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CT features of heterotopic pancreas and its correlation with pathologic changes

Qian WANG ; Xuehua YANG ; Jianbo GAO ; Pan LIANG ; Yijuan WEI

Journal of Practical Radiology.2014;(5):815-817. doi:10.3969/j.issn.1002-1671.2014.05.025

Objective To analyze the CT findings of heterotopic pancreas and the correlation with pathologic changes.Methods CT findings in 1 9 patients with heterotopic pancreas proven by surgery were reviewed retrospectively,14 of whom were scanned with enhanced CT.The correlation of CT findings and pathologic results were also analyzed.Results All patients had a single lesion with sized range from 0.8 to 4.7 cm and mean diameter of (2.2±0.6)cm.All lesions with homogeneous density were showed on plain scans including 7 lesions in stomach,8 in duodenum,2 in jejunum,1 in ileum and 1 beside the cardiac lymph nodes.The border of the lesions in 5 was unclear with exudative changes,mimicking acute pancreatitis.A sign of central umbilical concave was found in 2.Pathological results confirmed 14 lesions in submucosa,3 in muscular layer,1 in serosal layer and 1 in abdominal cavity.Hetero-topic pancreas presented early obvious enhancement in 9,mimicking normal pancreas,which was composed chiefly of pancreatic aci-ni.The enhanced degree of 4 lesions was lower than normal pancreas,which were composed of pancreas ductal epithelium and few pancreatic acini.No significantly enhancement was seen in 1,mimicing liomyoma,which was composed chiefly of pancreas ductal epithelium and smooth muscle hyperplasia.Conclusion Heterotopic pancreas in most cases presents characteristic submucosal disea-ses-like pattern,and different enhanced patterns of heterotopic pancreas are related with the pathologic changes.

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The value of high-field-strength MRCP in diagnosing intraductal papillary mucinous neoplasms of pancreas

Haizhen QIAN ; Guangwu LIN ; Ming JI

Journal of Practical Radiology.2014;(5):812-814. doi:10.3969/j.issn.1002-1671.2014.05.024

Objective To explore the value of high-field-strength MRCP in diagnosing of intraductal papillary mucinous neoplasms (IPMNs)of pancreas.Methods Fifteen cases with IPMNs confirmed surgically and pathologically were recruited.The magnetic res-onance imaging (MRI)and MRCP findings were retrospectively analyzed.Results All cases were benign,including main pancreatic duct type (MPD)in 1,branch pancreatic duct type(BPD)in 8,and the combined type in 6.The MPD type showed diffuse dilation of main pancreatic duct which is about 14.5 mm with no enhancement.The BPD type displayed unilocular or multilocular cystic le-sions which showed communication with main pancreatic duct .The combined type demonstrated dilation of main pancreatic duct and branch pancreatic duct.The septa and mural nodule in the BPD type and the combined type were moderately enhanced.Conclusion MRCP is superior with regard to the diagnosis and classification of IPMN type and is helpful to differentiate malignant tumors from benign ones combined with routine contrast-enhanced.

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Assessment of apparent diffusion coefficient in clinicopathologic and prognostic features of rectal cancer

Weihuan HOU ; Jing REN ; Qi PAN ; Na LI ; Huijia LIU ; Xufang HUANG ; Zhenhua ZHANG ; Juntao LU ; Hong YIN ; Yi HUAN

Journal of Practical Radiology.2014;(5):795-798. doi:10.3969/j.issn.1002-1671.2014.05.020

