1.Preoperative Assessment of Vascular Invasion in Pancreatic Cancer——Value of CT
Zixing HUANG ; Guangwen CHEN ; Bin SONG
Chinese Journal of Bases and Clinics in General Surgery 2008;0(11):-
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer.Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years.Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer.There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels,on the degree of circumferential contiguity of tumor to vessel,on the degree of lumen stenosis,and on the degree of contiguity between tumor and vessels combined vascular caliber.Conclusion CT grading criteria are not uniform,each one has defects.
2.CT Radiological Anatomy of Adult Groin Region
Shuang ZHAO ; Zixing HUANG ; Rongbo LIU ; Ying ZHOU
Chinese Journal of Bases and Clinics in General Surgery 2003;0(06):-
Objective To investigate the application of multi-detector row spiral CT(MDCT)and multi-planer reconstruction(MPR)in identify the anatomy detail of normal adult groin region.Methods We retrospectively collected the CT images of 50 adult subjects with normal groin anatomic structure underwent groin region thin-slice MDCT scans between July and December 2009,30 males and 20 females,obtained the coronal and sagittal views by MPR,investigated the value of different plans in identifying anatomic detail.Results Bilateral inferior epigastric artery(100/100,100%),spermatic cord(60/60,100%),and round ligament of uterus(40/40,100%)were well identified on all plans in all subjects.The bilateral "radiological femoral triangle" could be demonstrated on coronal views in all subjects(100/100,100%).The bilateral inguinal ligament were visible on coronal view in all subjects(100/100,100%)and on sagittal views in 34 subjects(68/100,68%),but on axial views was identified in 3 male subjects(6/100,6%).The bilateral inguinal canal and deep inguinal ring were reliably visible on coronal views in all subjects(100/100,100%),and on sagittal views in 46 subjects(92/100,92%).On coronal views,the widths of inguinal canal was(0.97?0.35)cm in left,(0.89?0.23)cm in right for males,and(0.62?0.11)cm in left,(0.71?0.11)cm in right for females.No significant difference was found between two sides(P=0.059 in males,P=0.067 in females),but there were significant differences between males and females(P=0.007 in left,P=0.009 in right).Transverse diameter of deep inguinal ring was(1.32?0.31)cm in left,(1.31?0.36)cm in right for males,and(1.07?0.35)cm in left,(1.07?0.30)cm in right for females.No significant difference was found between two sides(P=0.344 in males,P=0.638 in females),but there were significant differences between males and females(P=0.001 in left,P=0.002 in right).Conclusion MDCT with different plans plays an important role in identify the anatomic details of groin region,the coronal views especially.
3.Observation of the Effects of Astragulus Injection on Cardiac Function in Myocardial Infarction Convalescents
Huayun ZHAO ; Jieling HUANG ; Weiqiang CHEN ; Zixing LUO
China Pharmacy 1991;0(01):-
OBJECTIVE:The effects of Astragulus injection on cardiac function in myocardial infarction convalescents were observed.METHODS:42 cases were randomly divided into two groups(therapeutic group and control group).21 cases in therapeutic group were treated with routine treatment and 21 cases in control group were treated with Astragulus injection on the basis of routine treatment for three weeks.The ejection fraction(EF),early diastolic peak velocity of blood flow(E),late diastolic peak velocity of blood flow(A) and A/E of all patients were measured with pulse ultrasonic Doppler cardiography before and after the treatment.RESULTS:After the treatment,the EF,E and A/E were improved (P
4.Mortality outcomes of low-dose computed tomography screening for lung cancer in urban China: a decision analysis and implications for practice
Wang ZIXING ; Han WEI ; Zhang WEIWEI ; Xue FANG ; Wang YUYAN ; Hu YAODA ; Wang LEI ; Zhou CHUNWU ; Huang YAO ; Zhao SHIJUN ; Song WEI ; Sui XIN ; Shi RUIHONG ; Jiang JINGMEI
Chinese Journal of Cancer 2017;36(8):367-379
Background:Mortality outcomes in trials of low-dose computed tomography (CT) screening for lung cancer are inconsistent.This study aimed to evaluate whether CT screening in urban areas of China could reduce lung cancer mortality and to investigate the factors that associate with the screening effect.Methods:A decision tree model with three scenarios (low-dose CT screening,chest X-ray screening,and no screening) was developed to compare screening results in a simulated Chinese urban cohort (100,000 smokers aged 45-80 years).Data of participant characteristics were obtained from national registries and epidemiological surveys for estimating lung cancer prevalence.The selection of other tree variables such as sensitivities and specificities of low-dose CT and chest X-ray screening were based on literature research.Differences in lung cancer mortality (primary outcome),false diagnoses,and deaths due to false diagnosis were calculated.Sensitivity analyses were performed to identify the factors that associate with the screening results and to ascertain worst and optimal screening effects considering possible ranges of the variables.Results:Among the 100,000 subjects,there were 448,541,and 591 lung cancer deaths in the low-dose CT,chest X-ray,and no screening scenarios,respectively (17.2% reduction in low-dose CT screening over chest X-ray screening and 24.2% over no screening).The costs of the two screening scenarios were 9387 and 2497 false diagnoses and 7 and 2 deaths due to false diagnosis among the 100,000 persons,respectively.The factors that most influenced death reduction with low-dose CT screening over no screening were lung cancer prevalence in the screened cohort,low dose CT sensitivity,and proportion of early-stage cancers among low-dose CT detected lung cancers.Considering all possibilities,reduction in deaths (relative numbers) with low-dose CT screening in the worst and optimal cases were 16 (5.4%) and 288 (40.2%) over no screening,respectively.Conclusions:In terms of mortality outcomes,our findings favor conducting low-dose CT screening in urban China.However,approaches to reducing false diagnoses and optimizing important screening conditions such as enrollment criteria for screening are highly needed.
