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Applications of Rapid Exchange Method in Transnasal Intestinal Obstruction Catheterization

Chinese Journal of Medical Imaging.2013;(6):428-430. doi:10.3969/j.issn.1005-5185.2013.06.007

Purpose To evaluate the application value of rapid exchange method in transnasal intestinal obstruction catheterization. Materials and Methods Fifty-eight patients with adhesive intestinal obstruction underwent transnasal catheterization under X-ray fluoroscopy, of which 31 cases were treated with rapid exchange catheterization method (group A) and the other 27 cases with traditional catheterization method (group B), success rate, operation time and complications were compared between the two groups. Results Catheterization success rate of group A and group B were 96.77%(30/31) and 77.78%(21/27) respectively, which was significantly higher in group A than in group B (χ2=4.907, P<0.05);operation time of group A and group B were (28.2±12.3) min and (25.4±15.7) min respectively, and the difference between them was not statistically significant (t=1.219, P>0.05); no operation associated injury occurred in group A and only one case in group B (3.70%) resulted in bilateral nasal edema with a small amount of bleeding because the operating time was too long, complication rate between the two groups was also not statistically significant (P>0.05). Conclusion Rapid exchange method can improve the success rate of transnasal intestinal obstruction catheterization, but the operation time and complications are comparative to those of the conventional method.

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Efifcacy and Prognostic Factors of Alpha-fetoprotein Negative Hepatocellular Carcinoma by Transcatheter Arterial Chemoembolization

Zhongfei CHANG ; Maoqiang WANG ; Fengyong LIU ; Feng DUAN ; Zhijun WANG ; Peng SONG

Chinese Journal of Medical Imaging.2013;(6):417-421. doi:10.3969/j.issn.1005-5185.2013.06.005

Purpose To assess the efficacy and prognostic factors of alpha-fetoprotein (AFP) negative hepatocellular carcinoma (HCC) by transcatheter arterial chemoembolization (TACE). Materials and Methods 67 AFP negative HCC patients and 67 AFP positive HCC patients underwent TACE, the survival of two groups was compared, and the prognostic factors were also analyzed. Results All 134 HCC patients were followed up for 24 months, the one-year, two-year and five-year survival rate of AFP negative and AFP positive HCC patients were 86.6%, 58.2%, 31.3%; and 81.6%, 37.8%, 13.4%, respectively, with median survival time of 34.0 months and 19.0 months, respectively. The survival rate were statistically different between AFP negative and AFP positive HCC patients (P<0.001). In AFP positive group, the median survival time of patients with AFP>400 ng/ml and AFP ≤400 ng/ml were 18.0 months and 31.0 months, respectively with statistical difference (P<0.05). Univariate analysis showed that Child-Pugh classification, histological grade, tumor size, tumor number, portal vein tumor thrombus, BCLC staging and AFP level were independent risk factors influencing the prognosis of HCC patients. Conclusion AFP negative and AFP positive (AFP ≤400 ng/ml) HCC patients achieves good efficacy and prognosis by TACE, Child-Pugh classification, portal vein tumor thrombus, BCLC staging and AFP level were risk factors influencing the prognosis of HCC patients.

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Preliminary Study of Magnetic Resonance T1ρ in Early Detection of Disc Degeneration

Wei WANG ; Wen LIANG ; Ling CHEN ; Jianming YANG ; Xianyue QUAN

Chinese Journal of Medical Imaging.2013;(6):406-410. doi:10.3969/j.issn.1005-5185.2013.06.002

Purpose To investigate the value of 3.0T MR T1ρquantitative analysis in early detection of disc degeneration. Materials and Methods Conventional T2WI and T1ρwere collected in 35 healthy volunteers (male 16, female 19) on 3.0T MRI, and the classification of disc nucleus was performed by Pfirrmann classification. T1ρvalue of nucleus pulposus was measured and analyzed for the relationship among Pfirrmann classification, segmental and gender. Results There was a significant negative correlation between T1ρvalue and Pfirrmann grade (r=-0.542, P<0.001). T1ρvalue in L5/S1 segment (94.80±26.60) ms was significantly lower than that in L2/L3 (117.18±25.64) ms and L3/L4 (115.52±28.53) ms (P<0.01), and there was no significant difference among other segments (P>0.05);there was no gender differences among the T1ρvalue of each segment (t=0.006, 0.042, 0.797, 1.022, 0.038, P>0.05). Conclusion T1ρ value is closely related to the degree of disc degeneration, and T1ρimaging can be used as an objective, sensitive and effective tool for early detection of disc degeneration.

