Objective To state and analyze collateral vessels in patients with cirrhosis and portal hypertension with multislice spiral CT (MSCT).Methods 203 cases of cirrhosis and portal hypertension were included in the study and undergone upper abdomen examination with MSCT.Results 612 collateral vessels were demonstrated in this group: lower esophageal varices in 175, paraesophageal varices in 49, including greatly dilated azygos or hemiazygos veins and showing mediastinal pseudotumors in 13, gastric fundic varices in 119, left gastricvarices in 105, gastrorenal shunts in 34, splenorenal shunts in 15, paravertebral varices in 16, reopened umbilical vein in 48, reopenedparaumbilical vein in 22, reopened umbilical vein and paraumbilical vein in 4, abdominal wall varices and caput medusa sigh in 12, portalvein cavernous transformation in 8, greatly dilated right posterior portal vein connecting the inferior vena cava in 4 and left gastric veindirectly connected with the left portal branch in 1. Conclusion MSCT can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension. An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease, and may play a significant role in making a clinical treatment plan.

Objective:To evaluate the value of multi-slice computed tomography(CT) in differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma.Methods: The CT images of 47 patients with renal cell carcinoma(RCC) were reviewed.The RCC patients were divided into 2 groups pathologically,including 37 cases of clear cell RCC and 10 cases of papillary RCC.Plain scan and three phase(corticomedullary,nephrographic and excretory phases) CT were performed in all patients.Age and sex of patients,tumor size,enhancement degree and pattern(homogeneous,heterogeneous and predominantly peripheral),the presence of calcification or cystic degeneration(necrotic or hemorrhagic areas within the tumor) and tumor spreading(including perinephric change,venous invasion and lymphadenopathy) were compared between the 2 subtypes.Results: The degrees of enhancement were significantly different between the 2 subtypes in the corticomedullary,parenchymal and excretory phases(P

Objective To improve the level of diagnosis and differentiation of renal benign mass with renal cell carcinoma(RCC),so as to lower the misdiagnosis rate.Methods This study included 9 cases of benign renal mass,whose age ranged from 30 to 76 years with a mean of 54 years and included 52 patients with RCC.Three subtypes of RCC were noted,including clear cell in 37 cases,papillary RCC in 10 cases and chromophobe RCC in 5 cases.Plain scan and three phase CT(corticomedullary,nephrographic and excretory phases)were done in all patients.The CT features of RCC and benign mass were compared.Results All the cases were underwent radical nephrectomy as RCC,while they were postoperatively diagnosed as benign renal mass.There were 4 cases of angiomyolipoma (AML)with minimal fat,two cases of oncocytoma,one case of leiomyoma,one case of inflammatory pseudotumor,and one case of cyst with hematoma and organization.Fifty-two cases of RCC showed homogenous or inhomogeous,equal,slightly lower,slightly higher or mixed density on unenhanced scan,inhomogenous obvious enhancement after administration of contrast media.And the most obviously enhanced portion of renal carcinomas were isodense or slightly hyperdense relative to adjacent renal cortex in corticomedullary phase.Conclusion CT is an important radiologic approach to diagnose and differentially diagnose malignant or benign kidney mass.For those patients with benign mass that is not a typical case on radiology,the preoperative needle biopsy or intraoperative frozen section pathological diagnosis is the key to avoid misdiagnose and mistake resection of the kidney,and choose the proper treatment approach to avoid unnecessary kidney radical resection.

Objective To investigate the influence factors on the graft hemodynamics after liver transplantation by CT perfusion(CTP).Methods Thirty three liver recipients received CT angiography (CTA)and CTP after liver transplantation.The cases would be excluded when their peak values of the aorta enhancement on time-density curves were out of 95%confidence level.The 95% confidence levels of the hepatic artery perfusion(HAP),portal vein perfusion(PVP),total liver perfusion(TLP)and hepatic perfusion index(HPI)were calculated based on the recipients without postoperative complications and named them as references to those with complication.Results Twenty nine recipients were enrolled in the study.15 of them had no postoperative complication while the other 14 had.The 95% confidence levels of HAP,PVP,TLP and HPI on the 15 recipients without complications were(0.1509-0.3183),the 14 cases with complications.HAP decreased in 7 cases,5 of them had hepatic artery stenosis and 3 of them had splenomegaly.HAP increased in 2 cases.both of them had portal vein stenosis.PVP decreased in 13 cases,8 of them had portal vein stenosis,portal vein thrombosis or occlusion,4 of them had splenorenal shunts and 2 of them had fatty liver.TLP decreased in 12 cases and coincident with PVP decreasing.Only 2 cases had HPI decreasing accompanied with HAP decreasing.Conclusion The hepatic blood perfusion through the hepatic artery and portal vein could be quantitatively measured non-invasively by CTP.The severity and the subtypes of the hepatic ischemia could be evaluated objectively,which is helpful for treatment guidance.

