Objective To explore diagnostic value of multi-slice spiral CT imaging features with respect to pancreatic neuroendocrine tumors (pNET) of different histological grades. Methods A retrospective analysis of preoperative abdominal plain CT and dual-phased contrast-enhanced CT was performed in 21 patients (median age, 47 years;12 males and 9 females) with pathologically proven pNET. age, gender, endocrine function, location and size of lesion, cystic change or necrosis, completeness of capsule, calcification, dilation of pancreatic duct were evaluated.CT attenuation-related parameters (plain CT value, relative density index, and CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase) of each tumor were measured or calculated. All tumors were pathologically classified into three histological grades (G1, G2 and G3) based on mitotic count and ki-67 index. Kruskal-Wallis test was performed to compare differences of age, gender, endocrine function, morphological features among different grades. CT attenuation-related parameters were evaluated using Kruskal-Wallis or one-way analysis of variance (ANOVA). Results Twenty four pNET foci [grade G1 (n=13), G2 (n=7) and G3 (n=4)] were seen in the 21 patients. The difference of age, gender among different grades demonstrated no statistical significance (P>0.05). Nine lesions of G1 and 1 lesion of G2 demonstrated endocrine function, and the difference of endocrine function among three grades was statistically significant (χ2=8.355,P=0.012). For G1, G2 and G3, 11, 5 and 2 lesions were seen in uncinate process, pancreatic head and neck, respectively while 2, 2 and 2 lesions in pancreatic body and tail, respectively. The median maximum diameter of pNET of G1, G2 and G3 was 1.5, 2.5 and 6.7 cm, respectively;For G1, G2 and G3, 13, 4 and 0 lesions demonstrated intact capsule, respectively while 2, 3, and 3 lesions cystic degeneration and necrosis, respectivel; 0, 2 and 2 lesions calcification,respectively, 0, 1 and 2 lesions dilation of pancreaticobiliary duct, respectively, 0, 1 and 4 lesions sign of malignancy, respectively. The difference of size of lesion, completeness of capsule, calcification, and dilation of pancreatic duct showed statistical significance (P< 0.05). The difference of location of lesion and cystic change or necrosis displayed no significance (P>0.05). In addition, pNET of different grades demonstrated similar density and relative density index on plain CT. Regarding CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase, the pNET of G2 showed highest value, while pNET of G3 lowest value, however, the difference about CT attenuation-related parameters among three grades showed no significant difference (P>0.05). Conclusion pNET of different histologic grades have some specific CT imaging features, which can facilitate an accurate diagnosis of pNET prior to therapy.

Objective To investigate the value of diffusion-weighted magnetic resonance imaging in the differential diagnosis of primary gallbladder cancer with liver invasion and primary hepatocellular carcinoma (HCC) with gallbladder invasion. Methods From January 2009 to October 2010, 11 patients with primary gallbladder cancer and 19 patients with primary HCC were admitted to the PLA General Hospital. The clinical data of the 30 patients were retrospectively analyzed. All patients underwent diffusion-weighted magnetic resonance imaging with b value of 800 s/mm2, and the receiver operating curve (ROC) was drawn. The apparent diffusion coefficient (ADC) values of the patients with gallbladder cancer and HCC were compared by independent sample t test. Results Thirty tumors were detected in the 30 patients. All tumors showed high signal on DWI, slightly low signal on T1 WI and slightly high signal on T2 WI. The foci of 11 patients with primary gallbladder cancer were at the gallbladder fossa, and 10 of them had liver involvement. The mean ADC value of the 11 patients was (0.89 ±0. 14)mm2/s. Of the 19 patients with primary HCC, the foci of 15 patients were at the right lobe of liver, and 4were at the left lobe. The mean ADC value of the 19 patients was (1.04 ±0.18)mm2/s. There was a significant difference in the ADC value between patients with primary gallbladder cancer and those with primary HCC ( t =2.425, P＜0. 05). The area under the ROC was 0. 756 (95% confidence interval: 0.577-0. 935), and the sensitivity and specificity were 68.4% and 81.8%, respectively, when the threshold value was 0.96 mm2/s.Conclusion The ADC value of patients with primary gallbladder cancer is lower than those with primary HCC when the b value is 800 s/mm2, which is helpful in the differential diagnosis of primary gallbladder cancer and primary HCC.