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Logistic Regression Analysis of Gallbladder Lesions of≥1 cm in Diameter Diagnosed by Ultrasound

Xiaoran CHEN ; Shaoshan TANG ; Dongmei YU ; Zhan LIU

Chinese Journal of Medical Imaging.2013;(6):447-450. doi:10.3969/j.issn.1005-5185.2013.06.013

Purpose To establish Logistic regression model of gallbladder lesions of≥1 cm in diameter diagnosed by ultrasound, and to filter benign and malignant sonographic features. Materials and Methods The sonographic features were retrospectively analyzed in 165 patients with gallbladde apophysis lesions of≥1 cm in diameter which confirmed by pathology, including the number of lesions, size, shape and basal width, gallstones, continuous gallbladder wall continuous, blood flow signals detected by color Doppler flow imaging. Logistic regression model with bipartition was established by multivariate Logistic regression analysis, and the efficiency of Logistic regression model was evaluated to predict benign or malignant of these lesions. Results Three characteristic variables, including lesion morphology, basal width and flow signals, were took into the Logistic regression model by binary Logistic regression analysis, which was the sensitive indicators can differentiate the benign or malignant gallbladder lesions. The accuracy, sensitivity and specificity of this model were 97.0%, 93.8%and 97.3%for predicting the benign or malignant gallbladder apophysis lesions≥1 cm in diameter, respectively. Area under ROC was 0.979. Conclusion Binary Logistic regression analysis can filter the sonographic features which can differentiate the benign or malignant gallbladder apophysis lesions≥1 cm in diameter, and lesion morphology, basal width and flow signals are of important differential diagnosis value of benign lesions or malignant lesions.

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Multislice Spiral CT Features of Renal Chromophobe Carcinoma

Xianyong SUN ; Weidong SHI ; Yongxin XIAO ; Yuehua FENG

Chinese Journal of Medical Imaging.2013;(6):443-446. doi:10.3969/j.issn.1005-5185.2013.06.012

Purpose To explore the multislice spiral CT (MSCT) features of renal chromophobe carcinoma, and to improve the understanding and diagnosis of the disease. Materials and Methods MSCT features of 17 patients with renal chromophobe carcinoma confirmed by surgical pathology were retrospectively analyzed, plain MSCT and multi-phase dynamic contrast-enhanced scan were applied to these patients. Results Single substantive round or oval-shaped soft tissue mass was demonstrated in 17 cases. The lesions were all uniform density on plain MSCT, and mild to moderate homogeneous enhancement in 11 cases on enhanced MSCT, including 9 cases with significant enhancement above the renal medulla and below the renal cortex, and 2 cases with similar enhancement to renal medulla in corticomedullary phase. On nephrographic phase the lesion showed significant lower density than renal medulla. Heterogeneous enhancement presented in 6 cased, including 1 case with small necrosis and 1 case with stellate scar lesion in low-density. Conclusion Renal chromophobe carcinoma demonstrates a round solid mass of uniform density on plain MSCT, and mild to moderate homogeneous and heterogeneous, which can provide the reference value for preoperative diagnosis.

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Evaluation of Microcirculation of Pancreatic Carcinoma Using Whole Organ CT Perfusion Imaging

Xiaoxuan MA ; Huiping SHI ; Wei GUO ; Minxia QIAO ; Hong FANG ; Ping WANG

Chinese Journal of Medical Imaging.2013;(6):439-442. doi:10.3969/j.issn.1005-5185.2013.06.011

