ObjectiveTo analyze the CT appearances of primary pulmonary non-Hodgkin lymphoma(PPNHL)in order to improve its diagnosis.MethodsCT manifestations of 19 cases with PPNHL confirmed by pathology and clinical follow-up were retrospectively analyzed.ResuitsNodules 7 cases and masses 8 cases in PPNHL were ill-defined and markedly enhanced,in which air bronchogram was commonly seen.Muhiple patchy areas distributed in the bilateral lungs were found in 9 cases.Consolidation 7 cases was lobar and markedly enhanced,in which air bronchogram was commonly seen.Interstitial change manifested as bilateral diffuse ground-glass opacities and reticular shadow was found in 1 case.Mixed imaging manifestations were detected in 10 cases.Pleural effusion 4 cases was uncommon.Conclusion CT manifestations of PPNHL are varied,but some specific imaging features still exist,CT examination combined with clinical manifestations is helpful for the diagnosis of PPNHL.

Congresses as Topic ; Head ; surgery ; Neck ; surgery ; Otolaryngology

Objective To investigate the CT features of pulmonary sarcoidosis.Methods Ninety patients with histologically proved pulmonary sarcoidosis were retrospectively studied by using CT scans and clinical recording.Results The main CT findings of pulmonary sarcoidosis were nodules which were seen in 69 cases(76.7%),and the nodules mostly distributed around the bronchovascular bundle(n=37, 41.1%).Other abnormalities included consolidation(n=31,34.4%),ground-grass(n=39,43.3 %), thickening of bronchovascular bundle(n=30,33.3%),interlobular septal lines(n=58,64.4%), fibrosis(n=17,18.9%)including bronchial distortion(n=8,8.9%),linear shadow(n=5,5.6%), and honeycombing shadow(n=4,4.4%),air-trapping(n=3,5.3%),bronchial straitness(n=8, 8.9%),pleural thickening(n=42,46.7%),and hilar and mediastinal adenopathy(n=76,84.4%). Two or more abnormal findings co-existed in 83 cases.The pulmonary lesions co-existed with hilar and mediastinal adenopathy in 76 cases.The nodules(n=25),consolidation(n=9),ground-grass(n=11), thickening of bronehovascular bundle(n=10)were improved after therapy.Ten cases of the interlobular septal(10/22),0 of bronchial distortion(0/4),1 case of diffuse linear(1/3),and 0 case of honeycombing(0/2)were improved.Conclusion CT manifestations of pulmonary sarcoidosis are varied, but has some specific radiographic features.A correct diagnosis can be made.combined with hilar and mediastinal adenopathy.

Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.

Objective: Our aims were to study the expression of p73 protein in giant cell tumor of bone, and to investigate its function in the carcinogenesis and development of giant cell tumor of bone. Methods: The expression of p73 was detected by using S-P immunohistochemical method in 40 cases of paraffin-embedded sections of giant cell tumor of bone. Results: The positive rate of p73 in 40 patients with giant cell tumor of bone was 30.0%,and 20.0% in osteochondroma.The difference between them was not significant(P<0.05). There was significant difference between the expression of p73 in different stages of giant cell tumor of bone(P>0.05). Conclusion: The expression of p73 in giant cell tumor of bone increased prominently in this experiment. It suggests that p73 may play an important role in the carcinogenesis and development of giant cell tumor of bone, and p73 may also have a certain value for the diagnosis of giant cell tumor of bone.

Objective To evaluate multiple minimally invasive techniques in the treatment of severe acute pancreatitis (SAP).Methods The clinical data of 93 patients with SAP who received minimally invasive treatment at the First Affiliated Hospital of Harbin Medical University from January 2005 to July 2010 were retrospectively analyzed.Percutaneous catheter drainage (PCD),endoscopic retrograde cholangio-pancreatography (ERCP),endoscopic sphincterotomy (EST),endoscopic nasobiliary drainage (ENBD) and laparoscopy were applied according to the condition of the patients.The efficacies of different treatment methods were evaluated.Results On the basis of comprehensive treatment,32 patients received 1 kind of minimally invasive treatment,41 patients received 2 kinds of minimally invasive treatment,14 patients received 3 kinds of minimally invasive treatment and 6 patients received 4 kinds of minimally invasive treatment.Sixty-nine patients received ultrasoundguided PCD; 28 patients received ERCP,EST and (or) ENBD; 29 patients received laparoscopy; 19 patients received treatments with stepped approach; 4 patients were complicated with abdominal bleeding,and received interventional treatment.The mean time of abdominal pain relief and duration of hospital stay were (37 ± 18)hours and (31 ±21 )days,respectively.The abdominal infection rate,laparotomy transfer rate,curative rate and mortality rate were62％(58/93),4％(4/93),91％ (85/93) and 9％ (8/93),respectively.Conclusion Multiple minimally invasive techniques combined with individualized treatment may significantly improve the curative rate of SAP.

