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18F-FDG PET/CT in diagnosis of renal cell carcinoma

Chinese Journal of Medical Imaging Technology.2017;33(4):571-575. doi:10.13929/j.1003-3289.201608119

Objective To evaluate the value of 18F-FDG PET/CT in diagnosis of renal cell carcinoma (RCC).Methods Totally 32 patients with RCC confirmed by pathology were analyzed retrospectively.The tumor diameter and maximum standard uptake values (SUVrmax) of different pathological types (clear and none clear RCC),different Fuhrman grades (high grade and low grade of clear RCC) and different clinical stages (distant and without distant metastases) were ana lyzed and compared.Results 32 RCC patients including 33 primary tumors,31 lesions were detected by PET/CT and 2 were false negative,the detection rate was 93.94％.The PET/CT findings of 31 primary lesions were mixed density soft tissue masses,and the 18F-FDG uptake accessible,above or below to the normal renal parenchyma;the other 2 lesions of PET/CT findings were normal.18F-FDG uptake of vein tumor thrombus in 8 cases and metastases in 19 cases were higher than the organs affected.The tumor diameter and SUVmax had no statistically significant difference in different pathological types and Fuhrman grades;The tumor diameter had no statistically significant difference,and SUVmax had statistically sig nificant (t=3.852,P=0.001) between different clinical stages.Conclusion The PET/CT findings of RCC primary lesion are varied,and small clear RCC with low Furhman grade may have no obvious abnormality and missed diagnosis;18F-FDG PET/CT has important value in the preoperative staging of RCC.

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Application of right heart contrast echocardiography in patients with transient ischemic attack of unknown cause

Xinyu WANG ; Hong JIN ; Lei WANG ; Dan YU

Chinese Journal of Medical Imaging Technology.2017;33(4):487-489. doi:10.13929/j.1003-3089.201608118

Objective To explore the application value of right heart contrast echocardiography in patients with transient ischemic stroke (TIA) of unknow cause.Methods Totally 120 patients with TIA (TIA group) and 60 cases of normal healthy volunteers (normal group) were enrolled.Two groups underwent right heart contrast echocardiography to observe whether there was a foramen ovale arteriosus (PFO) or not.Diagnostic criteria were left ventricular internal appearing micro bubble≥5 that came from the right atrium to left atrium in three cardiac cycles.Results Small and medium amount of right to left shunt had no significant difference between TIA group and normal group (both P＞0.05),and large amount of right to left shunt had significant difference between the two groups (P＜0.01).Conclusion Contrast echocardiography can effectively diagnose of PFO,and amount of right to left shunt of PFO has relationship with the onset of TIA.

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Prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia

Yiwei XIAO ; Gang YU ; Ning SHANG ; Xiaoyan MA ; Jiangyu ZHANG ; Qiuping MA ; Siwei AN

Chinese Journal of Medical Imaging Technology.2017;33(4):566-570. doi:10.13929/j.1003-3289.201608124

Objective To investigate the value of prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia.Methods The ultrasonographic features of 65 fetuses with congenital diaphragmatic hernia were analyzed,which were confirmed by after birth surgery or examination.The lung-to-head ratio (LHR) of unaffected side and O/E LHR (LHR compared to normal fetuses on same gestational weeks) were obtained,and then the relationship with the prognosis of neonates were analyzed.Results In 65 cases,45 fetuses survived and 8 fetuses died after surgery,while 12 cases did not undergo surgery and death promptly.Overall mortality was 30.77％ (20/65).In 12 hepatic intrathoracic type of diaphragmatic hernia cases,the mortality rate was 66.67 ％ (8/12).In 53 hepatic intra-abdominal type of diaphragmatic hernia cases,the mortality rate was 22.64 ％ (12/53).In 9 cases combined with other structural abnormalities,there were 8 cases were dead and 6 cases (6/8) with abnormal chest structure.LHR values were from 0.40 to 2.72,the average value was 1.59±0.69.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different LHR (x2 =19.360,P＜0.001),The mortality rate in fetal of congenital diaphragmatic hernia with LHR 1.0 or less was higher than that with LHR ＞1.0.O/E LHR measurement values were from 23％ to 90％ and the average value was (58.25±17.61) ％.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different O/E LHR (x2 15.261,P=0.002).The mortality rate in fetal of congenital diaphragmatic hernia with O/E LHR ≤45 ％ was higher than that with O/E LHR＞45 ％.Conclusion The prenatal ultrasound can be used to diagnose congenital diaphragmatic hernia,and to assess the development of unaffected lung and prognosis.

