1.Diagnostic value of 18F-FDG PET/CT in thyroid nodules
Jiyou XU ; Lijuan YU ; Wenzhi WANG ; Peiou LU ; Yanying WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2013;33(5):343-346
Objective To investigate the diagnostic value of 18F-FDG PET/CT for thyroid nodules.Methods From January 2008 to May 2012,34 patients (13 males,21 females; age range:21-73 years,mean (53.00± 12.57) years) with thyroid nodules on 18 F-FDG PET/CT and with histopathological results were retrospectively analyzed.From January 2011 to December 2011,20 cases (9 males,11 females; age range:40-55 years,mean (45.00±4.72) years) were selected as control group.Wilcoxon rank sum test and ROC analysis (AUC ≥0.7 was considered the standard of medium-high accuracy) were used.PET/CT features taken to suggest malignant thyroid nodules were:focally high uptake on PET,indistinct boundary or heterogeneous density on CT with punctuate,round or curved calcifications,or with hypermetabolic cervical lymph nodes as ancillary supportive findings of metastasis.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of PET/CT for diagnosing thyroid nodules were calculated.Results (1) There were 18 patients with malignant and 16 with benign thyroid nodules.The SUVmax of benign,malignant nodules and normal controls were 7.59±8.69,5.75±4.48 and 1.38±0.57,respectively.The differences between malignant thyroid nodules and controls,between benign nodules and controls were significant (u=3.553,3.408,both P<0.01).There was no significant difference between benign and malignant thyroid nodules (u =0.207,P>0.05).(2) The AUC for the differentiation of benign and malignant thyroid nodules by ROC analysis was 0.557 (<0.70).(3) The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT for the differentiation of benign and malignant thyroid nodules were 72.2% (13/18),75.0% (12/16),76.5% (13/17),70.6% (12/17) and 73.5% (25/34),respectively.Conclusions 18F-FDG PET/CT has limited value for the differentiation between benign and malignant thyroid nodules based alone on the degree of metabolic intensity.It may have improved diagnostic certainty if combined with the morphological features on CT.
2.Diagnostic value of breast mass biopsy in different locating methods
Man ZHAO ; Wanqing QIAO ; Wenzhi QU ; Zuofu YU ; Wei TU
Chinese Journal of Postgraduates of Medicine 2011;34(11):33-34
Objective To explore the value of preoperative diagnosis for breast cancer patients in different locating ways. Methods The tissues were gotten by core needle biopsy from 146 breast cancer patients through different locating ways,and were taken for histopathological examinations and were compared with postoperative pathologic results. Results Seventy-four cases were biopsied with ultrasound-guide (ultrasound-guide group), and 72 cases with free-hand (free-hand group), without serious complications.Compared with postoperative pathologic results,the false negative rate in ultrasound-guide group was 5.41%(4/74);the false negative rate in free-hand group was 18.06% (13/72). The accuracy of the ultrasound-guided biopsy was higher than that in free-hand (U = 13.63,P < 0.01 ). Conclusions Preoperative ultrasoundguided biopsy and postoperative pathologic examination has no significant difference, with high consistency.The study provides a good basis for selection for clinical work,so as to the more effective guide for the comprehensive treatment of breast cancer patients.
3.The diagnostic performance of mediastinal lymph nodes in lung tumor with 18 F-FDG PET/CT examina-tion
Yingci LI ; Lijuan YU ; Wenzhi WANG ; Peiou LU
Practical Oncology Journal 2013;(6):485-489
Objective To explore the diagnostic performance and the distributive characteristics of me-diastinal lymph nodes in lung tumor with PET/CT examination .Methods Thirty-three cases of preoperative whole-body 18 F-FDG PET/CT examination revealed pulmonary lesions ,a radical surgery and lymph node dis-section patients were included in this study .PET/CT doctors read the image of PET/CT and recorded the lymph node short diameter,CT value,SUVmax,and analysed the patient′s visual graphics.The application of PET/CT a-nalysis was used for diagnosis of the mediastinal lymph nodes ,and compared with the pathological findings .Re-sul ts The diagnostic accuracy of mediastinal lymph nodes with the conventional CT method alone was 84 .1%, with the conventional PET method alone was 82.8%,with the conventional PET/CT analysis was 91.7%,with the PET/CT comprehensive analysis was 95.2%;Five benign lymph nodes were mis -diagnosed.In this study, there were eight cases of lung cancer with mediastinal or hilar lymph node metastasis ,all of the lymph nodes loca-ted in the right lung ,and in which five cases were in the inner zone .Conclusion The PET/CT comprehensive a-nalysis of lymph node performs better than either the CT method alone or the PET method alone (χ2 =9.10,P<0.05);The lesions in the inner zone are more prone to occur mediastinal lymph node metastasis .
