1.Clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma
Shasha ZHANG ; Mingcan WU ; Ning HU ; Pengcong LU
Chinese Journal of Primary Medicine and Pharmacy 2020;27(18):2188-2191
Objective:To evaluate and analyze the clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma.Methods:A total of 40 patients with cirrhosis admitted to Yuyao People's Hospital from January 2017 to June 2018 were enrolled in this study.MRI scan, Gd-EOB-DTPA dynamic enhanced scan and hepatobiliary specific scan were performed in these patients, and their magnetic resonance images were analyzed.All patients underwent magnetic resonance examination and were given surgery or needle biopsy to detect their pathological results.According to the signal intensity of hepatobiliary specific lesions, the patients were divided into three groups: low signal, mixed signal and other signals, and the results were compared with pathological grades of postoperative specimens.Results:After 40 patients with cirrhosis received MRI and dynamic contrast-enhanced scans, 136 nodules were diagnosed as cirrhotic regenerative nodules or hyperplastic nodules.Thirty-four patients were diagnosed with small hepatocellular carcinoma, and 42 small liver cancers were found after combined with Gb-EOB-DTPA hepatobiliary specific scan, the difference was statistically significant (χ 2=8.962, P<0.05). There was statistically significant difference between the signal intensity and pathological grade of 42 cases with hepatocellular carcinoma.There were no statistically significant differences in tumor size and pathological grade. Conclusion:For patients with clinically suspected hepatocellular carcinoma, Gd-EOB-DTPA magnetic resonance imaging is helpful to early detection of cirrhotic nodules and small liver cancer with malignant tendency, and can improve the accuracy of clinical diagnosis of diseases.
2.Comparison of clinical value of ultrasonography, MSCT and MRCP in early diagnosis of cholelithiasis
Lihua MAO ; Weigen YAO ; Pengcong LU ; Shasha ZHANG ; Wen HU
Chinese Journal of Primary Medicine and Pharmacy 2020;27(21):2605-2608
Objective:To compare the clinical value of ultrasonography, multi-slice spiral computed tomography(MSCT) and magnetic resonance cholangiopancreatography(MRCP) in the early diagnosis of cholelithiasis.Methods:The clinical data of 140 patients with suspected cholelithiasis treated in Yuyao People's Hospital from January 2017 to March 2019 were reviewed.All the patients were examined by ultrasonography, MSCT and MRCP.Based on the results of operation, the diagnostic results of ultrasonography, MSCT and MRCP were compared, and the consistency between the diagnostic results was analyzed.Results:Of 140 patients with suspected cholelithiasis, 100 cases were confirmed to be cholelithiasis by operation.The sensitivity, specificity and accuracy of MRCP were 97.00%(97/100), 95.00%(38/40) and 96.43%(135/140), which were higher than those of ultrasonography[87.00% (87/100), 80.00%(32/40), 85.00%(119/140)] and MSCT[89.00%(89/100), 77.50%(31/40) and 85.71%(120/140)](χ 2=6.794, 4.114, 10.854, χ 2=4.916, 5.165, 9.882, all P<0.05). The consistency between MRCP and surgical diagnosis was good, but the consistency between ultrasound, MSCT and surgical diagnosis was moderate. Conclusion:The accuracy of MRCP is better than ultrasound and MSCT in the diagnosis of cholelithiasis, which has good diagnostic value and can reduce the missed diagnosis and misdiagnosis of cholelithiasis.
