1.Comparison of lymph node dissection of single left chest incision and three cuts in esophageal cancer surgery
Jianfeng GU ; Zhiping JIANG ; Weijun MAO
Chinese Journal of Primary Medicine and Pharmacy 2013;20(22):3413-3415
Objective To compare the lymph node dissection of left chest single incision and neck-right chest-abdomen incision in esophageal cancer surgery,and to explore the reasonable range of lymph node dissection in esophageal cancer surgery.Methods We retrospectively analyzed the clinical data of 72 patients with esophageal cancer radical surgery.According to the surgical approach,the patients were divided into left chest single-incision group (32 cases) and three-incision group (40 cases).The surgery time,number of lymph node resected,drainage tube time,length of hospital stay,lymph node dissection status and incidence of postoperative complications were analyzed.Results In left chest single-incision group and three-incision group,the operative time [(225.44 ± 11.98) min vs (265.42 + 13.15) min],lymph node dissection number[(8.031 ± 1.153) vs (11.821 ± 1.138)],length of stay [(13.212 ± 1.294) d vs(15.691 ± 1.404) d] and other aspects had statistically significant differences (t =24.201,25.302,14.010,all P < 0.05).There were no significant differences between two groups in the chest tube indwelling time and the incidence of postoperative complications (P > 0.05).Conclusion Both surgical radical resection of esophageal cancer have their own characteristics in terms of surgical difficulty,risks,efficacy and complications.In clinical,these must be carefully evaluated in patients with lesions and body affordability flexibility to choose the surgical approach in order to achieve the best therapeutic effect.
2.The diagnostic ability of biexponential diffusion-weighted imaging (DWI) for organ-conifned prostate cancer in peripheral zone:compared to monoexponential DWI
Lei YUE ; Xiaohang LIU ; Liangping ZHOU ; Jian MAO ; Weijun PENG
China Oncology 2016;26(7):616-622
Background and purpose:With the widespread use of screening of prostate-specific antigen (PSA) levels, prostate cancers at organ-conifned stage are increasing in newly diagnosed cases. However, some defects remain in conventional monoexponential diffusion-weighted imaging (DWI) for differentiating organ-conifned prostate cancer from benign lesions. Therefore, the aim of this study was to obtain biexponential apparent diffusion parameters of prostate organ-conifned cancer, chronic prostatitis in peripheral zone (PZ) and normal PZ tissue, and to compare with monoexponential apparent diffusion coeffcient (ADC) for differentiating prostate cancer from prostatitis lesions. Methods:Sixteen patients with pathologically confirmed prostate organ-confined cancer in PZ, 14 with prostatitis underwent conventional (b-factors 0, 1 000 s/mm2) and 10b-factors (0-3 000 s/mm2) diffusion-weighted imaging (DWI).The monoexponential ADC value and biexponential parameters fast ADC (ADCf), fraction of ADCf (f), slow ADC (ADCs) value for prostate cancer, prostatitis and normal tissues were calculated and compared. Receiver operating characteristic analysis was performed for those parameters.Results:Biexponential and monoexponential parameters were obtained for 18 prostate cancers, 18 prostatitis and 37 normal PZ tissues. The ADC value of prostate cancer tissues was remarkably lower [(0.83±0.11)×10-3 mm2/s] than that of other tissues (P<0.01), while the ADC value of prostatitis [(1.45±0.19)×10-3 mm2/s] was lower than that of PZ [(1.67±0.31)×10-3 mm2/s] (P<0.01). Prostate cancer tissues had low-er ADCf [(1.54±0.23)×10-3 mm2/s],f [(45.8±5.4)%] and ADCs [(0.52±0.15)×10-3mm2/s] than the other tissues (P<0.01). The ADCf,f and ADCs were higher in PZ [(3.90±0.40)×10-3, (67.3±8.2)% and (1.51±0.36)×10-3 mm2/s] than prostatitis [(3.06±0.49)×10-3, (47.9±3.9)% and (0.91±0.29)×10-3 mm2/s) (P<0.01). The area under the curve (AUC) of ADCf and ADC were similar in differentiating cancer and prostatitis (0.96vs 0.94) (P>0.01), but the AUC off and ADCs in differ-entiating cancer from prostatitis (0.83 and 0.80) were signiifcantly lower than that of ADC (P<0.01).Conclusion:The biexponential DWI provided additional tissue characterization parameters for different prostate tissues. ADCf yielded comparable accuracy with ADC in identiifcation of prostate organ-conifned cancer. The biexponential parameter could further improve the diagnostic effcacy.
