Objective To compare the diagnostic accuracy of magnetic resonance (MR) images with multislice computer tomography (MSCT) for preoperative T-staging of patients with cardiac cancer. Methods MR and MSCT were performed in 28 cases of cardiac cancer diagnosed by biopsy prior to operation within one week. After an oral intake of 1000 ml water and an injection of hypotonic agent, MR and MSCT scan were carried out. MR sequences included FSE T1W, FSE T2W, FSE T1W with fat suppression and dynamic enhanced FSPGR with fat suppression. MSCT was applied with dynamic triphasic contrast enhancement. All of the findings were prospectively analyzed by two doctors separately and compared with the surgical and pathological findings. Results According to histopathologic staging, the accuracy of MR and MSCT in T1-staging were 88.8% and 11.1%, in T2-staging were 77.8% and 22.2%, in T3-staging were 83.3% and 32.7%, in T4-staging were 100.0% and 50.0%, respectively. Dynamic enhanced and delayed MR with fat suppression was superior to MSCT for revealing the involvement of esophagus and aorta, early stage of invasiveness and providing more evidences in T2 to T3 or T3 to T4 staging (P

This article presents several common problems.of medical injection pump through one case of ESD troubleshooting. Expounds the causes of the problem and provides solutions.
Equipment and Supplies ; Injections ; instrumentation ; Static Electricity

Objective To study X-ray, CT and MRI features of the spinal giant cell tumors (GCT)and to assess the clinical applied value.Methods Thirty cases of GCT of spine (13 males and 17 females with ages ranging from 17 to 69 years) were reviewed. Allcases underwent radiography,CT was done in 22 patients and MRI was performed in 16 cases.Results One lesion localized in cervical spine,10 in thoracic, 6 in lumbar and another 13 lesions in the sacrum.Osteolytic destruction and vertebral compression were seen on X-ray film. The main CT signs were expanding bone destruction and soft tissue mass. MRI showed low to intermediate signal intensity on T_1WI while high signal on T_2WI.Conclusion X-ray, CT and MRI are of significant value in diagnosis of the spinal GCT, and play an important role in surgical planning.

Objective To compare the clinical utility of CT-guided percutaneous biopsies for bone destruction. Methods The retrospective analysis of pathologic outcomes of 89 cases guided by X-ray and MRI, were obtained by needle aspiration (n=13) of 18-20G tru-cut biopsy needles (n=22) and 11-13G Ostycut biopsy needles (n=40). Results Seventy five (84.3%) patients with percutaneous biopsy outcome with concordant results from specimens subsequently obtained at surgery, 14 patients (15.7%) showed pseudo-negative results but no pseudo-positive cases. No obvious differences in pathological results were obtained among these three methods. Conclusions ① CT-guided percutaneous biopsy is effective in the evaluation of skeletal destructive lesions; ② Appropriate selection of percutaneous biopsy method for different kinds of lesion could raise the diagnostie accurracy.

Objective To evaluate the value of CT-guided biopsy of deep-located lesion in the diagnosis of lymphoma. Methods CT-guided percutaneous biopsy was performed in 58 patients with 16-20 gauge core-needle biopsy. The locations of lesion involved mediastinun, lung, retroperitonurn, spleen, kidney, adrenalal and musculoskeletal system. Pathology examination included hematoxylin and eosin staining and immunohistochemical assays. Results In 56 out of 58 cases,the biopsy findings could be confirmed by histologic examination including correctly diagnosed 47 malignant lymphomas, corresponding to a sensitivity of 81%;with fuithecmace subclassification 42 of the 47(89.4%) could be as diagnosed malignant lymphomas on the basis of CT-guided biopsy. Conclusions Biopsy of deeply located lymphoma mass under CT guidance has high diagnostic accuracy and low complication rate with convenience for subclassification of malignant lymphomas.

Objective To study the technique and clinical significance of percutaneous mediastinum biopsy guided by CT. Methods 35 cases with mediastinal masses were undergone this procedure. Results The successful rate of the procedure was 100%. The successful punctural rates reached 100% for malignant neoplasms(21/21)85.71% for benign lesions(11/14), and the diagnostic accuracy was 94.21%(33/35). The complication of pneumothorax occurred in 3 cases, and mediastinal bleeding presented in 1 case. Conclusions CT-guided percutaneous mediastinum biopsy possesses high diagnostic accuracy, simultaneously with great help for the management.

We are reporting in this article some analyzed data obtained from inspection and related information on current situations medical devices in use. Some ideas and suggestions are also proposed here on how to systematically and legally inspecting and monitoring medical devices in use.
Equipment Safety ; Materials Management, Hospital

Objective To explore the imaging manifestations of low-grade central osteosarcoma (LGCOS) and discuss their pathological features.Methods Twelve patients of LGCOS proved by surgery and pathology were analyzed retrospectively and a review of related literature was performed.All twelve patients had plain X-ray,1 1 patients CT examination,and 10 patients contrast-enhanced MR scan.Imaging features of the LGCOS were summarized,their clinical and pathological manifestations were discussed for differential diagnosis.Their prognosis was evaluated with followed up examination.Results Of the 12patients with LGCOS,six tumors were located in the distal femur,3 in the proximal tibia,2 in the proximal femur and 1 in the talus.The radiographic features of LGCOS were variable.There were 7 patients with predominantly osteolytic destruction,3 patients with mixed sclerotic and lyric changes,with well-defined margins,2 patients with Osteogenic changes on X-ray.On CT,9 patients showed a clear cortical breach,5 patients with soft tissue involvement,6 patients with peripheral incompletely sclerotic zone,2 patients with periosteal reaction.On MRI,there were 10 patients with abnormal signal in medullary cavity,8 patients with soft tissue masses,and all 10 patients exhibited contrast enhancement.The microscopic features of LGCOS were characteristically bland,comprising spindle cells arranged in interlacing fascicles in a heavily collagenous background with variable bone or osteoid production.There were mild nuclear atypia and rare mitoses.In four patients,misdiagnoses were made by biopsy or surgical pathology as fibrous dysplasia or fibrous histiocytoma and other benign lesions,all four patients had postoperative recurrence.Conclusions LGCOS should be differentiated form fibrous dysplasia,non-ossifying fibroma,and other benign lesions.An accurate diagnosis can be made in most cases by careful pathological and radiological correlation.

Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

OBJECTIVE: To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. MATERIALS AND METHODS: A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. RESULTS: The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). CONCLUSION: The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Prognosis ; Prospective Studies ; Regional Blood Flow ; Stomach Neoplasms/*blood supply/pathology/*radiography ; *Tomography, X-Ray Computed