3.Comparison of the clinical value of MRI and enhanced CT in the diagnosis of liver cancer
Shasha ZHANG ; Mingcan WU ; Lihua MAO ; Ning HU ; Pengcong LU
Chinese Journal of Primary Medicine and Pharmacy 2020;27(23):2817-2820
Objective:To compare the clinical value of magnetic resonance imaging (MRI) and enhanced CT in the diagnosis of liver cancer.Methods:From January 2017 to December 2017, 72 patients with liver neoplasms who received treatment in Yuyao People's Hospital were selected as the subjects of this study.Enhanced CT scan and liver MRI scan were used in all patients respectively to compare the examination conditions of the two scanning methods for the lesions, the positive rate and accuracy of the detection, as well as the sensitivity and specificity of the two methods.Results:There was no statistically significant difference in the detection of extrahepatic lesions between the two methods(41.67% vs.36.11%, P>0.05). The detective rate of intrahepatic lesions of MRI (94.44%) was higher than that of enhanced CT(77.78%), the difference was statistically significant(χ 2=8.361, P<0.05). The missed diagnosis rate[5.56%(4/72)], misdiagnosis rate[1.39%(1/72)] of MRI were lower than those of enhanced CT[22.22%(16/72), 11.11%( 8/72)], and the accuracy of MRI[93.06%(67/72)] was higher than that of enhanced CT[66.67%(48/72)], the differences were statistically significant(χ 2=8.361, 4.354, 15.587, all P<0.05). The sensitivity[92.86%(52/56)], specificity[93.75%(15/16)] of MRI were higher than those of enhanced CT[71.43%(40/56), 50.00%(8/16)](χ 2=8.675, 7.575, all P<0.05). Conclusion:In the clinical diagnosis of liver cancer, the diagnostic accuracy of liver MRI is relatively high, which is conducive to the establishment and implementation of patients' treatment plan, and is conducive to clinical application and promotion.
4.Diagnostic value of different gradient diffusion-weighted imaging for prostate cancer
Xingguo WU ; Weigen YAO ; Pengcong LU ; Jiaju ZHENG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(9):1331-1336
Objective:To investigate the value of diffusion-weighted imaging (DWI) quantitative parameters with different b values in the diagnosis of prostate cancer and its correlation with prostate cancer diagnosis to determine the optimal b values.Methods:Forty-one patients with pathologically confirmed prostate cancer who were admitted by Yuyao People's Hospital from May 2019 to April 2021 were included in this study. Forty-seven foci were selected to undergo 1.5T MR high-resolution T 2-weighted imaging (T 2WI) and DWI. Four different b values (800, 1 000, 1 500, 2 000 s/mm 2) were applied to DWI. The apparent diffusion coefficient (ADC) values and areas of tumor region were measured on different b-value ADC maps. Tumor signal intensity and area were measured on DWI. The same area in the same layer was selected as the reference area to calculate and analyze the signal intensity. Results:The ADC values of tumor area were 0.93 ± 0.21, 0.87 ± 0.19, 0.76 ± 0.17 and 0.68 ± 0.14 when b values were 800, 1 000, 1 500 and 2 000 s/mm 2, respectively, which were significantly different from the ADC values of the reference area (1.59 ± 0.26, 1.50 ± 0.27, 1.28 ± 0.25, and 1.08 ± 1.84, t = 13.53, 13.08, 11.79, 7.30, all P < 0.01). However, there was no significant difference in the signal intensity ratio (-0.26, -0.27, -0.25, -0.22) on the ADC maps of tumor area under different b values ( P = 0.52). The DWI signal intensities of tumor region were 68.2 ± 19.1, 59.5 ± 18.8, 47.9 ± 17.7, and 50.1 ± 11.5, respectively when b values were 800, 1 000, 1 500, and 2 000 s/mm 2, respectively, which were significantly different from the DWI signal intensities of reference area (49.1 ± 17.7, 38.7 ± 11.3, 25.3 ± 6.9, 19.6 ± 4.5, t = 5.02, 6.50, 9.43, 16.93, all P < 0.01). DWI signal intensity ratio of tumor region at the b value of 800 s/mm 2 was significantly different from that at the b value of 1 000, 1 500 and 2 000 s/mm 2 (0.16 vs. 0.21, 0.30, 0.33, t = 10.84, 23.27, 22.85, all P < 0.01). DWI signal intensity ratio at the b value of 1 000 s/mm 2 was significantly different from that at the b value of 1 500 and 2 000 s/mm 2 ( t = 12.34, 14.10, both P < 0.01). Conclusion:High b-value DWI ( b ≥ 1 500 s/mm 2) has a remarkable advantage in the diagnosis of prostate cancer over low b-value DWI.