Objective To assess the diagnostic value of MRI on multiple focal nodular hyperplasia (FNH) of the liver. Methods MR images of 9 cases with pathological-confirmed multiple FNH were retrospectively analyzed. MRI features of the lesions were correlated with pathological findings. Results Multiple FNH was considered in all these 9 cases. Among them, the primary diagnosis was FNH in 5,hepatic adenoma in 3 and fibrolamellar hepatocellular carcinoma in 1 case. A total of 31 lesions were detected in the 9 cases. On T2WI, 19 lesions presented slightly high-signal intensity, and the other 12 presented iso-signal intensity. On T1WI, 12 lesions presented slightly low-signal intensity, 7 presented iso-signal intensity, and the other 12 presented high-signal intensity. On opposed-phase, the signal intensity of 1 lesion dropped unevenly. After bolus injection of contrast agent Gd-DTPA, in hepatic arterial phase 18 lesions showed mild to marked heterogeneous enhancement, 11 showed marked homogeneous enhancement, 1 showed moderate ring-like enhancement, and the last one did not have obvious enhancement In portal venous and delayed phase, all the lesions turned to iso- or slightly high-signal intensity gradually. Sixteen of 31 lesions presented central scar, which demonstrated mild star-like enhancement in delayed phase. Conclusion Multiple FNH presented certain MRI features, which contributed to the preoperative diagnosis.

Objective To document the MRI features of renal angiomyolipoma (RAML) containing minimal fat and to explore whether the MR features vary depending on the tumor size. Methods The MR findings of 15 cases of pathologically-proved RAML containing minimal fat were reviewed retrospectively from January 2008 to March 2010. All patients underwent MR in a 1.5 T or 3.0 T scanners. The MR features of the lesions were analyzed, with emphasis on the signal intensity and homogeneity on T2WI, in regards to pseudocapsule, lipid component, hemorrhage, cystic degeneration or necrosis, blood vessels, interface with renal parenchyma and enhancement pattern. All lesions were categorized into 2 groups; those with diameter ＞4 cm and those with diameter ≤4 cm. The difference of imaging characteristics between these two groups was analyzed using Fisher exact test. Results All 15 lesions demonstrated hypointensity on T2WI compared to the renal parenchyma. Homogeneous signal intensity on T2WI was seen in 6 lesions (6/15); peritumoral pseudocapsule in 3 lesions (3/15); cystic degeneration or necrosis, hemorrhage in 5 lesions (5/15); flow void of blood vessels in 2 lesions (2/15); lipid component in 4 lesions (4/15); angular interface with renal parenchyma in 10 lesions (10/15); homogeneous enhancement in 8 lesions (8/15). Fifteen lesions were divided into two groups; 9 categorized into group 1 (the maximum diameter ≤ 4 cm) and 6 into group 2 ( the maximum diameter ＞ 4 cm). Cystic degeneration or necrosis was seen in 0 of 9 in group one and 5 of 6 in group two respectively, hemorrhage(0 of 9 and 5 of 6 respectively) and pseudocapsule(0 of 9 and 3 of 6 respectively. The difference between these findings in the two groups demonstrated statistical significance (P ＜ 0. 05). Conclusion The MR features of RAML containing miminal fat were hypointensity on T2 WI,angular interface with renal parenchyma and homogeneous contrast enhancement, however, these findings can vary depending on the tumor size.

The literatures of classic and modern application of herbal juice , like ginger juice, licorice juice, rice water, evodia rutaecarpa juice, black soya bean juice, bile, etc were collected.The history and successive changes of the processing research of herbal juice used as processing excipient were summarized , which could offer the reference to the modern processing excipient of herbal juice .

Neoadjuvant chemoradiotherapy (NCRT) combined with total mesorectal excision (TME) has become the recommended standard treatment strategy for local advanced rectal cancer (cT3 or cN+). After neoadjuvant chemoradiotherapy, preoperative T/N re-staging and efficacy evaluation of rectal cancer are directly related to the available treatment options and prognosis, so they are the common questions concerned by physicians. At present, magnetic resonance imaging (MRI) is acknowledged to be one of the more effective and feasible methods of T/N re-staging and efficacy evaluation, especially in the molecular microscopic scale. The diffusion weighted imaging (DWI) can reflect the movement of water molecules outside the tumor cells, and the multi-phase dynamic contrast enhanced MRI (DCE-MRI) can indirectly reflect the permeability of tumor vascular wall and local blood perfusion of tumor from the view of pathophysiological point. Because of the influence of edema, inflammatory response and fibrous tissue proliferation after radiotherapy, scholars both at home and abroad increasingly pay more attentions to the accuracy of T/N re-staging and efficacy prediction in MRI following neoadjuvant therapy. In this review, we elucidate the application value and limitation of MRI based on T/N re-staging and local efficacy evaluation.
Chemoradiotherapy ; Humans ; Magnetic Resonance Imaging ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms ; diagnostic imaging ; therapy ; Treatment Outcome