Clinically,hepatocellular carcinoma(HCC)is characterized by its high incidence and high malignancy,and in most patients the disease has already been in the middle-advanced stage when the diagnosis is confirmed.Transcatheter hepatic artery chemoembolization(TACE)has been the preferred treatment for patients with unresectable HCC,which can significantly reduce the pain of patients'suffering.So far,enhanced CT scan or enhanced MR scan are often used to evaluate the efficacy of TACE,but there are still certain difficulties in making accurate and objective evaluation of the early tumor response after TACE treatment.With the emergence of novel imaging methods such as cone beam CT,energy spectrum CT,functional MR imaging,contrast-enhanced ultrasonography,positron emission CT in recent years,the observation of microscopic and objective changes in tumors has become possible.This paper aims to make a comprehensive review about the recent advance in imaging examination techniques for HCC after TACE.

Objective To assess the clinical value of conventional contrast enhanced CT(CECT),multi parameter energy spectrum CT,and contrast enhanced MR(CEMR)imaging methods in evaluating hepatocellular carcinoma(HCC)after TACE treatment.Methods The clinical data of 66 HCC patients,who underwent TACE treatment at authors' hospital and received CECT,multi parameter energy spectrum CT and CEMR in 1-3 months after treatment,were retrospectively analyzed.Taking DSA results as the gold standard,the recurrent or residual lesions detected by DSA were classified as positive lesions,while the lesions having no obvious recurrence or residues were classified as negative lesions.The positive lesions that were detected by both DSA and other imaging methods were regarded as true positive lesions.The accuracy,sensitivity,specificity,Kappa value were used to compare the values of CECT,multi parameter energy spectrum CT and CEMR in evaluating the positive/negative lesions of HCC after TACE treatment,and the number of detected lesions and accuracy rate were used to evaluate the values of the above imaging methods in demonstrating the iodine oil deposition status and in diagnosing true positive lesions.Results A total of 133 positive lesions and 35 negative lesions were detected by DSA.The accuracy of CEMR in diagnosing lesions was highest,the accuracy rate was 88.70％(both P＜0.05);CEMR and energy spectrum CT had the highest diagnostic efficiency,the sensitivity for positive lesions was 92.31％and 81.95％respectively,and the difference between the two methods was not statistically significant(P＞0.05).No statistically significant difference in the ability of diagnosing negative lesions existed between each other among the three groups(all P＞0.05).The Kappa value suggested that the ability for diagnosing lesions after TACE treatment of CEMR was stronger than that of energy spectrum CT(Kappa value was 0.68 and 0.56 respectively,both P＜0.05).CECT and multi parameter energy spectrum CT had the same accuracy in evaluating the iodine oil deposition status(both were 91.7％).No statistically significant difference in diagnosing even iodine oil deposition of the true positive lesions existed between each other among the three groups(all P＞0.05).For diagnosing uneven iodine oil deposition of the true positive lesions,CEMR had the highest accuracy(92.50％,all P＜0.05).Conclusion CEMR and multi parameter energy spectrum CT have more reliable diagnostic performance than conventional CECT,besides,CEMR has the highest diagnostic performance.However,multi parameter energy spectrum CT and CECT are the better choice for evaluating the deposition status of iodine oil.

Objective To explore the application value of a special fence in percutaneous transhepatic cholangial drainage(PTCD)under the guidance of C-arm CT.Methods A total of 43 patients who underwent PTCD were randomly divided into observation group and control group.The intervention operation in the observation group was guided by C-arm CT and located by special fence;in the control group,the intervention operation was only performed under digital subtraction angiography(DSA)fluoroscopy.Respectively,the differences in operation time,number of puncture needles and number of complications between the two groups were compared.Results The operation time,puncture times and complications in the observation group were(39.33±12.96)min,(1.67±0.80)times and 3 cases respectively;in the control group were(86.77±22.70)min,(3.41±1.26)times and 13 cases respectively;There were significant differences between the two groups(P<0.05).Conclusion The application of special fence in PTCD under the guidance of C-arm CT can short the operation time,reduce the number of punctures and reduce complications,which has important clinical application value.

Objective To analyze the factors influencing the occurrence of post-embolization syndrome(PES)after transhepatic arterial chemoembolization(TACE).Methods A total of 107 patients with hepatocellular carcinoma(HCC),who received TACE treatment at authors'hospital between February 2021 and March 2023,were included in the study.Among them,56 patients developed PES(PES group)and 51 patients did not develop PES(non-PES group).The demographic data,medical history,pathological findings,laboratory indicators and operation-related materials were compared between the two groups,and the risk factors for PES were analyzed.Results There were statistically significant differences in tumor diameter,albumin(ALB)level,preoperative physical condition(ECOG)score,type of embolization agent,drug-loaded microspheres,number of microspheres,and dosage of loaded drug between the two groups(all P＜0.05).Multivariate Logistic analysis revealed that drug-loaded microspheres,number of microspheres,and dosage of loaded drug were the independent risk factors for PES occurring after TACE(all P＜0.05).Conclusion HCC patients treated with TACE using drug-loaded microspheres,large amount of microspheres and high dosage of loaded drug have a higher risk of PES occurring after TACE.For patients having the above risk factors,the formulation of corresponding perioperative intervention strategies is necessary so as to avoid the occurrence of PES and to improve the safety of TACE.

