1.CT diagnosis and differential diagnosis of mucoepidermoid carcinoma of the lung
Hong LU ; Jiafei CHEN ; Haitao LI
Journal of Regional Anatomy and Operative Surgery 2015;(2):187-189
Objective To improve the diagnostic accuracy by analyzing the computed tomography ( CT) characteristic performance of mucoepidermoid carcinoma of the lung. Methods CT findings 15 cases proved by pathology of mucoepidermoid carcinoma of the lung were retrospectively analyzed,and CT characteristic performance were studied by reviewing the literatures. Results The mucoepidermoid carcino-ma were located in right bronchial of 8 cases,left bronchial of 6 cases,peripheral part of the lung of 1 case. Calcification was seen in 7 mas-ses. Most masses density was not homogeneous at plain scanning. Venous phase have significantly enhanced compared with arterial phase. Ten cases showed obstructive pneumonia and atelectasis,3 cases with mediastinal lymph node metastases. Conclusion Multiple mucoepidermoid carcinoma of the lung grows extension of the long axis of bronchial,calcification be seen in most of patients. The enhanced mode of the lesions appeared as continuous progressive enhancement,some were illustrated with post obstructive pneumonia or atelectasis,CT have a certain value of diagnosis and diffenertial diagnosis.
2.CT and MRI imaging features of primary ventricular lymphoma
Hong LU ; Haitao LI ; Wei CHEN ; Jiafei CHEN ; Kang CHEN
Journal of Regional Anatomy and Operative Surgery 2017;26(1):55-57,58
Objective To evaluate the CT and MRI imaging features of primary ventricular lymphoma ,so as to provide a reference for the diagnosis and differential diagnosis of the disease .Methods The clinical data and imaging findings of primary ventricular lymphoma in one case was retrospectively analyzed with literature review and compared with primary lymphoma in parenchymal brain .Results Slightly high density tumor presented with regular shape in the trigone of lateral ventricles on CT findings , and slightly low signal intensity on T 1 and slightly high signal intensity on T 2 appeared on MRI findings with small cystic necrosis in tumour .An enhancement scan showed obviously enriched, and there was perilesional edema.After 14 day’s dehydration treatment, rechecked indicated that the lesions were significantly en-larged, the shape were irregula , the area of cystic necrosis was enlarged , heterogeneous enhanced scanning were enhanced , perilesional ede-ma became more heavier , and the imaging feature of “closed fist” appeared .It was proved to be diffuse large B cell lymphoma with surgical pathologic examination , and there was no lymphoma in other regions of the body with whole body PET-CT examination , which was clinically diagnosed as primary ventricular lymphoma .Conclusion Primary ventricular lymphoma is rarely reported ,and it has similar imaging mani-festations with primary lymphoma in parenchymal brain .The combination of multiple imaging modalities will be helpful to diagnosis and dif -ferential diagnosis for the suspected patients .
3.Imaging diagnosis of prostatic hyperplasia and prostate cancer
Aijun SHI ; Kaihang JIANG ; Jinye CHEN ; Wanchun GAO ; Jiafei CHEN
Journal of Regional Anatomy and Operative Surgery 2017;26(9):682-686
Objective To explore the methods of improving diagnosis correctness between the patients with prostate cancer and benign prostatic hyperplasia.Methods Totally 87 patients with benign prostatic hyperplasia or prostate cancer which confirmed by MRI and prostate biopsy for the PSA significantly increased in our hospital from July 2013 to March 2016 were collected.By using the three methods of the PI-RADS V2 score,the T2WI+DWI/ADC+DCE-MRI+MRS and PI-RADS V2 score+MRS to diagnose,and comparing with the pathology results,the diagnostic consistency of the two physicians were analyzed.The sensitivity,accuracy and specificity of three ways were compared,and the correlation between PI-RADS V2 score and Gleason score were calculated.Results The diagnostic consistency of the two physicians:PI-RADS V2 score,K=0.951;T2WI+DWI/ADC+DCE-MRI+MRS score,K=0.838;PI-RADS V2+MRSI score,K=0.937.The correlation between PI-RADS V2 score and Gleason score,r=0.871,P=0.001 4;diagnostic sensitivity,specificity and accuracy of PI-RADS V2 score were 77.3%,74.4%,75.9%;diagnostic sensitivity,specificity and accuracy of T2WI+DWI/ADC+DCE-MRI+MRS were 88.6%,76.7%,82.8%;diagnostic sensitivity,specificity and accuracy of PI-RADS V2+MRSI score were 86.4%,81.4%,83.9%,respectively.Conclusion Compared with the traditional diagnostic methods,the combination of new prostate report and data system and MRSI can improve the diagnostic accuracy of prostate cancer and benign prostatic hyperplasia.The PI-RADS V2 score is more objective and accurate in the description of the lesion,but the low signal of benign hyperplastic nodules in transitional zone should be dialogued carefully through a variety of image parameters.
