Objective To explore the value of prenatal ultrasound in diagnosis of fetal anomalies of the inferior vena cava (IVC) and to improve the prenatal detection rate.Methods Fourteen cases of fetal anomalies of IVC examined by prenatal ultrasound from June 2013 to April 2016 in our hospital were analyzed,the prenatal ultrasonographic characteristics through abdominal transverse,coronal and IVC long axis were summarized,and were compared with the autopsy results.Results In 14 cases of anomalies of IVC,12 cases were isolated IVC interruption,and 2 cases were high confluence of IVC.In 12 cases of isolated IVC interruption,9 cases compicated by left isomerism,1 case complicated by sistus inversus viscerum,1 case complicated by isolated IVC interruption;2 cases of high confluence of IVC were combined with multiple malformations,including 1 case of chromosome 18-trisomy syndrome.Thirteen cases were confirmed by pathology,and 1 case of the high confluence of IVC lost follow-up.Conclusions Fetal anomalies of IVC have characteristic manifestations in prenatal ultrasonographic.When detecting the IVC interruption,left isomerism should be highly suspected.

Objective To investigate the clinical features and CT appearances of primary adenosquamous carcinoma (ASC)of the liver and to improve the understanding of this disease for the sake of misdiagnosis.Methods The clinical features and CT appearances in 7 patients proved by operation and pathology were reviewed,retrospectively.Results All of the patients had dull pain in upper abdo-men,fever,chills and a long history of cholangitis and biliary calculi.In addition,all patients had not the history of hepatitis B and liver cirrhosis.And the serum AFP level was normal.The single lesion was found in every patient including 4 lesions in the left lobe of liver and the other 3 in the right lobe.Plain CT showed all masses with hypodensity,heterogeneity and unclear edge in liver,and multiple irregular and more hypodense areas in lesions were found.Slight heterogeneous honeycomb-like enhancement in the arterial phase was showed.In the venous phase,persistent honeycomb-like enhancement with uneven separations,nodular bulge and hypo-dense necrotic area was found.In the delayed phase,further honeycomb-like enhancement with hypodense necrotic area and obvious-ly enhanced nodular bulge was showed.The bile ducts in the liver and around the mass were dilated and had pneumatosis in company with lithiasis in choledochus and intrahepatic bile duct in 5 patients.Conclusion Primary hepatic ASC has certain clinical character-istics in older patients.The CT characteristic features included:honeycomb-like lesions with persistent,heterogeneous,delayed en-hancement and heterogeneous separation,uneven inner edge and enhanced nodular bulge.

Objective To evaluate ultrasonography combined with magnetic resonance imaging(MRI) diagnosis value for fetal brain deformities.Methods The results of ultrasonography and MRI was analysied in 12 fetuses with deformities,which were compared to postnatal,autopsy or other hospital inspection results and evaluated the accuracy.Results In 8 cases,the diagnoses established by ultrasonography were correct.3 cases were misdiagnosed by ultrasonography,1 case was missed the diagnosis.In 11 cases,the diagnoses established by MRI were correct and 1 case was missed the diagnosis.Conclusion Ultrasonography must be choosed in diagnosising fetal skull brain deformities,MRI was supplement to ultrasonography in complicated pregnancies.The combination of ultrasonography and MRI have an important value in guiding pregnant women to determine whether or not to continue the pregnancy.

To investigate the characteristics of prenatal ultrasound sonography of fetal intestinal volvulus and intussusception , and analyze the misdiagnosis . Methods T he prenatal two‐dimensional and three‐dimensional sonographic features of 11 patients with volvulus and intussusception confirmed by prenatal ultrasound and/or postnatal confirmation from June 2017 to December 2018 were summarized and the prognosis were followed up . Results Of the 11 fetuses ,8 had intestinal volvulus and 3 had intussusception . Of the 8 cases of intestinal volvulus ,6 cases were correctly diagnosed by prenatal ultrasound ,and 2 cases were missed . Among the 6 cases diagnosed correctly ,3 cases showed a typical ＂vortex sign＂on the two‐dimensional sonogram . One case showed ＂coffee beans＂sign ,and 6 cases of three‐dimensional sonograms showed that the intestines were ＂coiled＂.＂Bread ring＂ sign appeared in 3 cases of intussusception ,and 1 case of intrauterine intestine was automatically reset . One of the 11 fetuses was induced to give birth ,1 was still in pregnancy ;9 cases were born and confirmed by surgery ,1 case died after operation . Conclusions Intestinal volvulus and intussusception have their characteristic sonographic features .When there is a short‐term fetal bowel dilatation with meconium peritonitis ,the existence of these two acute abdomen should be considered ,but w hen it is accompanied by intestinal necrosis ,typical signs of two‐dimensional sonograms are missing ,and three‐dimensional imaging aids in diagnosis .