Objective To assess the value of apparent diffusion coefficient (ADC)in clinic ,pathology and prognosis of rectal cancer. Methods The MRI and DWI findings of 109 patients with pathological proved rectal adenocarcinoma were retrospectively analyzed. DWI with b=0 s/mm2 and b= 1 000 s/mm2 were acquired.Mean tumor ADCs were measured and compared between subgroups stratified by histologic differentiation grades,T-stage,N-stage,mesorectal fascia status and presence of lymphangiovascular or peri-neral invasion.Results Mean tumor ADCs were significantly different when comparing groups stratified by histologic differentiation grades,T-stage,mesorectal fascia status and presence of lymphangiovascular invasion.Tukey’s post hoc test showed that the differences of mean ADCs between good-moderate differentiated group and moderate differentiated group(P =0.996),moderate-poor differentiated group and poor differentiated group(P =0.957)were not significant.The differences among other groups of differentia-tion grades differed significantly(P <0.05).In the T-stage groups,the mean ADCs of T1 stage tumor was significantly higher than that of T3 stage tumor(P <0.05).There were no significant differences among other T-stage groups(P >0.05).There were no sig-nificant differences among N0,N1 and N2 in N-stage groups(P >0.05).Conclusion ADC values can reflect pathologic and prognos-tic features of rectal cancer.

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MRI study of the infantile developmental dislocation of the hip

Liang WANG ; Mao SHENG ; Wanliang GUO ; Qi WANG ; Yan REN ; Yunfang ZHEN ; Yi YANG ; Junkang SHEN

Journal of Practical Radiology.2014;(4):649-652. doi:10.3969/j.issn.1002-1671.2014.04.028

Objective To investigate the diagnostic value of MRI in the infantile developmental dislocation of the hip.Methods Forty-five cases of preoperative hip MRI data of DDH (patient group)and 40 cases of normal hip (control group)MRI data were retrospectively analyzed.Three types were classified according to the standard of Dunn.Then the bony acetabular index (BAI),cartilaginous acetabular index (CAI)were measured on coronal MRI and all the intra-articular structures (articular cartilage,labrum, teres ligament and iliopsoas)in the acetabulum that impeded the reduction of the femoral head were observed.Results There were normal hips (80 hips)and dislocated hips (73 hips).In dislocated hips typeⅠ (30 hips),typeⅡ (20 hips),and typeⅢ (23 hips) were found.The values of BAI were (26.13±2.19)°and (35.87±4.42)°,CAI (13.84±1.07)°and (21.92±4.70)°for patient group and control group.The values of BAI were (31.80±1.74)°,(37.80±3.40)°and (39.17±4.11)°,CAI (17.20±2.68)°,(20.91±2.02)°and (27.50±2.78)°for the typesⅠ,Ⅱ,Ⅲ respectively.Differences of BAI and CAI between patient group and control group were showed (t=-11.048 and -9.188,P =0.000).Statistically significants were found among the typeⅠ,Ⅱ,Ⅲ(F=22.159 and 47.241,P =0.000).There were linear correlations for patient group ,control group,and the typeⅠ,Ⅱ,Ⅲ (r= 0.964,0.844,0.953,0.931 and 0.870,P =0.000).Some pathological changes such as varus labrum,thick teres ligament,iliopsoas spasm,articular cartilage hyperplasia,fat hyperplasia,joint effusion were observed in the type Ⅱand Ⅲ.Conclusion MRI is not only used for measuring the values of BAI and CAI,and a linear correlation among all kinds of DDH,but also some factors hindering the reduction of the femoral head can be found clearly.It can provide an important reference basis for the diagnosis and treatment of DDH.

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Imaging manifestations of pulmonary mucosa-associated lymphoid tissue lymphoma

Weiben WU ; Tongfu YU

Journal of Practical Radiology.2014;(4):620-622. doi:10.3969/j.issn.1002-1671.2014.04.020

Objective To investigate the imaging characteristics of pulmonary mucosa-associated lymphoid tissue(MALT)lym-phoma,in order to improve the diagnosis of this disease.Methods X-ray and CT features of 1 9 cases of pulmonary MALT lympho-ma confirmed by operation or biopsy were retrospectively analyzed.Results Among 1 9 cases,there were 4 cases with a single nod-ule,2 cases with a single consolidation,5 cases with multiple consolidations,2 cases with a single patchy shadow,4 cases with patchy consolidations,1 case with multiple patchy shadows combined with irregular cavities,and 1 case with diffused interstitial changes.Grossus air bronchogram was found in 1 1 cases with nodules,consolidations and patchs.Irregular margin was found in 1 5 cases.Spiculation was found in 3 cases.Pleural retraction was found in 2 cases.Pleural effusion was found in 3 cases.Conclusion Pulmonary MALT lymphoma can be showed as solitary nodule,patchy shadow,consolidation,cavity and diffused interstitial change.Pulmonary MALT lymphoma should be considered if such lesions combined with grossus air bronchogram,irregular mar-gin,spiculation or plural retraction..