4.Association of heart rate variability with 5-minute Apgar score in neonates with severe asphyxia
Jin WANG ; Li LI ; Yanan KAN ; Hongwei LIANG ; Jiafei CHEN
Journal of Clinical Pediatrics 2013;(9):817-819
Objective To explore the relationship between 5-minute Apgar score and heart rate variability (HRV) in severely asphyxiated neonates. Methods A total of 103 severely asphyxiated neonates with 1-minute Apgar score of 0 to 3 points were selected. They were divided into Group A (>7 points, n=50) and Group B (≤7 points, n=53) based on 5-minute Apgar score. Meanwhile, 40 full-term neonates with 1-and 5-minute Apgar score greater than 7 points were selected as control group. 24-hour dynamic electrocardiogram was performed and HRV was analyzed on the third day after birth in three groups. Results PNN50, rMSSD, SDSD were decreased and SDNN, SDANN were increased in group B as compared with group A and control group (P<0.05). No signiifcant difference of HRV was observed between group A and control group (P>0.05). Conclusions Neonatal asphyxia can cause damage to autonomic nervous system. 5-minute Apgar score and HRV can be joint-ly used as a non-invasive index in autonomic nervous damage and its prognosis in asphyxiated newborns.
5.Clinical value of color Doppler ultrasound and computed tomography angiography in diagnosis and interventional therapy of Budd-Chiari syndrome
Jin GU ; Yu WANG ; Yilin DU ; Li LUO ; Jiafei CHEN
Journal of Regional Anatomy and Operative Surgery 2017;26(2):119-124
Objective To evaluate the clinical value of color Doppler ultrasound (CDUS) and computed tomography angiography (CTA) in diagnosis of Budd-Chiari syndrome(BCS).Methods The CDUS and CTA data about 33 BCS patients diagnosed by digital subtraction angiography(DSA) and treated by interventional therapy were retrospectively analyzed.All of 33 patients with BCS were examined with CDUS,26 cases of then received CTA.The diagnostic value of BCS between two methods were compared.Results The diagnostic accordance rate of CDUS and CTA for BCS were 90.9% and 96.2% respectively,which had no significant statistical difference(P > 0.05).The two methods could not only comprehensively systematically reflect the morphologic changes of liver and spleen,the stenosis and blood flow state of the lesion regions,but also clearly display the intrahepatic/extrahepatic collateral vessels trend in the abdomen.One week after interventional therapy,the CUDS results showed blood vessels pristine and stable hemodynamics.Conclusion CDUS is the preferred imaging in the diagnosis and postoperative re-examination of BCS.While,CTA can provide many important parameters for preoperative assessment and operation way.
6.Clinical application and value of dual-source spiral CT enhanced scan and multiplanar reformatting in diagnosis of gastric cancer
Jing PENG ; Qide YAN ; Jiafei CHEN ; Xiaoyu HOU
Journal of Regional Anatomy and Operative Surgery 2015;(2):185-186,187
Objective To discuss the clinical application and value of dual-source spiral CT enhanced scan and multiplanar reformatting ( MPR) in the diagnosis of gastric cancer. Methods The 335 patients with gastric cancer who conducted dual-source spiral CT enhanced scan of upper abdomen under the hypotonic state before the definite pathological diagnosis were retrospectively analyzed,and had multi-di-mensional multiplanar reconstruction for the enhanced thin-section CT data by the multiplanar reformatting technique. Results Of 335 ca-ses,288 cases were detected by simple axial data,the detection rate was 86. 0%,320 cases were detected by MPR,the detection rate was 95. 5%,the differences were statistically significant (P<0. 05). The overall accuracy rate of Preoperative T staging by conventional axial and MPR images were 78. 3% and 89. 1% respectively, the difference was statistically significant. The overall accuracy rate of preoperative N staging by two methods were 73. 6% and 82. 3%,respectively,the difference was not significant. Conclusion Application of dual source spiral CT multiplanar reconstruction can significantly improve the detection rate of gastric cancer,and the average accuracy rate of preopera-tive TNM staging for gastric cancer is 84. 6%.
