1.Pathological Basis of Ovarian Cystic Teratoma and its Differential Diagnosis Using Grey Scale Ultrasonography
Qingwei DING ; Ning SUN ; Shaowen WANG ; Guoying SUN ; Huifang MAO ; Zhengtao ZHU ; Ming LI ; Meiyu WANG
Chinese Journal of Medical Imaging 2010;(1):69-71,74
Purpose To investigate the diagnostic value of gray-scale ultrasound on ovarian cystic teratoma.Materials and Methods 83 patients with primary diagnosis of ovarian cystic teratoma underwent gray-scale ultrasonography. The ultrasonic images were compared with postoperative pathologic results. Results 91 cases of 83 lesions were detected. The ultrasonic features were categorized into 6 types: cystoid, solid-like, intracystic dough sign, intracystic hair-ball, intracytic fat-fluid level, and intracytic cluttering sign. The diagnose accordance rate for each sign was 81.0%, 77.8%, 96.2%, 100% and 70.0% respectively. The diagnose accordance rate of ultrasonic diagnosis compared with pathologic results was 89.0% (81/91), and misdiagnosed rate and rate of missing diagnosis was 11.0% (10/91). Conclusion The ultrasonic features of ovarian cystic mature terotoma were of importance diagnostic value, whereas differentiation with ovarian chocolate cysts and ovarian mucus-cystic adenoma should be made cautiously.
2.Multi-slice Spiral CT Manifestations of the Arrhythmogenic Right Ventricular Dysplasia
Lin QI ; Dingbiao MAO ; Ming LI ; Yang CHEN ; Yanqing HUA
Chinese Journal of Medical Imaging 2013;(11):834-836,840
Purpose To investigate the diagnostic value of the arrhythmogenic right ventricular dysplasia (ARVD) using multi-slice spiral CT (MSCT). Materials and Methods Thirty-four patients who were suspected as ARVD received right ventricular radiography, including 16 ARVD patients and 15 non-ARVD patients regarded as control group. The structural and shaped change of heart on reconstructed images of long axis, short axis and four cavity surface and analyze were observed, and MSCT features of right ventricular radiography characteristics were analyzed for ARVD patients. Results Sixteen cases of ARVD were correctly diagnosed by MSCT, and 14 cases had fatty infiltration including 11 cases of apex of heart, 8 cases of inferior wall, 5 cases of anterior wall, 5 cases of anterior wall of funnel area, 3 cases of diagram, 4 cases of papillary muscle, 6 cases of muscular trabecula and moderator band and 1 case of whole right ventricular free wall. Five cases showed scallop sign, 16 cases excessive trabecular change, 11 cases thinned changes, and 16 cases enlarged changes of right ventricular wall. Conclusion MSCT features of right ventricular for ARVD have relative diagnostic characteristics, and the scallop sign and excessive trabecular change of right ventricular wall are its specific imaging characteristics.
3.In Vitro Study of Cell Proliferation Inhibition Using Ultrasound Combined with Photodynamic Therapy with Microbubbles Containing Quantum Dots
Lan HAO ; Yajing ZHAO ; Zhigang WANG ; Haitao RAN ; Weixiang SONG
Chinese Journal of Medical Imaging 2013;(10):729-732,736
Purpose To explore the apoptosis mechanism of human ovarian cancer cells SKOV3 processed with ultrasound (US) combined with photodynamic therapy (PDT), with self-contained lactic acid/glycolic acid (PLGA) microbubbles (MBQDs/PLGA) containing quantum dots (QDs) as a photosensitizer. Materials and Methods MBQDs/PLGA was prepared with double emulsion method, and MTT was used to compare the cytotoxic activity difference between QDs and MBQDs/PLGA, to determine the proper treatment condition. SKOV3 cells were treated under selective conditions, cell damage manifestation was observed with HE staining, and double staining flow cytometry was used to detect cell apoptosis. Results When cells were treated with PDT with energy density of 180.0 J/cm2 and US with sound intensity of 0.5 W/cm2 (1.0 MHz, 10 s), cell deformation could be observed under a microscope in both US-PDT-MBQDs/PLGA group and PDT-MBQDs/PLGA group, and cell connections were absent between cells;transmission electron microscope showed dense chromatin gathered along the nuclear membrane, with the formation of apoptotic bodies also be displayed. Maximum apoptosis rate was (22.17±0.38)% Conclusion MBQDs/PLGA-mediated PDT contains proliferation inhibition effect for SKOV3 cells, which can be synergied with low-power ultrasonic irradiation due to sonoporation effect.