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Antepartum and postpartum echocardiographic diagnosis of isolated ventricular septal defect

Nan GUO ; Qi ZHU ; Jiao CHEN

Chinese Journal of Medical Imaging Technology.2017;33(4):562-565. doi:10.13929/j.1003-3289.201608146

Objective To investigate the differences between prenatal and postnatal ultrasound findings in isolated ventricular septal defects.Methods Totally 244 cases of isolated ventricular septal defect were retrospectively analyzed and followed in one year after birth.All fetus were divided into the correct group and the error group according to the postnatal results.The size and type of ventricular septal defect and ventricular shunt were assessed and analyzed statistically.Results In all of the 244 cases,correct group included 181 cases and error group included 63 cases.There was no significant difference in the type of defects between two groups (P=0.061);there were significant differences in the size of postpartum defect and the velocity of ventricular shunt between the two groups (both P＜0.05),and no significant difference of the direction of shunt between two groups (P=0.408);there were significant differences in the size of defects between the prenatal and postnatal in correct groups (P＜0.05),but the direction of shunt had no significant difference (P=0.087).Conclusion There is certain detection rate in prenatal diagnosis of isolated ventricular septal defect;anatomical characteristics of defect may affect antenatal examination results.There was significant difference between prenatal and postnatal ultrasound in the same lesion.

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Imaging performance of hepatic inflammatory myofibroblastic tumor

Xiaonan MAO ; Zaiming LU ; Qiyong GUO

Chinese Journal of Medical Imaging Technology.2017;33(4):554-557. doi:10.13929/j.1003-3089.201609026

Objective To assess the radiological imaging findings of hepatic inflammatory myofibroblastic tumor and to discuss the appropriate morphological classification.Methods A total of 22 patients with hepatic inflammatory myofibroblastic tumor confirmed by pathology were enrolled.Imaging performance of hepatic inflammatory myofibroblastic tumor were analyzed and the lesions were classified into appropriate type based on the imaging findings.Results Totally 23 lesions were found in 22 patients.The typical imaging features included great enhancement at later phase (13/20),moth eat en central necrosis (12/23) and peripheral shell (12/23).Seed in fruit was the most typical classification (8/23),followed by Seedless fruit (7/23).Conclusion Hepatic inflammatory myofibroblastic tumur typically shows as a single nodular lesion with moth eaten necrosis and peripheral shell like a Seed in fruit.The enhancement at later phase (especially the peripheral enhancement) can be regarded as a particular feature.

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Gd-BOPTA enhanced MRI in evaluation of reserved liver function

Jie LI ; Chen ZHANG ; Zhuozhao ZHENG

Chinese Journal of Medical Imaging Technology.2017;33(4):545-549. doi:10.13929/j.1003-3289.201609061

Objective To investigate the value of gadobenate dimeglumine (Gd-BOPTA) enhanced MRI in evaluation of reserved liver function.Methods Totally 68 patients were included among 143 patients who underwent Gd-BOPTA en hanced MRI.The enhancement ratios of SNR and CNR of right lobe,left lobe and caudal lobe were calculated on the ima ges from liver acquisition with volume acceleration flex sequence (LAVA-Flex) of hepatobiliary phase.The average values of right and left lobes and of three lobes were calculated and compared.According to Child-TurcottePugh (CTP) classification,the patients were divided into Class A and Class B.Integrated model of end-stage liver disease (iMELD) was applied to divide the patients into iMELD≤30 and iMELD＞30.The differences of SNR and CNR enhanced ratios were com pared,and the relationship between enhancement ratios and iMELD scores was analyzed.Results There were no significant differences in the enhancement ratios of SNR and CNR among each lobe,the average of two or three lobes (all P＞0.05).The SNR and CNR enhancement ratios of Class A were higher than those of Class B (both P＜0.05).The SNR and CNR enhancement ratios of iMELD≤≤30 were higher than those of iMELD＞30 (both P＜0.05).The SNR and CNR enhancement ratios showed negative correlations with iMELD scores (SNR:r=0.29,P-0.02;CNR:r=-0.32,P=0.01).Conclusion The intracellular uptake of Gd-BOPTA decreases with impaired liver function.Measurement of the de gree of parenchymal enhancement of any lobe or the whole liver on the images of Gd-BOPTA enhancement MRI in the hepatobiliary phase might reflect the reserved liver function.