Objective To compare the diagnostic value of MRE and DWI in staging hepatic fibrosis in pa-tients with CHB. Methods In this retrospective analysis ,we investigated 93 patients with CBH and live fibrosis. Ninety-three patients were grouped according to their pathological grading of fibrosis ,from S0 to S4. Sixteen healthy patients were enrolled as the control group. Spearman correlation analysis was used to analyze the correla-tion between the stiffness and ADC value and their staging fibrosis. ROC analysis was conducted to compare the per-formance of the stiffness and ADC value in staging hepatic fibrosis. Results Both liver stiffness value(r=0.962, P<0.01)and ADC value(r=-0.823,P<0.01)were highly correlated with the stage of liver fibrosis. The area un-der ROC(AUC)for the detection of≥S1≥S2/≥S3/S4 stage fibrosis with the stiffness and ADC value were 0.963/0.868、0.995/0.947、0.998/0.948、0.996/0.889 respectively ,with statistically significant differences (P < 0.05 , resectively). Conclusions MRE and DWI have higher value ,and MRE is more accurate than DWI for staging hepatic fibrosis in patients with CHB.

Objective To investigate the relationship between apparent diffusion coefficient (ADC) values and histopathological grading of cerebral gliomas.Methods A retrospective analysis was performed to investigate the clinical data of 76 patients with cerebral gliomas,admitted to our hospital from April 2013 to December 2016.According to Classification Criteria of Central Nervous System Tumors by WHO in 2016,these 76 patients were divided into low grade cerebral glioma group (grading Ⅰ-Ⅱ,n=21),moderate grade cerebral glioma group (grading Ⅲ,n=23) and high grade cerebral glioma group (grading Ⅳ,n=32).MR imaging,enhanced MR imaging and diffusion weighted imaging (3.0T,b value:1000 s/mm2) were performed to detect the ADC values.One-way ANOVA was used to compare ADC values between the 3 different histopathological groups.Spearman correlation analysis was used to analyze the correlation between histopathological grading of cerebral gliomas and ADC values.A receiver operating characteristic curve (ROC) analysis was performed to evaluate the diagnostic efficiency of ADC values.Results The ADC values of low grade,moderate grade and high grade cerebral gliomas were (1.37±0.26)×103 mm2/s,(0.97±0.11)×103 mm2/s,(0.75±0.13)×10-3 mm2/s,respectively;statistically significant differences were observed between each two groups (P＜0.05).There was a negative correlation between ADC values and histopathological grading of cerebral gliomas (r=-0.868,P=-0.000).ROC analysis showed that the optimal cutoff point of ADC values was 1.11 × 10.3 mm2/s in diagnosing low grade cerebral gliomas,enjoying sensitivity and specificity of differential diagnosis of 95.2％ and 96.4％;ROC curve showed that the optimal cutoffpoint of ADC values was 0.93×10-3 mm2/s in diagnosing high cerebral gliomas,enjoying sensitivity and specificity of differential diagnosis of 81.8％ and 93.7％.Conclusion ADC values are important for predicting histopathological grading of cerebral gliomas.

In recent years, the development of bispecific antibodies (bsAbs) has been rapid, with many new structures and target combinations being created. The boom in bsAbs has led to the successive issuance of industry guidance for their development in the US and China. However, there is a high degree of similarity in target selection, which could affect the development of diversity in bsAbs. This review presents a classification of various bsAbs for cancer therapy based on structure and target selection and examines the advantages of bsAbs over monoclonal antibodies (mAbs). Through database research, we have identified the preferences of available bsAbs combinations, suggesting rational target selection options and warning of potential wastage of medical resources. We have also compared the US and Chinese guidelines for bsAbs in order to provide a reference for their development.