4.Value of Multi-slice CT in Diagnosis of Papillary Renal Cell Carcinoma
Tianjiao JIANG ; Li ZHENG ; Chongfeng DUAN ; Wei LI ; Qing YANG
Chinese Journal of Medical Imaging 2013;(11):857-860,863
Purpose To evaluate the value of multi-slice spiral computed tomography (MSCT) scan in the diagnosis of papillary renal cell carcinoma. Materials and Methods A retrospective study was conducted on the findings of plain CT scan and triphasic dynamic contrast enhanced CT scan of 23 patients with papillary renal cell confirmed pathologically, and further contrasted with the findings of 96 patients with clear cell renal cell carcinoma at corresponding phases in such aspects as cystic degeneration, enhancement degree and pattern (homogeneous, peripheral or heterogeneous) and tumor spreading pattern (perinephric invasion, lymphadenopathy or venous invasion). Results The degree of enhancement CT value for both diseases showed statistical significance in corticomedullary phase, parenchymal phase and excretory phase (t=9.70, 8.08, 5.92;P<0.01), but papillary renal cell carcinoma was lower than clear cell renal cell carcinoma. In terms of cystic degeneration, papillary renal cell carcinoma was significantly lower than clear cell renal cell carcinoma (21.7%vs 54.2%,χ2=7.54, P<0.01). Papillary renal cell carcinoma mainly showed homogeneous enhancement (60.9%) whereas clear cell renal cell carcinoma mainly presented heterogeneous enhancement (68.8%) with statistical difference (χ2=30.40, P<0.01). The tumor spreading patterns like perinephric invasion, lymphadenopathy and venous invasion had no significant difference (χ2=0.51, 0.11, 0.03;P>0.05). Conclusion Papillary renal cell carcinoma shows homogeneous enhancement, seldom cystic degeneration or necrosis on MSCT scan, which is helpful for the differential diagnosis from clear cell renal cell carcinoma.
5.CT Manifestations of Thyroid Carcinoma and Its Correlation with Lymph Node Metastasis
Zhenghua ZHANG ; Jianqiang HUANG ; Dan HAN ; Xiaojie XIE ; Zhongxia LI
Chinese Journal of Medical Imaging 2013;(11):804-807,811
Purpose To explore CT manifestations of thyroid carcinoma and its correlation with neck lymph node metastasis. Materials and Methods CT findings of 165 patients with thyroid carcinoma confirmed by surgical pathology were studied, including number, shape, size, calcium, necrosis, surrounding invasion and enhancement of substantial part, and its correlation with neck lymph node metastasis was also analyzed. Results 107 out of 165 patients (64.85%) suffered from neck lymph node metastasis. Different tumor number, calcium and necrosis were not associated with the rate of neck lymph node metastasis (χ2=0.009, 2.606, 1.522;P>0.05);tumor shape, size, surrounding invasion and enhancement were significantly different from the rate (χ2=26.510, 75.995, 68.922, 20.819;P<0.05). Patients age, tumor shape, size, enhancement and surrounding invasion were positively correlated with lymph node metastasis (r=0.124, 0.243, 0.276, 0.287, 0.395;P<0.05);the sequence of correlation was as follows:surrounding invasion>enh ancement>shape>size>age. However, patients gender, tumor number, calcium and necrosis showed on correlation (r=0.074, 0.126, 0.005, 0.121;P>0.05). Conclusion Lymph node metastasis is mainly associated with factors like age, tumor shape, size, enhancement and surrounding invasion. It is advisable that patients with high risk rate may consider selective cervical lymph node dissection.
6.Iterative Reconstruction Algorithm CT Perfusion and Angiography in the Diagnosis of Ischemic Cerebrovascular Disease
Peijun LI ; Biao HUANG ; Changhong LIANG ; Wenzhen ZHU ; Jieying FENG ; Xiaoling ZHONG
Chinese Journal of Medical Imaging 2013;(12):881-885,890
Purpose To reconstruct perfusion computerized tomography angiography (PCTA) images from the volume data of low-dose brain CT perfusion scan with iterative reconstruction algorithm, to analyze the capability of PCTA on the display of brain arteries, and to explore the methods to reduce the radiation dose for stroke CT examinations. Materials and Methods This was a prospective study, 55 patients (605 arterial segments) with clinical diagnosis of ischemic cerebrovascular disease underwent cranial CT scan, iterative algorithm low-dose brain CT perfusion scan and conventional cranial CTA examinations using a 256-slice spiral CT. 11 segments of the cerebral artery in each case were analyzed using conventional CTA results as the reference standard to assess the display of brain arteries in PCTA. Results Effective dose of CT perfusion scan was 2.12 mSv. Among the 580 vessel segments which CTA showed no stenosis or stenosis<30%, only one vessel segment of PCTA was inconsistent with CTA; among the 19 vessel segments which CTA showed stenosis≥30%but not occluded, results of 12 vessel segments in PCTA were consistent with CTA, while the stenosis states were exaggerated by PCTA in the other seven vessel segments;results of the two methods were consistent in six vessel segments which was found occluded by CTA. Kw values were >0.75 for the consistency test between PCTA and CTA on the display of brain arteries. Conclusion Radiation dose of iterative algorithm cranial CT perfusion scan is significantly lower, and the images reconstructed from the volume data of perfusion CT are highly consistent with the CTA results, thus are able to meet the needs of the clinical diagnosis.
