5.7 cm. Tumors were located at body tail of pancreas in 5 cases, at the head in 1 case, and at the tail in 1 case. The tumor were exogenous in 5 cases, endogenous in 2 cases. Five tumors showed the regular margin, inregular in 2 cases. Four cases of plain and enhanced CT scan showed cystic-solid tumors, the solid and encapsulation part ofSPNP presented as hipo-, iso-density, and gradually enhancement after injecting contrast medium. Three cases were examined by MRI, 2 cases appeared hemorrhage, tumor located in the head of pancreas leaded to the secondary ducts dilatations in 1 case. Conciusions There are some characteristics in CT and MRI manifestation of SPNP. Accurate diagnosis meybe created by the imaging study combined with the clinical feature.
ObjectiveTo investigate clinical value of magnetic resonance imaging (MRI) in differentiating xanthogranulomatous cholecystitis (XGC) with gallbladder cancer (GBC). MethodsMRI data of 7 patients with XGC and 13 patients with GBC proved by surgery and pathology were analyzed retrospectively. The main contents of the observation included:①Maximum thickness of gallbladder wall; ②Diffuse thickening or localized thickening of gallbladder wall; ③Enhancement pattern (uniform or nonuniform) of gallbladder wall; ④Gallbladder wall sandwiches enhancement; ⑤Gallbladder wall nodules; ⑥Completeness of gallbladder mucosa lines; ⑦Obstruction of biliary tract; ⑧Calculus in gallbladder or bile duct; ⑨Involvement of adjacent liver; ⑩Definition of surrounding fat layer; Lymphadenopathy. ResultsIn above 11 MRI comparing features, these features such as the gallbladder wall sandwiches enhancement, the gallbladder wall nodules, the completeness of gallbladder mucosa lines, the biliary obstruction, and the lymphadenopathy were statistically significant between the XGC and the GBC (P < 0.05), while the rest features such as the maximum thickness of gallbladder wall, the type of gallbladder wall thickening, the gallbladder wall enhancement pattern, the calculus in gallbladder or bile duct, the involvement of adjacent liver, and the definition of surrounding fat layer were not statistically significant between the XGC and the GBC (P > 0.05). ConclusionMRI has important values in differentiating XGC with GBC.
ObjectiveTo systematically review the independent physical risk factors associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus. MethodsWe searched MEDLINE, EMbase, CBM, CNKI and VIP for all studies about the independent physical risk factors associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus up to December 2012. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 11 studies involving 12 957 patients with type 2 diabetes were included. Of these 11 studies, 9 were cross-sectional studies, two were cohort studies, and one was case-control study. The results showed that:the main physical factors associated with DKD were:duration of diabetes (OR=1.11, 95%CI 1.05 to 1.18), waist circumference (OR=1.02, 95%CI 1.00 to 1.04), fasting glucose (OR=1.11, 95%CI 1.07 to 1.16), glycosylated hemoglobin (OR=1.20, 95%CI 1.06 to 1.36), systolic blood pressure (OR=1.03, 95%CI 1.02 to 1.05), diastolic blood pressure (OR=2.41, 95%CI 1.15 to 4.64), triglycerides (OR=1.24, 95%CI 1.02 to 1.51), high-density lipoprotein (OR=0.558, 95%CI 0.369 to 0.844), blood uric acid (OR=1.005, 95%CI 1.002 to 1.009), blood urea nitrogen (OR=1.58, 95%CI 1.37 to 1.82), past history of kidney disease (OR=3.26, 95%CI 1.20 to 8.87) and family history of kidney disease (OR=1.83, 95%CI 1.29 to 2.60). ConclusionCurrent evidence shows that multiple physical factors were associated with the development of type 2 diabetic kidney disease. However, due to the limited quantity and quality of the included studies, more high quality studies are needed to verify the conclusion.