7.Aggravation of electroencephalographic features in an epileptic child treated by oxcarbazepine monotherapy: A case report and review of the literature
Fang YANG ; Ling LIU ; Qian LI ; Jiafei DAI ; Maowei CHENG ; Li KONG ; Shenning ZHANG ; Guanghui CHEN
Journal of Medical Postgraduates 2011;24(5):495-498
Objective Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common partial epilepsy syndrome in children, and responds well to carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA). The aim of this study is to investigate the therapeutic effect of OXC on BECT. Methods We retrospectively discussed a case of partial epilepsy in a 6-year-old boy with no abnormality on neuroradiologic examination. Results The patient′s seizures were easily controlled by administration of OXC, but electroencephalography (EEG) identified deterioration of the EEG features following the introduction of OXC monotherapy. Then OXC was gradually decreased in dose and substituted with VPA. When VPA was increased to the dose of 0.5g/d, the boy had no more seizures and exhibited normal EEG in the conscious state. Conclusion OXC may induce new types of seizure and aggravate EEG features although it is considered to be the first-line anti-epileptic drug (AED) and much better tolerated than either phenytoin or CBZ.
8.Meta-analysis on laparoscopy-assisted total gastrectomy for gastric cancer
Ke CHEN ; Yiping MOU ; Xiaowu XU ; Yucheng ZHOU ; Jiafei YAN ; Jie WANG
Chinese Journal of General Surgery 2012;(12):1014-1019
Objective To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy (LATG) for gastric cancer by systematic review and meta-analysis.Methods The literature database before February,2012 was extensively searched to retrieve the comparative studies of LATG and open total gastrectomy(OTG) with a relevance of study goal.The inclusion and exclusion criteria were formulated.Aftera quality evaluation,the data was extracted.The Cochrane collaboration RevMan 5.1 version software was used for meta-analysis.Results There are ten studies meeting the inclusion criteria for meta-analysis.The total sample size of these studies was 942 cases.Compared to OTG,LATG experienced longer operation time [weighted mean difference(WMD) =41.12 min,95% confidence interval(CI):20.62-61.63,P <0.01)],less blood loss(WMD =-198.36 ml,95% CI:-300.94--95.78,P < 0.01),earlier time to flatus(WMD =-0.80 days,95% CI:-1.17--0.42,P<0.01),shorter hospital stay(WMD =-4.02days,95% CI:-6.03--2.01,P < 0.01) and decrease in overall complications [relative risk (RR) =0.55,95% CI:0.40-0.76,P < 0.01)].The number of dissected lymph nodes,proximal or distal resection margin and mortality were similar between the two groups.Conclusions Laparoscopy-assisted total gastrectomy is a safe and feasible procedure with less blood loss,less overall complications and quick recovery.