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Application of 320-detector row CT one-stop scanning in valuation of internal cerebral veins and their tributaries

Yongheng FENG ; Min TANG ; Minggang HUANG ; Xiaoling ZHANG ; Jian LI ; Zhiqian MIN ; Xiaolong CHEN ; Changlei Lü

Journal of Practical Radiology.2014;(4):660-663. doi:10.3969/j.issn.1002-1671.2014.04.031

Objective To observe clinical significance、anatomy and variation of normal internal cerebral veins and their tributa-ries.Methods The studies included 284 sides in 142 patients.The patients were performed with 320-detector Row CT One-stop Scanning.Then,the anatomical features of internal cerebral veins and their tributaries were evaluated.Results The detection rate of internal cerebral veins(ICA)、thalamostriate veins(TSV)、septal veins(SV)、anterior caudate nucleus veins、posterior caudate nucleus veins and lateral direct veins was 100%、100%、98.9%、95.4%、93.7%、48.6%.Type of IA was seen frequently in four types of ICA,the parts of ICV and their tributaries were mirror symmetry,the majorities of ICA were located the same plane.Anterior cau-date nucleus veins were classified four types on basis of these different draining patterns,they were drained to TSV commonly.There was no significant difference between venous angle or false venous angle and type of their draining(P>0.05).There was significant difference between detection rate of lateral direct veins and development of posterior caudate nucleus veins(P<0.05).Conclusion 320-detector Row CT One-stop Scanning was an important method that internal cerebral veins were detected effectively and non-inva-sively,observed anatomy,course and morphological change of ICV.

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The optimization of portal venous system imaging with 6 4-slice spiral CT

Yindi ZHU ; Yinyin CHEN ; Liang GUO

Journal of Practical Radiology.2014;(4):656-659. doi:10.3969/j.issn.1002-1671.2014.04.030

Objective To compare the image quality of portal venous system in the patients with live cirrhosis and portal hyper-tension using two different inj ection methods,so as to investigate the optimization of imaging techniques.Methods Single-phase in-jection (group A)or biphasic injection (group B)was applied by random on 40 patients for portal venous system vascular imaging, and subsequently image quality and technical advantages between the two groups were compared and analyzed respectively.Results 1.There was no significant difference in image quality between the two groups(P>0.05),while contrast agent dosage (90 mL)in group B is less than group A(100 mL).2.The CT value of Portal vein,liver parenchyma and P-L discrepancy in group B were slightly lower than those in group A,however,no statistical difference was noted(P>0.05).After 45 second,the P-L discrepancy of group B was larger than that of group A.The peak times of portal vein,liver parenchyma and the P-L discrepancy in group B were longer than those in group A(P<0.05).3.The graph of P-L discrepancy demonstrated:the threshold interval of P-L discrep-ancy in group B was longer than that in group A.Conclusion Biphasic inj ection methods could not only afford reliable imaging quali-ty on portal venous system vascular imaging in the patients with liver cirrhosis and portal hypertension,but also lead to a less total dose of contrast agent.Therefore,it could be used as an optimal choice of imaging technology for portal venous system vascular ima-ging.