3.Role of the dynamic contrast-enhanced MRI in assessing the response to neoadjuvant chemotherapy of breast cancer
Ruimin LI ; Yajia GU ; Weijun PENG ; Jiao MAO
China Oncology 2016;26(7):623-628
Background and purpose:Neoadjuvant chemotherapy to breast cancer has become a mature treat-ment method. The purpose of this study was to evaluate the dynamic contrast-enhanced MRI in assessing the response to neoadjuvant chemotherapy (NAC).Methods:Twenty-four female patients with breast carcinoma (24 were all inva-sive ductal carcinoma) underwent dynamic contrast-enhanced MRI (DCE-MRI) before, after the second and ifnal cycle of NAC. For each patient and each MRI examination, the maximum diameter of tumor, volume transfer constant (Ktrans), exchange rate constant (Kep), and extravascular extracellular volume fraction (Ve) were compared. According to the method of response evaluation criteria in solid tumor (RECIST), the results of neoadjuvant chemotherapy were divided into responder and non-responder.Results:All 24 patients were unilateral and single breast cancer; there were 17 cases of responders and 7 cases of non-responders according to RECIST criteria. For 17 cases of responders, both the average values ofKtrans andKepwere signiifcantly descended after neoadjuvant chemotherapy (allP<0.05).Conclusion:The quantitative parameters ofKtrans andKep can evaluate objectively and veridically the response to neoadjuvant chemother-apy for breast cancer in dynamic contrast-enhanced MRI.
4.Primary non-Hodgkin lymphoma of skeletal muscle:imaging findings
Liangping ZHOU ; Weijun PENG ; Wentao YANG ; Feng TANG ; Jian MAO
Chinese Journal of Radiology 2000;0(12):-
Objective To analyze the imaging manifestations of primary non-Hodgkin lymphoma of skeletal muscle and improve the recognition of this rare disease.Methods Five cases of primary non-Hodgkin lymphoma of skeletal muscle proved pathologically underwent imaging exam,including MRI and CT in 3 cases,only MRI in 1 case,only CT in 1 case,X-ray in 2 cases and bone scintigraphy in 2 cases.Results Diffuse enlargements of involved muscle with presentation of overall configuration were observed in all five cases.All 4 cases manifested as homogeneous soft masses,which is isoattenuating to normal muscle on unenhanced CT images.After intravenous injection of contrast media,the masses enhanced homogeneously and slightly(2 cases)or moderately(1 case)on CT images.The lesions were homogenous and had isointense or slightly low signal intensity compared with that of uninvolved muscle on T1-weighted images and high signal intensity on T2-weighted images.After intravenous injection of contrast media,all 2 cases enhanced homogeneously and moderately with the enhanced signal intensity of involved muscle greatly higher than that of uninvolved muscle on MR images.Two cases of X-ray plain showed no destruction of bone and 2 cases of bone scintigraphy exams showed increased radiotracer uptake of involved muscle with no infiltration of bone marrow.Conclusion There are several characteristics on the imaging of primary non-Hodgkin lymphoma of skeletal muscle.MRI is the optimal imaging method for the diagnosis of this disease.
5.MRI in the differential diagnosis of breast ductal cancer in situ
Chao YOU ; Yajia GU ; Weijun PENG ; Jian MAO ; Tingting JIANG
China Oncology 2014;(6):463-468
Background and purpose: Ductal carcinoma in situ (DCIS), is precursor lesions of invasive breast cancer, belongs to non-systemic ductal lesions, which is similar to other ductal lesions on imaging. This study aimed to investigate the differential diagnostic value of MRI in DCIS between DCIS with microinvasion (DCIS-MI) and breast intraductal papilloma (BIDP). Methods:All the cases were surgico-pathologically conifrmed. Twenty-four patients were DCIS, 9 patients were DCIS-MI, and 20 patients were BIDP. The MRI charateristics of DCIS, DCIS-MI and BIDP were analyzed and compared. Results:DCIS and DCIS-MI’s performance in the form of MRI is dififcult to differentiate (P<0.05). Compared with BIDP, the ductal and segmental enhancement, typeⅢtime-signal intensity curve (TIC), and the red pseudo-color image were associated with the DCIS. The local area enhancement, typeⅡTIC, and no-red pseudo-color image were associated with BIDP. Conclusion:MRI is a useful for differentiate between DCIS and BIDP, but is dififcult for DCIS and DCIS-MI.