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Manifestations of cerebral developmental venous anomalies and its associated lesions in MRI

Jianxun SONG ; Shuixia ZHANG ; Hongxia LU ; Jiuping LIANG ; Huarong PENG

Chinese Journal of Medical Imaging Technology.2017;33(4):518-522. doi:10.13929/j.1003-3289.201608134

Objective To evaluate the application value of different MR sequences in cerebral developmental venous anomalies (DAVs),and to explore the relationship between DVAs and its associated lesions.Methods MRI findings in 38 patients of DAVs were analyzed retrospectively.Imaging performance and characteristics of DAVs and its associated lesions in different MR sequences were analyzed.Results In all of the 38 cases,3 cases were multiple DVAs without associated lesions,1 case was combined right lateral ventricle hemorhage,1 case was combined with multiple cavernous hemangioma,8 cases were single DVAs with solitary cavernous hemangioma,5 cases were combined with astrocytoma,1 case was combined with intracranial hematoma,and 19 cases were single DVAs with no comorbidity.DVAs in 16 cases showed strip or small patchy hypo-intensity lesions and 15 cases were not visible on T1WI;16 cases showed strip or small patchy hypo-intensity,5 cases showed strip or flocculent hypo-intensity and 10 cases could not seen on T2WI;19 cases showed patchy or strip hypo-intensity and 8 cases showed iso intensive signal on DWI;8 of the 10 cases who performed susceptibility weighted imaging (SWI) examination showed dendritic low signal,showing a typical caput medusae sign,2 cases showed no lesions on SWI;30 cases underwent 3D-T1WI enhanced scan showed clearly all lesions of DAVs,19 cases of them showed typical caput medusae sign and large draining veins.Conclusion Routine MR sequence can demonstrate part of the DVAs and associated peripheral lesions,DWI showed lesions of DAVs is superior to routine MR sequence,SWI and enhanced 3D-T1WI can accurately diagnose DVAs and show the venous drainage.

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Transcranial sonography in patients with Parkinson disease and Alzheimer disease

Zhifen DONG ; Yingchun ZHANG ; Yujing SHENG ; Caishan WANG ; Ying ZHANG ; Hua HU ; Weifeng LUO ; Chunfeng LIU

Chinese Journal of Medical Imaging Technology.2017;33(4):514-517. doi:10.13929/j.1003-3289.201610021

Objective To assess the features of transcranial sonography (TCS) in Parkinson disease (PD) and Alzheimer disease (AD).Methods Totally 38 PD patients (PD group),28 AD patients (AD group) and 26 controls (control group)underwent TCS.The echogenicity of the substantia nigra,widths of third ventricle and parameters of middle cerebral artery among the three groups were analyzed.Results The ratio of hyperechogenicity of substantia nigra in PD group (31/38,81.58％) were higher than those in AD group (8/28,28.57％) and control group (3/26,11.54％;x2 =18.74,30.41,both P＜0.001),and there was no significant difference in hyperechogenicity of substantia nigra between AD group and control group (x2 =2.41,P=0.120).The widths of third ventricle in AD group ([0.82±0.14]cm) were wider than those in PD group ([0.63±±0.16]cm) and control group ([0.56±0.16]cm,both P＜0.001),and there was no significant difference in widths of third ventricle between PD group and control group (P=0.098).The mean velocities in bilateral middle cerebral artery in AD group were lower than that of in PD group and in control group (all P＜0.05).The pulsatility index in right middle cerebral artery in AD group were greater than that in PD group and control group (both P＜0.05).Conclusion According to the changes of echogenicity of substantia nigra,widths of third ventricle and parameters of middle cerebral artery,TCS may provide some useful information for diagnosis of PD and AD.