Purpose To analyze the perfusion differences of different pancreatic diseases using the low-dose whole organ dynamic volume CT perfusion imaging, and to provide the evidence for the clinical application. Materials and Methods Twenty-eight patients suspected as pancreatic disease were applied by 640 layer volume CT perfusion imaging for the pancreas. Data were collected at the same time of bolus injection of contrast agent, then were analyzed by spatial alignment and perfusion calculation using the perfusion software. The time-density curve, blood perfusion flow diagram and tissue artery blood flow were obtained using the maximum slope method. Results Normal pancreatic tissue (n=9) blood flow was (117.04±12.05) ml/(min?100 ml), pancreatitis organizations (6 cases with acute pancreatitis and 3 cases with chronic pancreatitis) (118.67±37.18) ml/(min?100 ml), pancreatic carcinoma tissue (n=10) was (67.16±18.94) ml/(min?100 ml). There was significant difference among three groups (F=8.59, P<0.001);the difference was demonstrated in pancreatic cancer vs. normal pancreas and pancreatic cancer vs. pancreatitis group (q=3.70, P<0.05), which could be clearly demonstrated by blood perfusion flow diagram. The difference was not statistically revealed pancreatitis and normal pancreas group (q=2.91, P>0.05). The total dose of X-rays in the whole scanning process was 21.5-23.9 mSv. Conclusion Low-dose whole pancreas organ CT perfusion scan can quantitatively analyze the hemodynamic changes in pancreatic disease, which be of great value for evaluating changes in microcirculation during the treatment of pancreatic cancer.

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Observing the Inlfuence of Dexmedetomidine on Femoral Artery Hemodynamics During the Induction of General Anesthesia Using Color Doppler Ultrasound

Wei WANG ; Dongmei LIU ; Jin ZHANG

Chinese Journal of Medical Imaging.2013;(6):422-427. doi:10.3969/j.issn.1005-5185.2013.06.006

Purpose To investigate the influence of single slow intravenous infusion of dexmedetomidine (Dex) on femoral artery color Doppler hemodynamics during the induction of general anesthesia. Materials and Methods Forty patients of elective abdominal surgery under general anesthesia were elected and randomly divided into Dex group and the control group, with 20 cases in each group. Dex (0.2 μg/kg) 20 ml was injected with intravenous infusion in Dex group, and 20 ml saline was infused in control group, the infusion time was 10 min;then intravenous injection of Sufentanil, Propofol and Rocuronium were performed in turn for the induction of general anesthesia and endotracheal intubation. Femoral artery peak systolic velocity (Vs), early diastolic reverse peak velocity (Vd), systolic diameter (Ds), diastolic diameter (Dd), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) changes at each time point were observed and recorded. Results ① Compared with baseline, Vs increased and Vd decreased (P<0.05) 10 min after the infusion of Dex in Dex group;after induction, Vs and Vd in both of the two groups decreased, and the difference between the two groups was not statistically significant (P>0.05);Vs reduced significantly in both of the two groups at the intubation moment and 1, 3, 5 min after intubation, but the Dex group changed more smoothly (P<0.05), and Vd raised in both groups with the Dex group changing more smoothly (P>0.05);Ds and Dd of both groups did not change significantly at each time point (P>0.05). ② Compared with baseline, MAP and HR decreased (P<0.05) after the infusion of Dex in Dex group;after induction, MAP and HR of both groups decreased, and the difference between the two groups was not statistically significant (P>0.05); MAP and HR increased in both groups at intubation moment, but the Dex group changed more smoothly than the control group (P<0.05).③SBP, DBP and HR were negatively correlated with Vs (r=-0.507,-0.619,-0.750, P<0.05) in both groups; SBP, DBP and HR were positively correlated with Vd (r=0.821, 0.881, 0.883, P<0.05) in both groups;there was no significant correlation (r=0.419, P>0.05) between Vs and Vd. Conclusion Single slow intravenous infusion of Dex (0.2μg/kg) can accelerate the femoral artery Vs and slow down the Vd, resulting in more stable hemodynamics during the induction of general anesthesia.