4.Application value of contrast-enhanced ultrasound in the diagnosis of tuberculous diaphragmatic muscle abscess
Wenzhi ZHANG ; Gaoyi YANG ; Jianping XU ; Jun MENG ; Tianzhuo YU
Chinese Journal of General Practitioners 2015;14(6):453-454
Contrast-enhanced ultrasound images of tuberculous diaphragmatic muscle abscess of 26 surgically confirmed patients were retrospectively analyzed.The coincidence rate of preoperative diagnosis was 77%.The contrast-enhanced ultrasound images could be divided into three types of homogeneous,uneven and non-enhancement.Contrast-enhanced ultrasonography could decipher the blood supply characteristics and the different extents of tuberculous diaphragmatic muscle abscess.Thus it has important diagnostic values in the diagnosis of tuberculous diaphragmatic muscle abscess.
5.The protection effect and mechanism of aloe polysaccharide on experimental colitis mucosa
Wenzhi ZHANG ; Shuiping OU ; Huichao WU ; Qingsheng YU
The Journal of Practical Medicine 2016;32(3):352-355
Objective To investigate the protective effect of aloe polysaccharide on experimental colitis mucosal. Methods The TNBS-induced experimental rat colitis model was successfully established and were treated by aloe polysaccharide, and enteric-coated tablets with sulfasalazine (SASP). Results DAI score, gross morphology score , histopathologic score and MPO in the model group were significantly higher than that in the normal group (P < 0.01), while those indicators were significantly lower after treatment (P < 0.01), IL-12 and IFN-γ mRNA and protein expressions in the model group were significantly higher than that in the normal group (P < 0.01), and IL-12 and IFN-γ expression levels in treatment group were significantly lower than that in the model group (P < 0.01), IL-4 and IL-13 mRNA and protein expression levels in the model group were significantly lower than that in the normal group (P < 0.01), and IL-4 and IL-13 expression in treatment group was significantly higher than that in the model group (P < 0.01). Conclusion Aloe polysaccharide on experimental colitis in rats has a good protective effect , of which mechanism may be reduced by IFN-γ and IL-12 levels, increased IL-4, IL-13 levels, and correct the imbalance of Thl/Th2.
6.Correlation Between Diffusion Weighted Imaging, Tumor Cellularity and Expression Level of Hypoxia-inducible Factor-1αin Cerebral Astrocytoma
Yongpeng CUI ; Chang SHU ; Yanbing ZHU ; Huan WANG ; Wenzhi YU
Chinese Journal of Medical Imaging 2013;(12):891-893,898
Purpose To evaluate the correlation among diffusion weighted imaging (DWI), tumor Cellularity and hypoxia-inducible factor-1α (HIF-1α) for the high and low grade astrocytoma. Materials and Methods DWI was applied with 33 patients with astrocytoma confirmed by pathology, and ADC value was measured. Tumor Cellularity was measured using Scion Image 4.0.3.2. The expression of HIF-1α was tested using immunohistochemisty. Results Mean ADC value was higher in the low grade astrocytoma than that in the high grade astrocytoma (t=7.300, P<0.001). The tumor Cellularity was higher in the high grade astrocytoma than that in the low grade astrocytoma (t=-3.845, P<0.01). HIF-1αexpression could be demonstrated in the low grade [(20.08±10.01)%] and high grade [(47.91±19.03)%] astrocytoma. The negative correlation was demonstrated between ADC value and HIF-1αand tumor Cellularity (r=-0.756,-0.617;P<0.001). The positive correlation was demonstrated between HIF-1αand tumor Cellularity (r=0.622, P<0.001). Conclusion ADC value can be used to discriminate the low and high grade astrocytoma, and the role of HIF-1αshould be further to study with enlarged sample.
7.Application of multiple methods in puncture fluid examination for diagnosis of axillary cystic/solid mass
Wenzhi ZHANG ; Gaoyi YANG ; Yu PEI ; Jianping XU
Chinese Journal of General Practitioners 2016;15(10):792-794
The clinical data of 91 patients with axillary cystic/solid mass receiving ultrasound-guided mass puncture in Hangzhou Red Cross Hospital and Hangzhou Third Hospital from March 2010 to October 2015 were retrospectively analyzed.The biopsy cytology examination and routain bacteria culture of puncture fluid were applied in 44 cases ( control group); while X-pert examination of puncture fluid was performed in addition to biopsy cytology examination and routain bacteria culture in 47 cases ( study group) . The histopathological examination of surgical specimens were used as gold standard.The overall diagnostic accuracy rates of study and control groups were 93.6% (44/47) and 68.2% (30/44), respectively(P=0.002) .The diagnostic accuracy rates for tuberculous abscess in study and control groups were 100.0%(28/28)and 57.7%(15/26), respectively (P=0.000).However, there were no significant differences in diagnosis of other diseases, including metastatic carcinoma, abscess other than tuberculous and lymphatic hygroma between two groups.The study shows that diagnostic accuracy of multiple examination methods of puncture fluid for axillary cystic/solid mass is high and has clinical application value.