6.A preliminary study of murine walker-256 tumor hypoxia detected by blood oxygen level dependent-MR
Shengjian ZHANG ; Jian MAO ; Bin WU ; Weijun PENG
Chinese Journal of Radiology 2013;(2):178-182
Objective To establish Walker-256 transplantation tumor model in SD Rats.To study of R2 * signal changes on murine Walker-256 tumor after inhaling Carbogen by blood oxygen level dependent (BOLD)-MR,and to explore the feasibility of BOLD-MRI on detecting tumor hypoxia.Methods Walker-256 tumor cell implanted subcutaneously in right lower abdomen of 95 female SD rats.MR was performed on the tumor-forming rats when the maximum diameter of tumor reached 1-3 cm,using a 3.0 T MR scanner equipped with a 3 inch animal surface coil BOLD-MRI was done by using a multiecho SPGR sequence during inhaling air and at 10 minute after inhaling Carbogen,respectively.All images were transferred to GE ADW 4.3 workstation,then a baseline R2* (R2 * a) and R2 * (R2 * b) after inhaling Carbogen of tumor was calculated using R2 Star analysis software and △R2 * was calculated through △R2 * =R2 * b-R2 * a,meanwhile the volume of tumor were calculated as well.The difference of R2 * signal preand post-inhaling of Carbogen was compared with a paired t test,Pearson correlation was calculated between R2 * a,△R2 * and the volume of tumor,respectively.The correlation between △R2 * and R2 * a was also assessed by Pearson correlation.Results Sixty-eight of ninety-five female SD rats formed the tumor (71.6%).The volume of tumor was from 352 to 13 173 mm3.Mean △R2* decreased significantly (-2.26 ±3.90) s-1 from (41.18 ±22.29) s-1 during breathing air to(38.91 ±21.35) s-1 10 min after inhaling Carbogen (t =4.01,P < 0.01).△R2 * was inversely correlated with R2 * (r =-0.32,P < 0.05).The △R2 * was well correlated with volume of tumor (r =0.35,P < 0.05),but R2 * a was not correlated with volume of tumor(r =-0.03,P > 0.05).Conclusions BOLD-MRI can detect the R2 * signal change of murine Walker-256 tumor pre-and post-inhaling of Carbogen.The R2 * signal showed significant decrease after inhaling Carbogen,however,the individual variation was remarkable.
7.CT and MRI features of primary adrenal lymphoma
Liangping ZHOU ; Weijun PENG ; Jianhui DING ; Xiaohang LIU ; Chaofu WANG ; Xigang SHEN ; Min QIAN ; Jian MAO
Chinese Journal of Radiology 2009;43(9):969-972
dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.