Objective To explore the value of MRI in the diagnosis of fetal aortic arch anomalies. Methods We retrospectively collected 10 fetuses with aortic arch anomalies indicated by prenatal ultrasound and underwent MR examination and were subsequently proven by autopsy or post-birth follow-up from 320 pregnant women. We focused on the observations of the location of the aortic arch and brachiocephalic artery anomalies, the locations of the liver and stomach in the abdominal cavity, and the large vessels in abdomen. The above-mentioned finding were compared with prenatal ultrasound and follow-up findings. Results Of 10 cases, right aortic arch with aberrant left subclavian artery was seen in 7 cases, right aortic arch with the mirror branch, left aortic arch with aberrant right subclavian artery, right aortic arch with aberrant left subclavian artery combined with cervical aortic arch and double aortic arch was seen in 1 case, respectively. All aortic arch anomalies detected by MRI were consistent with post-birth or autopsy findings. Ultrasound misdiagnosed aortic branch malformation in 5 places, which included right aortic arch but misdiagnosed aberrant left subclavian artery in 2 cases, right aortic arch never diagnosed mirror branch anomaly in 1 case, right aortic arch with left subclavian artery misdiagnosed cervical aortic arch in 1 case, left atrial isomerism but misdiagnosed left aortic arch with aberrant right subclavian artery in 1 case;One double aortic arch was misdiagnosed as right aortic arch with aberrant left subclavian artery in ultrasound. Conclusion Fetal cardiovascular MRI is an effective and supplementary examination to complement ultrasound in diagnosis of fetal aortic arch anomalies.

Objective:Tumor-treating fields (TTFields) is a kind of non-invasive anti-mitotic tumor therapy, which has been approved for patients with newly diagnosed and recurrent glioblastoma. This study aims to explore the efficacy and safety of TTFields in high-grade gliomas in clinical practice settings.Methods:The clinical data of 15 patients with recurrent glioma and 9 patients with newly diagnosed high-grade glioma admitted to our center from April 2019 to January 2021 were retrospectively analyzed. All patients accepted TTFields≥1 month. Follow-up was performed for 5.3 months (ranged from 2.3 to 10.7 months); Response Assessment in Neuro-Oncology Working Group (RANO) criteria was used to evaluate the glioma responses. The progression-free survival (PFS) and overall survival (OS) were calculated according to Kaplan-Meier method. Common Terminology Criteria for Adverse Events v5.0 (CTCAE v5.0) and TTFields related skin adverse reaction (dAE) criteria were used to evaluate the adverse events. Quality of life questionnaire-core 30 (QLQ-C30) and QLQ-brain cancer module (QLQ-BN20) questionnaires were used to evaluate the health-related quality of life (HRQoL). Treatment compliance was evaluated by data on the use of NovoTTF-200A devices, and calculated as a percentage of daily TTFields usage.Results:The median duration of TTFields was 4.2 months (ranged from 1.0 to 10.7 months), with a median compliance rate of 91.5% (67.0%-97.0%). TTFields was used alone in 2 patients and used with combination of chemotherapy in 22 patients. From follow-up to April 2021, 14 patients had stable symptoms and 10 had disease progression (8 died). The median PFS and OS of recurrent patients were 5.9 months ( 95%CI: 3.3-8.6 months) and 8.5 months ( 95%CI: 3.2-13.8 months), respectively; and the median PFS and OS of newly diagnosed patients were both 10.7 months (without 95%CI). The common adverse events included grading 1 dAE (58.3%) and grading 2 dAE (12.5%), without grading 3 or 4 dAE, manifested as contact or allergic dermatitis, erosion, folliculitis and ulcers. And 87.5% patients had stable HRQoL. Conclusions:The preliminary results showed that the survival of recurrent high-grade glioma patients treated by TTFields is similar to that reported in foreign literature; and the newly diagnosed patients need further survival follow-up. The patients' treatment compliance and safety are good. The dAE incidence (grading 1-2) is higher than that reported in the literature, and the toxicity was acceptable.