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Effect of abstinence duration on brain small-world network characteristics in heroin addicts:Resting-state fMRI study

Jiajie CHEN ; Yongbin LI ; Xuan WEI ; Jierong LIU ; Jia ZHU ; Wei LI ; Qiang LI ; Wei WANG

Chinese Journal of Medical Imaging Technology.2017;33(4):504-509. doi:10.13929/j.1003-3289.201608127

Objective To investigate the effects of different abstinent duration on brain functional network of heroin addicts at resting state.Methods Sixteen heroin addicts during protracted abstinence for 11-13 months (PA12 group) and twenty heroin addicts during protracted abstinence for 5-7 months (PA6 group) were recruited in the resting-state functional MRI study.Graph theoretical methods were applied to construct topological organization of whole brain network and nodes betweenness of the networks in all subjects,and the between-group differences were analyzed.The correlation of the node betweenness with the abstinence duration was conducted.Results There was no significant difference (P＞0.05) in the small world characteristic (γ≈1,λ》1) between two groups.Compared with the PA6 group,the PA12 group demonstrated significantly decreased nodal betweenness in regions of left parahippocampal gyrus,left precentral gyrus,and significantly enhanced nodal betweenness in regions of the left cuneus,left temporal and right middle occipital gyrus (all P＜0.05).Moreover,the betweenness of the left precentral gyrus (r =-0.52,P =0.001) and parahippocampal gyrus (r=-0.49,P=0.002) were negatively related with the abstinence duration,the betweenness of the right middle occipital was positively correlated with the abstinence duration (r=0.49,P=0.003).Conclusion The brain network small world topology of heroin addicts tend to be stable after 5-7 months of abstinence.Long-term abstinence may minimize the addicfs memory of drugs and potential drug seeking behavior,and recover addicts' visual spatial attention function.

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Preparation of gadolinium-loaded stearic acid grafted chitooligosaccharide and application in pancreatic tumor imaging

Weihua ZHANG ; Shuangshuang ZHENG ; Xiuzhong YAO ; Bin DU ; Weiyu WENG

Chinese Journal of Medical Imaging Technology.2017;33(4):499-503. doi:10.13929/j.1003-3289.201609159

Objective To prepare gadolinium-loaded stearic acid grafted chitooligosaccharide (COSSA-DTPA-Gd) and evaluate its micelle properties,cytotoxicity,relaxation rate in vitro,and pancreatic tumor in vivo imaging.Methods Stear ic acid grafted chitooligosaccharide (COSSA) was synthesized by acetylation reaction between stearic acid and chitooligosaccharide.Diethylenetriaminepentaacetic dianhydride (DTPA) was conjugated to the residual amino groups of COSSA,then Gd3+ was chelated to obtain the final product.The micelle properties were measured using an electron microscopy and a laser particle sizer.The MTT assay was adopted to determine cytotoxicity.The in vitro relaxation rate and in vivo imaging of pancreatic tumor were evaluated using an MR scanner.Results COSSA-DTPA-Gd could self-assemble into stable micelles in aqueous solutions with a critical micelle concentration of (5.12±0.43)μg/ml.The micelles had positive charge and exhibited roughly spherical shape with a mean diameter of (58.3± 5.7)nm.The content of Gd3+ in COSSA-DTPA-Gd was 330.31 μmol/g.The nanoprobe and Magnevist,the commercial formulation,showed similar cytotoxicity (P＞0.05).The cell survival rate within 24 h were higher than 85％.The in vitro relaxation rate of COSSA-DTPA-Gd was 8.23 mM-1 ·s-1.After intravenous injection,COSSA-DTPA-Gd showed a better positive contrast-enhancing effect for pancreatic tumor than Magnevist.The MR images at the tumor periphery was rapidly enhanced,while a slow increase in image quality was observed in tumor core.Conclusion The prepared COSSA-DTPA-Gd can be used for efficient MR imaging of pancreatic tumor.

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