8.Application of MR diffusion-weighted imaging in the evaluation of salivary glands with gustatory stimulation
Yunyan ZHANG ; Dan OU ; Yojia GU ; Xiayun HE ; Jian MAO ; Xigang SHEN ; Lei YUE ; Weijun PENG
Chinese Journal of Radiology 2012;46(5):425-429
ObjectiveTo evaluate the function of the salivary glands with gustatory stimulation by using MR DWI.MethodsA prospective study was conducted in 30 patients with nasopharyngeal carcinoma who had normal salivary function.A DWI sequence was performed on the salivary glands at resting state,and continually repeated on the parotid immediately after oral ascorbic acid stimulation over a period of 21 minutes (once every 18 seconds).The multiple b-values (0,400,600,800,1000 s/mm2) were used.ADC maps were evaluated with a manually placed region of interest including the entire salivary gland.The ADC of each gland was obtained by taking the mean of values on three contiguous sections containing the largest areas of the gland.The paired two-tailed Student t test was used to compare the ADC values of the parotid and the submandibular glands at rest,and of the parotid before and after stimulation.ResultsThe mean ADC value at rest was significantly lower in the parotid [ (1.23 ±0.12) × 10-3 mm2/s] than in the submandibular glands [(1.34 ± 0.07 ) × 10 -3 mm2/s,t =4.545,P < 0.01 ].After acid stimulation,the ADC value increased from the baseline to (1.41 ±0.19) × 10-3 mm2/s firstly and then fluctuated at the following time,with a peak value of ( 1.49 ± 0.20 )× 10 -3 mm2/s and the average value of ( 1.36 ±0.17) × 10-3 mm2/s.The average value was significantly different from the baseline value (t =15.127,t =11.905,P < 0.01 ).The minimum value [ ( 1.24 ± 0.14) × 10-3 mm2/s] was not significantly different compared to the baseline value (t =1.329,P > 0.05 ).ConclusionMR DW1 can noninvasively evaluate the physiologic changes of salivary glands before and after acid stimulation.
9.Clinical application study on malignant metastatic diseases between DWIBS and PET/CT
Xigang SHEN ; Liangping ZHOU ; Weijun PENG ; Jian MAO ; Ling ZHANG ; Yajia GU ; Zhifeng YAO ; Jingyi CHENG
China Oncology 2015;(6):456-466
Background and purpose: Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for magnetic resonance imaging systemic examination, especially in examing the metastatic lesions, lymph node and bone diseases, and the imaging result is similar with PET. This study aimed to evaluate the application value of magnetic resonance DWIBS and positron emission tomography with computed tomography (PET/CT) on malignant metastatic diseases. Methods: Thirty-six patients confirmed with malignant tumors accompanying metastasis by the pathology of operation or biopsy underwent both DWIBS imaging and PET/CT, chi-square test and Kappa test were used for comparing the detection results of metastasis by these 2 imaging methods. Results:Among the 36 malignant tumor patients with 238 metastatic lesions, 218 (91.6%, 218/238) lesions in DWIBS and 209 (87.8%, 209/238) lesions in PET/CT were detected, with 200 lesions detected by the two methods simultaneously, and the concordance rate was 88.7%(211/238);but there was no statistical signiifcance between this two methods (χ2=1.843, P=0.157). Kappa test showed a fair concordance rate between DWIBS and PET/CT (P=0.000).There were different significance between DWIBS and PET/CT in detecting metastatic lesions of brain and bone (P=0.005 and 0.031);But there was no signiifcant differences (P=0.309 and 1.000) in detecting metastatic lesions of lymph nodes and liver. Conclusion:DWIBS could detect metastatic lesions effectively, and there is ifne consistency with PET/CT. DWIBS is more sensitive than PET/CT in detecting metastatic lesions of brain and bone, so DWIBS could be chosed for screening metastatic lesions according to the characteristics of different primary tumors.
10.MRI-guided breast lesion localization and lesion analysis
Yajia GU ; Linghui XU ; Shengjian ZHANG ; Weijun PENG ; Jian MAO ; Fei SUN
Chinese Journal of Radiology 2013;47(8):685-689
Objective To analyze the indications,techniques of MR-guided localization and the imaging features of breast lesion.Methods Hook wire localization was performed in 43 patients whose lesions were only detected by MRI,based on a 1.5 T MR scanner and a special MR biopsy positioning frame.The feasibility of operation and accuracy of localization were explored.Lesion features and pathologic findings were analyzed using Fisher exact test.Results A total of 37 patients (86.0%) with 38 lesions underwent MR-guided localization.Of the 6 patients canceled,the lesions were not obvious in 4 patients,and the positioning was difficult in 2 cases.Of the 38 lesions,17 were masses,20 were non-mass enhancement lesions,and one lesion was undetermined enhancement.There were 11 (28.9%) malignant lesions.The distribution of internal enhancement pattern was different between benign and malignant non-mass lesions (P =0.028),while the other morphological features between benign and malignant were not significantly different (P > 0.05).Conclusions MR-guided localization provides an accurate and safe method for localizing the suspicious lesions on MRI.The morphological findings of these lesions are not characteristic for the differentiation of benign and malignant lesions.