6.Diagnostic value of quantitative dual-source CT dual-energy iodine maps combined with morphological CT features in assessing histological subtypes of lung cancer
Xiaoli XU ; Xin SUI ; Wei ZHONG ; Yan XU ; Zixing WANG ; Lan SONG ; Yao HUANG ; Xiao WANG ; Zhengyu JIN ; Wei SONG
Chinese Journal of Radiology 2018;52(11):823-828
Objective To investigate the clinical usefulness of quantitative dual-source dual-energy CT (DECT) iodine enhancement metrics combined with morphological CT features in distinguishing different lung cancer subtypes. Methods One hundred and sixty-two consecutive patients suspected with lung cancer were prospectively enrolled and underwent DECT in arterial phase prior to biopsy or surgery.Tumor histological subtypes were determined in 110 patients. Two radiologists interpreted CT morphologic features of 110 lesions in a consensual manner. In addition, two radiologists independently contoured lesions and placed regions of interest in descending aorta or subclavian artery on the same section for normalization , from which automated computer measurements were generated:iodine density and iodine ratio (the ratio of iodine density of lesion to that of artery on the same section). DECT metrics and morphological CT features were compared among different lung cancer subtypes. Chi-square was used to compare qualitative parameters. One way ANOVA was used to compare quantitative parameters satisfying normal distribution, while those parameters not satisfying normal distribution or ranked data were compared by Kruskal-Wallis rank sum test. Multinomial logistic regression models were used to differentiate the histological subtypes of lung cancer: adenocarcinoma, squamous cell carcinoma (SCC), small cell lung cancer (SCLC). Results There were 48 cases of adenocarcinomas, 36 cases of SCC and 26 cases of SCLC. In analysis of CT features, tumor diameter, distribution, spiculation, pleural retraction, vascular involvement, confluent mediastinal lymphadenopathy, encasement of mediastinal structures and enhancement heterogeneity showed statistical difference (all P<0.05). The diameter of SCC[(5.73 ± 3.67)cm] and SCLC [(6.08 ± 4.39)cm] were larger than adenocarcinoma [(3.75 ± 2.80 cm)] (H=13.806,P<0.05). Adenocarcinomas were mostly located in the periphery (31 cases), while SCC (26 cases) and SCLC (21 cases) were mainly centrally located. Spiculation was mostly found in adenocarcinoma (44 cases) rather than SCLC (13 cases). Pleural retraction was mostly observed in adenocarcinoma (36 cases) rather than SCC (10 cases) and SCLC (5 cases). Vascular involvement was mostly found in SCLC (19 cases) rather than adenocarcinoma (15 cases). Confluent mediastinal lymphadenopathy was more frequently found in SCLC (15 cases) compared with adenocarcinoma (3 cases) and SCC (4 cases). Encasement of mediastinal structures was mostly found in SCLC (13 cases) rather than adenocarcinoma (7 cases). Homogeneous enhancement was more frequently found in SCLC (10 cases) than SCC (6 cases). No significant differences were observed in other CT features between any other two groups. Iodine density and iodine ratio were statistically different among these three subtypes lung cancer (H=16.817,20.338,P<0.001). Iodine density of adenocarcinoma and SCC was (1.50±0.80) and (1.40± 0.40) mg/ml, respectively, higher than the (1.20±0.40) mg/ml for SCLC (P<0.01). Iodine ratio of adenocarcinoma and SCC was (16.10 ± 7.02)%and (15.05 ± 4.62)%, respectively, higher than the (11.55 ± 3.15)% for SCLC (P<0.01). No significant difference was observed between adenocarcinoma and SCC. Accuracy of the model based on CT features was 69.1%, accuracy of the model based on CT features combined with DECT parameters was 80.9%. Conclusions Quantitative DECT metrics are different among adenocarcinoma, SCC and SCLC, when combined with morphological CT features, higher diagnostic accuracy can be achieved.