7.Application of 3.0T MR Diffusion Tensor Imaging in Normal Female Pelvic Floor Muscles
Hua SHANG ; Jianyu LIU ; Guangjin ZHOU ; Yan ZHOU
Chinese Journal of Medical Imaging 2013;(12):943-945,950
Purpose To explore the three-dimensional display and parameter features of 3.0T MR diffusion tensor imaging (DTI) in the imaging of normal female pelvic floor muscle fiber bundles, and to provide a reference standard for the application of DTI in patients with pelvic organ prolapse. Materials and Methods Fifty cases of females who had not given birth or had given birth by cesarean delivery were divided into four groups:20 to 29 years (15 cases), 30 to 39 years (15 cases), 40 to 49 years (12 cases) and 50 to 54 years (8 cases). First, the conventional sagittal, axial, coronal T2WI and axial T1WI images were acquired with a 3.0T MRI scanner;then a dynamic sagittal fiesta sequence was executed to exclude pelvic organ prolapse; at last, the transverse two-dimensional diffusion-weighted spin echo-echo planar imaging (SE-EPI) pulse sequence was executed to acquire pelvic floor DTI data, through the post-processing of the data, normal female pelvic floor muscle fiber bundle images can be obtained and apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value were calculated. Results Content three-dimensional muscle fiber bundle images and corresponding ADC and FA values of the pubic visceral muscles in pelvic wall and obturator muscles in pelvic wall were acquired in all subjects;there was no statistically significant difference (P>0.05) for the ADC and FA values between the left and right side of the pubic visceral muscles and obturator muscles within the same age group;and the difference of ADC and FA values of pubic visceral muscles and obturator muscles among different age groups were not statistically significant (P>0.05), either. Conclusion 3.0T MR DTI fiber tracking imaging can be applied for the three-dimensional observation of the complicated muscle fiber bundle structures in female pelvic floor, through the measurement of ADC and FA value changes, functional abnormity can be suggested before the anatomy structure changes of the pelvic muscles occurs, thus provides an important new approach for further study of pelvic organ prolapse.
8.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.
9.Differentiation of Non-puerperal Mastitis from Breast Carcinoma with Non-mass-like Enhancement by Texture Analysis of Contrast-enhanced Magnetic Resonance Imaging
Honsum LI ; Qiang ZHANG ; Haikun QI ; Xinlei PAN ; Sheng XIE ; Huijun CHEN
Chinese Journal of Medical Imaging 2017;25(5):354-359
Purpose To investigate the feasibility of texture analysis of breast contrastenhanced magnetic resonance imaging in differentiating non-puerperal mastitis and breast carcinoma with non-mass-like enhancement in order to prevent misdiagnosis of nonpuerperal mastitis.Materials and Methods In this retrospective study,the contrastenhanced MRI images of 42 female patients of invasive ductal carcinoma with non-masslike enhancement and 30 female patients of non-puerperal mastitis were analyzed.3234 texture features were generated from manually selected region of interest (ROI) of normal breast tissue and breast lesions.By means of genetic algorithm and linear discriminative analysis,10 texture features were selected based on their stability and accuracy in breast tissue classification.Results With these 10 features,the linear discriminative analysis classifiers had sensitivity of 92.9% and specificity of 90.0% in classifying two lesions,and accuracy of 89.6% in classifying all three types of tissue.The result showed that texture analysis successfully differentiate non-puerperal mastitis and breast carcinoma with nonmass-like enhancement.Conclusion Texture analysis demonstrates the ability of differentiating invasive ductal carcinoma with non-mass-like enhancement,non-puerperal mastitis and normal breast tissue,and provides reliable results for clinical diagnosis.
10.Differentiation of Multiple System Atrophy and Parkinson's Disease Using 11C-CFT PET/CT
Hui YANG ; Zhihui SHEN ; Baixuan XU
Chinese Journal of Medical Imaging 2017;25(5):349-353
Purpose To investigate the value of 11C-CFT PET/CT dopamine transporter (DAT) imaging in differential diagnosis of multiple system atrophy (MSA) and Parkinson's disease (PD).Materials and Methods The 11C-CFT PET/CT images of clinically confirmed MSA patients (21 cases),PD patients (24 cases) and healthy adults (10 cases as normal control) were analyzed retrospectively.The volume of interest (VOI) were drawn manually,and the DAT binding indexes and asymmetry indexes of different regions of striatum,including caudate and putamen,were calculated.The differences of DAT binding indexes and asymmetry indexes among the above three groups were analyzed.Results Compared with the normal control group,the striatal DAT binding indexes of MSA group or PD group were significantly reduced (P<0.05).There were no significant differences in DAT binding indexes between the MSA group and the PD group (P>0.05).Compared with the normal control group,the DAT binding asymmetry indexes were significantly increased in the PD group (P<0.05),but the indexes showed no significant differences in MSA group (P>0.05).The DAT asymmetry indexes of caudate and putamen in the PD group were higher than those in the MSA group (P<0.05).Conclusion 11C-CFT PET/CT imaging can detect the degeneration of dopaminergic neurons in striatum.The number of striatal dopamine transporters declines in both MSA and PD patients,but the asymmetry of striatal dapamine transporter in PD patients is higher than that in MSA patients.11C-CFT PET/CT can differentiate MSA and PD.