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DCE-MRI features and ADC value analysis in triple-negative breast cancer and HER-2 overexpression subtype of breast cancer

Yingying GAO ; Yan LIU ; Aimei YANG

Journal of Practical Radiology.2014;(4):606-609. doi:10.3969/j.issn.1002-1671.2014.04.016

Objective To analyze the DCE-MRI features and ADC value in triple-negative breast cancer and HER-2 overexpres-sion breast cancer,and to improve the j udgment of both characteristic in MRI.Methods To analyse the DCE-MRI imaging of TNBC and HER-2 overexpression breast cancer,measured the ADC value and compared the statistics.Results Compared with the shape, margin,the way of enhancement and ADC value of the TNBC and HER-2 overexpression breast cancer,the distinction has statisti-cally significant(P<0.05);there were no statistically significant difference among age,mass or nomass,categories of lesions and TIC,(P>0.05).Conclusion DCE-MRI features of the shape,margin,the way of enhancement and ADC values were useful for the diagnosis of TNBC and HER-2 overexpression breast cancer.

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Diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease:a Meta-analysis

Jing ZHAO ; Pan XU ; Honghan GONG ; Lin WU

Journal of Practical Radiology.2014;(4):593-599. doi:10.3969/j.issn.1002-1671.2014.04.013

Objective To evaluate the value of stress perfusion cardiovascular magnetic resonance in the diagnosis of coronary ar-tery disease.Methods Relevant literatures about stress perfusion cardiovascular magnetic resonance in the diagnosis of coronary ar-tery disease were searched.According to the recommended contents of the Cochrane Collaboration,we set inclusion criteria and screen literatures.Using software STATA 12.0 and Meta-disc 1.4,we analyzed the data ,including the heterogeneity,publication bias,subgroup analysis,Meta-regression,clinical application,pooled sensitivity(SEN),specificity(SPE),positive likelihood ratio (PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR)and 95%confidence interval(95%CI),we drew the summary receiver operating characteristic curve(SROC)and calculated the area under the curve(AUC).Results Twenty-nine literatures were included,the pooled SEN,SPE,PLR,NLR,DOR and 95%CI were 0.90(0.89~0.92)、0.78(0.75~0.80)、4.03(3.32~4.91)、0.14 (0.11~0.18)、32.54(22.25~47.60)respectively.The AUC of SROC was 0.907 8.Conclusion The current evidence indicates that stress perfusion cardiovascular magnetic resonance has a high diagnostic accuracy for detection coronary artery disease.However, the relatively high false positive rate was found due to the medium specificity.

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The application of 6 4-slice spiral CT cardiac enhancement scanning in the morphological assessment of left atrial appendage

Yankun YANG ; Hong ZHENG ; Xin SUN ; Zhengming XU ; Xinling YANG ; Bin Lü

Journal of Practical Radiology.2014;(4):584-587. doi:10.3969/j.issn.1002-1671.2014.04.011

Objective To explore the application value of 64-slice spiral CT cardiac enhancement scanning in the morphological as-sessment of left atrial appendage(LAA).Methods Patients were selected retrospectively between April 16,2013 and May 1,2013, including 142 patients with sinus rhythms underwent MDCT coronary angiography,25 patients with atrial fibrillation underwent MDCT pulmonary vein-left atrial angiography.All images were post-processed,datas were measured and the morphology of left at-rial appendage were classified into different types.Results 167 patients were enrolled,including 88 males and 79 femals,age 53.7± 8.9 years.Anatomical relationship of the orifice of left atrial appendage to left superior pulmonary vein(LSPV)were classified as high type (superior to LSPV,2.4%),middle type(parallel to LSPV,86.2%),low type(inferior to LSPV,11.4%).LAA orifice could be classified into three types including oval(162,97%),round-like(3,1.8%)and drop-like(2,1.2%).LAA morphology could be classified in four types including Cauliflower(35,21%),Windsock(41,24.6%),Cactus(7,4.2%),Chicken-wing(84, 50.3%).Patients with atrial fibrillation have a larger LAA volume than who with sinus rhythm.Conclusion 64-slice spiral CT car-diac enhancement scanning can provide a vivid and intuitive reference to the anatomy of LAA and its adjacent structures,and it can also provide quantitative evaluation of LAA anatomical parameters,so it may have a nice significance in the direction of LAA occlu-sion.

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