9.Morphological changes of mitral valve geometry caused by repair procedure
Jiafei CHEN ; Wei ZHANG ; Wei SHI ; Wenrui MA ; Wei YE ; Weihua WU
Journal of Shanghai Jiaotong University(Medical Science) 2017;37(3):363-367
Objective · To assess the morphological changes of mitral valve geometry after mitral valve repair by using real-time 3D transesophageal echocardiography. Methods · The clinical data including 3D echocardiography of 36 patients undergoing mitral valve repair for mitral valve prolapse and 56 patients without mitral valve diseases were collected. Parameters of mitral annular and leaflet geometry were acquired and analyzed. Results · The ellipse index of the two-dimensional view (E2D), and non-planar leaflet angle (θNPA) were decreased, while other parameters were increased significantly in patients with mitral valve prolapse compared with controls before mitral valve repair. After repair, patients displayed larger θNPA, and still smaller E2D.Some parameters also get smaller, such as the anterior to posterior diameter of the mitral annulus, the anterolateral to posteromedial coaptation diameter,the minimum circumference of the three-dimensional view of the annulus, the minimum area of the two-dimensional view of the annulus, the exposed area of the anterior leaflet, inter-commissural diameter. Other parameters were not changed significantly. All parameters showed no significant difference between respect group and resect group in posterior valve prolapse before and after mitral valve repair. Conclusion · The repair procedure can restore the function of the mitral valve effectively. In view of the morphology, the geometry of the mitral valve annulus is still different from the normal apparently after the mitral valve repair, but the normal morphology of the leaflets can be regained. It seems to have similar curative effect morphologically for patients with posterior leaflet prolapse to have respect or resect strategy.
10.Tilt and decentration of intraocular lens after four-point suspension fixation and their relationship with visual prognosis
Jiafei CHEN ; Liying WANG ; Yueling ZHANG ; Zhaohui GU ; Fei XIAO
Recent Advances in Ophthalmology 2024;44(4):306-310
Objective To compare and analyze the tilt and decentration of the intraocular lens in patients receiving four-point and two-point suspension fixation,as well as their relationship with visual prognosis.Methods A total of 80 patients(80 eyes)who underwent intraocular lens suspension fixation at the Ophthalmology Department of Baoding No.1 Central Hospital from June 2021 to April 2022 were selected as the subjects.These patients were randomly divided into the experimental group(41 patients,41 eyes,underwent four-point suspension fixation)and the control group(39 patients,39 eyes,underwent traditional two-point suspension fixation).They were followed up for at least 6 months after surgery to re-cord their uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)before surgery and at the last follow-up.The tilt angle and decentration distance of the intraocular lens of patients in the two groups were measured after surger-y by a panoramic ultrasound biomicroscope.The preoperative and last follow-up UCVA and BCVA of patients in the two groups,as well as tilt angle and decentration distance of the intraocular lens after surgery,were compared,and the corre-lation between tilt angle,decentration distance and postoperative UCVA,BCVA was analyzed by Person correlation analy-sis.Results The UCVA and BCVA at the last follow-up in the experimental group and control group were better than those before surgery(all P<0.05).The difference in postoperative UCVA between the experimental group and the control group was statistically significant(t=-6.20,P=0.00),and the experimental group had better postoperative UCVA than the control group.There was no statistically significant difference in postoperative BCVA between the experimental group and the control group(t=-1.43,P=0.16).The postoperative horizontal and vertical tilt angles of the intraocular lens in the experimental group were 0.70°±0.24° and 0.60°±0.16°,respectively;while those in the control group were 2.66°± 1.40° and 3.76°±0.67°,respectively.The differences between the two groups were statistically significant(t=-8.51 and-29.42,P=0.00 and 0.00).The postoperative horizontal and vertical decentration distances of the intraocular lens in the experimental group were(0.24±0.10)mm and(0.25±0.10)mm,respectively,while those in the control group were(0.85±0.77)mm and(2.14±0.50)mm,respectively.The differences between the two groups were statistically signifi-cant(t=-4.82 and-21.68,P=0.00 and 0.00).In the experimental group,neither the horizontal and vertical tilt angles of intraocular lenses nor the horizontal and vertical decentration distances were correlated with postoperative UCVA and BCVA(all P>0.05).In the control group,the horizontal tilt angle of intraocular lenses was positively correlated with post-operative UCVA and BCVA(both P<0.05),while the vertical tilt angle was not correlated with postoperative UCVA and BCVA(both P>0.05);the horizontal decentration distance was positively correlated with postoperative UCVA and BCVA(both P<0.05),but the vertical decentration distance was not correlated with postoperative UCVA and BCVA(both P>0.05).Conclusion Both four-point suspension fixation and traditional two-point suspension fixation can effectively im-prove postoperative vision of patients,while the tilt and decentration of the intraocular lens are smaller after four-point sus-pension fixation.