8.Diagnostic performance of diffusion-weighted magnetic resonance imaging for preoperative T staging and metastatic lymph nodes of gastric adenocarcinoma
Xiaodan GENG ; Lijuan YU ; Munan CHEN ; Wenzhi WANG ; Yingci LI
China Oncology 2016;26(7):629-634
Background and purpose:Gastric cancer impacts human health seriously. Accurate preoperative assessment of T staging and metastatic lymph nodes of gastric cancer was beneifcial to patients’ treatment options and their prognosis. The purpose of this study was to evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging for preoperative assessment of T staging and metastatic lymph nodes in patients with gastric cancer. Methods:This study selected 35 gastric cancer patients met the criteria for this prospective study. They all underwent gastric 3.0 T MRI+DWI imaging scan. These patients’ T stage and metastatic lymph nodes were evaluated before the surgery, with the reference of post-operative histopathological ifndings. Kappa consistency test was used to assess the consistency of T staging between the two methods. This study analyzed short axis diameter, long axis diameter and apparent diffusion coeffcient (ADC) values of lymph nodes, relative of muscle’s ADC (rADCm) values (rADCm=ADC values of lymph nodes/ADC values of right erector spinae), and relative of primary tumor’s ADC (rADCp) values (rADCp=ADC values of lymph nodes/ADC values of primary tumor) on MRI image. Independent samples test was used to assess the difference between metastatic lymph nodes and benign lymph nodes. The receiver operating characteristic(ROC) curve was generated to evaluate the accuracy of diffusion-weighted magnetic resonance imaging (MRI) for preoperative assessment of metastatic lymph nodes of gastric cancer.Results:The accuracy of diffusion-weighted MRI for T stages was 77.14%, 75% for T1, 100% for T2, 76.47% for T3 and 75.00% for T4 and respectively. There were statistically signiifcant differences in the long axis diameter, the short axis diameter, ADC value, rADCm and rADCp between metastatic lymph nodes and benign lymph nodes (P<0.05). The area under the ROC curve of rADCm was greater than thats of other criteria, so rADCm was the most signiifcant parameter. The best discriminative cut-off value of long axis, short axis, ADC value, rADCm value and rADCp value were 9.55 mm, 6.05 mm, 0.934×10-3mm2/s, 0.60 and 1.083, respectively. The sensitivity and speciifcity were 59.00% and 73.10%, 59.00% and 69.80%, 82.60% and 88.50%, 83.70% and 84.60%, 78.20% and 80.80%, respectively.Conclusion:Diffusion-weighted MRI has great signiifcance for preoperative assessment of T staging and metastatic lymph nodes of gastric cancer.
9.Puerarin Inhibits Inductible Nitric Oxide Synthase expression in Lipopolysaccharide -induced RAW264.7 Macrophage Cells
Jian YU ; Wenzhi HU ; Ling JI ; Lie SUN
Chinese Journal of Rehabilitation Theory and Practice 2010;16(9):835-836
ObjectiveTo investigate the effect of Puerarin on expression of inductible nitric oxide synthase (iNOS) in RAW264.7 macrophage cells induced by lipopolysaccharide (LPS). MethodsThe protein and mRNA levels of lipopolysaccharide (LPS)-induced iNOS was determined in RAW264.7 macrophage cells using Western blotting and RT-PCR respectively. ResultsPuerarin inhibited expression of iNOS concentration dependently (P<0.01). ConclusionPuerarin may reduce iNOS level, result in prevention of inflammation.
10.Targeted injection of ozone through the posterior approach via the spinal canal and dural sac for treating lumbar disc herniation.
Zhijian YU ; Wenzhi LUO ; Baoan WANG
Journal of Southern Medical University 2012;32(2):243-246
OBJECTIVETo evaluate the effect of targeted percutaneous injection of medical ozone through the posterior approach via the spinal canal and dural sac under CT guidance for treatment of lumbar disc herniation.
METHODSIn 262 patients with lumbar disc herniation, medical ozone was injected percutaneously under CT guidance into the lumbar intervertebral disc by the posterior approach at paramedian 1-2 cm from the spinous process, targeting the affected lumbar discs, protruded nucleus pulposus and ipsilateral lateral recess. The concentration of ozone was 40-50 µg/ml in the disc/protruded nucleus pulposus and 30 µg/ml in the lateral recess (around the nerve root).
RESULTSThe treatment procedures were successfully completed in all the 262 patients. The average scores of JOA and VAS before treatment were 8.30∓1.4 and 8.73∓0.8, and changed significantly to 24.16∓3.2 (P=0.0158) and 2.41∓0.2 (P=0.0242) after treatment, respectively. According to the modified MacNab criteria, the therapeutic effect was excellent in 165 cases, fair in 64 cases, acceptable in 20 cases, and poor in 13 cases, with a total success rate of 87.4%. No patient showed serious complications after the treatment.
CONCLUSIONCompared with routine ozone therapy by the posterior-lateral approach, targeted percutaneous ozone injection into the intervertebral disc by the modified posterior approach is safe and yields better therapeutic effect for lumbar disc herniation.
Adult ; Aged ; Female ; Humans ; Injections, Intralesional ; methods ; Intervertebral Disc Displacement ; drug therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Ozone ; administration & dosage ; Spinal Canal ; Young Adult