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Application of Contrast-enhanced Ultrasound in Detection Non-vascular Channel

Yanpeng KONG ; Lei FENG ; Yaoyou XIA ; Yan SUN ; Kun CHEN ; Cuiyun LIN

Chinese Journal of Medical Imaging.2014;(9):704-707. doi:10.3969/j.issn.1005-5185.2014.09.017

Purpose To explore the application value of contrast agent in non-vascular channel. Material and Methods Totally 68 patients with drainage tube/stoma were collected in the pattern of real-time contrast enhanced ultrasound. Position, scope and moving of contrast agent in non-vascular channel were observed. Results It was accurately revealed enhanced areas in 68 cases of drainage tube and stoma, including 9 abnormal cases. CEUS implied 3 cases of failed drainage ifrstly, 5 cases of bleeding and 1 case gallbladder stone. It judged the degree and location in 25 PTBD cases and 22 PCN cases. The distance with renal hilum of one parapelvic cyst was measured accurately. Conclusion It is very important in diagnosis and treatment of interventional ultrasound to CEUS, therefore is worthy of wide application.

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Differentiation of Two Contrast Media Using Dual-energy CT

Qi WANG ; Mengyue SUN ; Gaofeng SHI ; Zhihui TIAN

Chinese Journal of Medical Imaging.2014;(9):701-703. doi:10.3969/j.issn.1005-5185.2014.09.016

Purpose To evaluate the feasibility of using dual-energy CT scanner to differentiate two contrast media bismuth and gadolinium. Materials and Methods Two phantoms containing contrast media of different ratio were scanned on dual-energy CT. Group 1 was mixture of iodine and gadolinium solution with volume ratio of 0∶1, 1∶6, 1∶1, 6∶1 and 1∶0. Group 2 was mixture of iodine and bismuth solution with mass ratio of 0∶1, 1∶6, 1∶1, 6∶1, 1∶0. Monoenergetic image reconstruction was performed at 80 keV. Liver VNC software was used for virtual scanning and iodine concentration analysis. Results Under 80 keV reconstruction, the measured CT attenuation of Group 1 was 379-383 HU, and 170-173 HU in group 2. The iodine concentration of two groups was not signiifcantly different between the calculated and actual iodine concentration (P>0.05). The dual-energy CT can distinguish two contrast media. Iodine and gadolinium contrast media were not statistically different, while iodine and bismuth contrast media agent could be easily differentiated. Conclusion Dual-energy CT can distinguish two contrast media with different attenuation.

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Factors Inlfuencing Shear Wave Velocity by Using Elasiticity Imaging Technique

Long YANG ; Jianjun YUAN ; Qi WANG ; Gang WU ; Wenqing GUO ; Wenwei WANG ; Bing ZHAO

Chinese Journal of Medical Imaging.2014;(9):697-700. doi:10.3969/j.issn.1005-5185.2014.09.015

Purpose To investigate the influence on shear wave velocity (SWV) by different probe frequency, scanline angle and ROI depth. Materials and Methods The elasticity QA Phantoms was used in the study. First the SWV was measured by curve probe at depths of 1 cm, 2 cm, 3 cm, 4 cm, 5 cm, 6 cm, 7 cm and 8 cm. The scanline angle changed from 0°from midline, 1°-15°, 16°-30°and 31°-45°. Then the SWV was measured again by using line probe at depths of 1 cm, 2 cm, 3 cm and 4 cm. The measured data were analyzed statistically. Results The SWV showed difference by using the two probes (P<0.05). As depth increased, the measurement by curve probe changed from overestimate to underestimate, while the measurement by line probe always showed underestimate from standard value. When the curve probe was used, the angle and depth affected SWV interactively (F=85.87 and 35.96, P<0.01), and had interactive effects (F=17.63, P<0.01). When the scanline angle was within 15°, the angle had little inlfuence upon the measurement. When the scanline angle was 0 °, the measurement was the closest to the standard value at the depth of 4 cm, and the maximum deviation occurred at the depth of 5 cm. The inlfuence of depth upon measurement had signiifcant difference when the line probe was used (P<0.05). The measurement was the closest to the standard value at the depth of 1 cm, and the maximum deviation occurred at the depth of 4 cm. Conclusion Factors like probe frequency, scanline angle and ROI depth can affect the SWV. When the curve probe is used, the accurate measurement occurs at the depth of 4 cm when the scanline angle is within 15°. When the line probe is used, the accurate measurement occurs at the depth of 1 cm.

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