ABSTRACT:Objective To investigate the clinical value and application indications of the second biopsy-cervical conization in the diagnosis and treatment of cervical lesions.Methods We selected 413 patients from Department of Gynecology and Obstetrics,General Hospital of Jinan Military Command,who received cervical multi-point biopsy pathology IA for cervical cancer and cervical conization (LEEP knife)of the second biopsy between January 2012 and October 2015.Their data were retrospectively analyzed.Results Compared with cervical multi-point biopsy, the second biopsy-cervical conization after operation had pathological upgrade in 10.65% (44/413),agreement in 73.37% (303/413),and reverse (pathological levels drop and overcast)in 15.98%(66/413).Cervical multi-point biopsy and the second biopsy-cervical conization significantly differed in the diagnosis of cervical low-level intraepithelial lesion,high-grade intraepithelial lesions,and early invasive cancer (IA)(T=21.740,v=3-1=2,P<0.05).Before conization high-risk type HPV infection positive rate was 71.91%(297/413);after operation it was 86.36% (38/44)in upgrade pathology and 70.20% (259/369)in non-upgrade one.And thin prep cytologic test (TCT)showed that the positive rate (ASC-US and above)was about 87.89% (363/413), of which about 11.85% (43/363)was pathological upgrade after conization.The positive rates of high-risk type HPV infection and TCT result (ASC-US and above)in cervical lesions differed significantly between pathological upgrade and non-upgrade after conization (χ2=5.092,P<0.05,χ2=4.476,P<0.05).Conclusion The second biopsy-cervical conization technique as a means of reevaluation of cervical pathological changes in diagnosis and treatment of cervical biopsy under colposcopy can significantly improve diagnosis rate,reduce misdiagnosis and occult cervical cancer,but its clinical application has some indications.

Objective To evaluate and testify the diagnostic efficacy of the ADC value of the diffusion-weighted imaging (DWI) in prostatic peripheral zone cancer. Methods There were 40 patients with prostatic diseases proved by ultrasound guided systemic biopsy. DWI scans were performed with 1.5T MR scanner using TOSORPA coil and b value of 800 s/mm2. The peripheral zones of prostate were divided in six areas and were attributed to noncancerous and cancerous areas according to the results of biopsy. The minimal ADC values of each peripheral zone were recorded and analyzed. Results There were 240 areas, in which 89 areas were cancerous and the others were noncancerous. The mean ADC value of cancerous areas was (0.98±0.30)×10-3 mm2/s, while the noncancerous areas was (1.59±0.29)×10-3 mm2/s. The diagnostic sensitivity, specificity and accuracy were 80.58%, 92.42% and 86.73% respectively with cutoff point ≤1.24×10-3 mm2/s, whereas 66.56%, 96.95% and 86.26% respectively with cutoff point ≤1.04×10-3 mm2/s. The diagnostic sensitivity was 98.63%, the specificity was 37.07%, the accuracy was 58.82% with cutoff point <1.69×10-3 mm2/s. Conclusion The ADC value ≤1.24×10-3 mm2/s should be regarded as the diagnostic standard of prostate cancer. When ADC value is between (1.04-1.24)×10-3 mm2/s, some cancer might be missed.

Objective To evaluate collateral flows using vessel encoded arterial spin labeling (VE-ASL) perfusion imaging. MethodsVE-ASL was achieved to assess the presence and function of collateral flow on patients with internal carotid artery (ICA) stenosis. The presence of the anterior and posterior collateral flow was demonstrated by flow patterns of the A1 segment and posterior communicating artery (PCoA).Distal function of collateral flow of stenotic hemisphere was categorized as adequate ( cerebral blood flow ≥10 ml · min-1·100 g-1 ) or deficient (cerebral blood flow < 10 ml · min-1· 100 g-1 ). The results were compared with magnetic resonance angiography (MRA) and intraarterial digital subtraction angiography (DSA) in crosstable by using Kappa values. The VE-ASL before and after ICA stent therapy were compared. ResultsThe Kappa values of the flow patterns of AI segment and PCoA between VE-ASL and MRA were 0. 746 and 0. 700. The Kappa value of the function of collaterals using VE-ASL and DSA was914. VE-ASL showed collateral flow via leptomeningeal anastomoses. VE-ASL changed significantly after ICA steat therapy. ConclusionVE-ASL reveals the presence and distal function of collateral flow, which helps to evaluate the efficacy of ICA steat therapy.

Objective To evaluate a noninvasive vessel encoded imaging for selective mapping of the flow territories of the left and right internal carotid arteries and vertebral-basilar arteries. Methods Seven volunteers [(33.5±4.1) years ; 3 men, 4 women] and 6 patients [(55.2 ± 3.2) years; 2 men,4women] were given written informed consent approved by the institutional review board before participating in the study. A pseudo-continuous tagging pulse train is modified to encode all vessels of interest. The selectivity of this method was demonstrated. Regional perfusion imaging was developed on the same arterial spin labeling sequence. Perfusion-weighted images of the selectively labeled cerebral arteries were obtained by subtraction of the labeled from control images. The CBF values of hemisphere, white matter, and gray matter of volunteers were calculated. The vessel territories on patients were compared with DSA. The low perfusion areas were compared with high signal areas on T2-FLAIR. Results High SNR maps of left carotid, right carotid, and basilar territories were generated in 8 minutes of scan time. Cerebral blood flow 100 g-1 were in agreement with data in the literature. Vessel encoded imaging in patients had a good agreement with DSA. The low perfusion areas were larger than high signal areas on T2-FLAIR. Conclusion We present a new method capable of evaluating both quantitatively and qualitatively the individual brain-feeding arteries in vivo.