Objective To evaluate the diagnostic value of cardiac magnetic resonance imaging (CMRI) for pulmonary arterial hypertension(PAH).MethodsOne hundred and thirty patients with PAH confirmed by right cardiac catheterization were examined by CMRI and the results were compared with that of 31 healthy control participants.The main pulmonary artery diameter( MPAD),aortic diameter( AOD),main pulnonary arterydiameter/aorticdiameter(MPAD/AOD), rightventricular end-diastolicvolume ( RVEDV ),right ventricular end-systolic volume ( RVESV),right ventricular ejection fraction (RVEF) and right ventricular mass (RVM) were measured.The independent samples t-test was used to compare the PAH group with the control group.The Pearson correlation analysis and linear regression analysis were used to evaluate the relationship between cardiac and arterial measurements and pulmonary arterial pressure (PAP).ResultsThe MPAD,MPAD/AOD,RVEDV,RVESV,RVM in PAH group[ (3.88 ±0.57) cm,1.36 ±0.17,(161.63 ±56.37) ml,( 112.61 ±41.46) ml,(82.70 ± 20.73) g,respectively ] were increased compared with those in normal control group[ (2.74 ±0.31 ) cm,0.90 ±0.07,( 131.31 ± 15.14) ml,(61.33±9.00) ml,(44.39±5.87) g,respectively].The RVSV and RVEF in PAH group[(49.02 ±19.20) ml,( 30.76 ± 5.85 ) ％,respectively ] were decreased compared with those in normal control group [ (69.95 ± 9.63 )ml,(53.28 ± 4.14 )％,respectively ].The MPAD,MPAD/AOD,RVEDV,RVESV,RVSV,RVEF,RVM were significantly different between PAH patients and control participants(tMPA =10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,respectively,P＜0.01).There were no significant correlations between MPAD,RVEDV,RVESV,RVSV and PAP (r=0.299 for MPAD,r =0.127 for RVEDV,r=0.278 for RVESV,r =-0.229 for RVSV).Moderate positive correlations were found between MPAD/AOD, RVM and PAP (r =0.702 for MPAD/AOD,r =0.683 for RVM ).A moderate negative correlation was found between RVEF and PAP (r=-0.660).Conclusion CMRI is an excellent imaging modality for the diagnosis of PAH. The MPAD/AOD,RVM,and RVEF can be used to indicate the severity of PAH.

Objective To evaluate the feasibility of perfusion weighted imaging (PWI) in the differentiation of recurrent glioma and radiation-induced brain injuries. Methods Fifteen patients with previously resected and irradiated glioma, presenting newly developed abnormal enhancement, were included in the study. The final diagnosis was determined either histologically or clinicoradiologically. PWI was obtained with a gradient echo echo-planar-imaging (GRE-EPI) sequence. The normalized rCBV ratio[CBV(abnormal enhancement)/CBV(contralateral tissue)], rCBF ratio[CBF(abnormal enhancement)/CBF(contralateral tissue)]and rMTT ratio[(MTT abnormal enhancement)/MTT(contralateral tissue)]were calculated, respectively. The regions of interest (ROIs) consisting of 20-40 mm2 were placed in the abnormal enhanced areas on postcontrast T1-weighted images. Ten to fifteen ROIs measurements were performed in each lesion and the mean value was obtained. Mann-Whitney test was used to determine whether there was a difference in the rCBV/rCBF/MTT ratios between glioma recurrence and radiated injuries. Results Nine of the 15 patients were proved recurrent glioma,6 were proved radiation-induced brain injuries. The mean rCBV ratio[2.87(0.70-4.91)]in glioma recurrence was markedly higher than that[0.70(0.12-1.62)]in radiation injuries (Z=-2.55,P＜0.05). The mean rCBF ratio[1.89(0.64-3.96)]in glioma recurrence was markedly higher than that[0.56(0.12-2.08)]in radiation injuries (Z=-2.08,P＜0.05). The areas under rCBV and rCBF ROC curve were 0.893 and 0.821. If the rCBV ratio ≤0.77, the diagnosis sensitivity of radiation-induced brain injuries was 100.0%;If ≥2.44, the diagnosis specificity of recurrent glioma was 100.0%. Conclusion PWI was an effective technique in distinguishing glioma recurrence from radiation injuries and rCBV and rCBF ratios were of great value in the differentiation.

Objective To explore the incidence and risk factors of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical data of 72 cases allo-HSCT from Oct 2004 to Dec 2008 were analyzed. Thirteen factors possibly correlated with the development of aGVHD were analyzed. Results aGVHD was developed in 32 cases (44.4 %), in which grades Ⅰ aGVHD was 11.1%, gradesⅡaGVHD was 18.1%, and grades Ⅲ-Ⅳ aGVHD was 15.3 %. The univariate analysis showed that diagnosis, the status of disease, use ATG, conditioning regimen, donor type,ABO blood group disparity between donor and recipient, CD34+ cell number, early engraftment and neutropenic infection, HLA locus were associated with the occurence of aGVHD (P ＜0.1). On the COX regression mode, an increased risk of aGVHD was associated with HLA mismatch (HR =2.58, P ＜0.005), GVHD prophylaxis without ATG (HR =2.94, P ＜ 0.001), and unrelated donor (HR =1.97, P ＜0.01). Conclusion aGVHD is a common complication after allo-HSCT, and HLA mismatch and unrelated donor are independent risk factors for aGVHD.

Objective To verify the inter-rater reliability,intra-rater reliability and internal reliability of the action research arm test(ARAT)in patients with chronic stroke.Methods 30 people with chronic stroke were tested with the ARAT by two experienced raters.The inter-rater reliability,intra-rater reliability and internal reliability were examined.Results The ARAT showed high inter-rater reliability and intra-rater reliability(ICC=0.992 and 0.987,respectively)and internal consistency(Cronbach's alpha coefficient=0.936).Conclusion The ARAT shows good inter-rater reliability,intra-rater reliability and internal reliability in assessing patients after stroke.