Purpose To explore the effect of compressed sensing(CS)technique with different acceleration factors on the quality of cardiac magnetic resonance cine sequences and feasibility of clinical application.Materials and Methods From January to July 2021,40 healthy volunteers were prospectively recruited for cardiac magnetic resonance cine imaging in Hefei First People's Hospital.Four scan protocols of volunteers were designed:SENSE 2 and CS-cine sequences with acceleration factors of 3,4 and 8.The imaging slices include four chamber heart,short axis heart,left ventricular two chamber heart and three chamber heart.Subjective score of image quality,left ventricular cardiac function and 16-segment myocardial thickness of SENSE 2 and CS3,CS4 and CS8 were compared and analyzed.Results Taking SENSE 2 image as the standard score of 5,the scores of CS3 and CS4 were above 3,and the scores of CS8 were below 3.There was no significant difference between the scores of four chamber heart and short axis heart images of CS3 and SENSE 2 sequence(all P>0.05).There were statistically significant differences in the subjective scores of image quality between the left ventricular two chamber heart and three chamber heart groups of each sequence(all P<0.05).There was no statistically significant difference in left ventricular function(left ventricular ejection fraction,left ventricular end systolic volume,left ventricular end diastolic volume,left ventricular stroke volume,left ventricular end-diastolic mass)(F=0.027,0.182,0.057,0.140,0.545)and myocardial thickness(F=0.052-7.366)among the four imaging schemes(all P>0.05).Conclusion Cardiac cine based on compressed sensing technology have good application prospects.With the increase of acceleration factors,the scanning time gradually decreases,and the corresponding image quality will also decrease.When the acceleration factor is 4,that is,the scanning time of the conventional cine sequence is reduced by 50%,the left ventricular function and myocardial thickness can still be accurately measured,and the image quality basically meets the diagnostic requirements.

Humans ; Asthma/drug therapy* ; Biological Therapy

Objective: To explore the imaging changes of lung lesions in patients with imported COVID-19 patients when reaching the discharge standard. Method: The clinical and CT imaging data of 60 patients with imported COVID-19 cured and discharged from January to February 2020 in Anhui Province were retrospectively collected. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed. Results: Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. In 5 light patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. . The first CT imaging features of 55 patients (53 common type and 2 severe type)were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common. (55 cases). The clinical features of chest CT in clinical outcomes are that the ground glass shadow in the lung gradually fades and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbs again followed by Fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed . Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a big amount of fibrous foci remained after slowly absorption. Conclusion Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.

Objective:To explore the imaging changes of lung lesions in patients with imported COVID-19 when reaching the discharge standard.Methods:The clinical and CT imaging data of 60 cured patients with imported COVID-19 and discharged from January to February 2020 in Anhui Province were retrospectively collected. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.Results:Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. In 5 mild patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. The first CT imaging features of 55 patients (53 common type and 2 severe type) were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common (55 cases). The features of chest CT in clinical outcomes were that the ground glass shadow in the lung gradually faded and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbed again followed by fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed. Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a large amount of fibrous foci remained after slow absorption.Conclusions:Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.

Objective To establish the rabbit model with hepatic VX-2 tumor and to investigate the intake of folate-conjugated silica-coated gold nanorods (GNRs@SiO2-FA) in experimental rabbits. Methods Under CT-guidance, animal model with VX-2 liver cancer was established in 27 rabbits by using puncture inoculation method. CT scanning and sonography were employed to observe the tumor growth. After two weeks, the rabbits were randomly and equally divided into blank control group (n=9, injection of saline), portal vein injection group (n=9, injection of GNRs@SiO2-FA) and intra-tumoral injection group (n=9, injection of GNRs@SiO2-FA). Every three rabbits from each group were sacrificed each time at 24 h, 48 h and 72 h after the treatment. The tumor tissue and the major organs were collected and sent for pathological examination. The cellular uptake of GNRs@SiO2-FA was studied by confocal laser scanning microscopy. Results The rabbit model of VX-2 liver cancer was successfully established. CT and sonography examination indicated that the tumor was rich in blood supply. Confocal laser scanning microscopy revealed that GNRs@SiO2-FA could specifically bind with tumor cells within 24 hours after injection, then the GNRs@SiO2-FA entered into the tumor cells and gathered in the tumor cytoplasm. Conclusion GNRs@SiO2-FA has highly targeted effect on the liver cancer cells in experimental animals, which has very important application prospect in targeting hyperthermia therapy and in 125I seed implantation therapy.

Objective To explore the possible mechanism of the apoptosis of hepatoma cell line HepG2 induced by the combination use of GNRs@SiO2-FA and 125I seeds and to discuss its relationship with Bcl-2 and Bax protein expressions so as to provide theoretical basis for clinical treatment of hepatic cancer with interstitial brachytherapy by using 125I seeds. Methods In vitro cultured HepG2 cells were randomly divided into 4 groups: blank control group (not treated), simple GNRs@SiO2-FA group, simple 125I seeds group, and combination group (GNRs@SiO2-FA plus 125I seeds). The apoptosis of HepG2 cells was determined by flow cytometry. The expression of Bax mRNA and Bcl-2 mRNA of HepG2 cells were tested by RT-PCR. The apoptosis-related genes (Bax and Bcl-2) and the tumor proliferation cell nuclear antigen (Ki67) proteins expression on HepG2 cells were examined with immunohistochemistry method. Results The flow cytometry examination showed that the apoptosis rate of HepG2 cells in the simple GNRs@SiO2-FA group and simple 125I seeds group was higher than that in blank control group (P<0.05), and the apoptosis rate of the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group (P< 0.05). The expression level of Bax mRNA in the combination group was higher than that in the simple GNRs@SiO2-FA group and simple 125I seeds group, while the expression level of Bcl-2 mRNA in the combination group was obviously lower than that in the simple GNRs@SiO2-FA group and simple 125I seeds group. Bax protein was expressed on cytoplasm, Bcl-2 protein was expressed on cytoplasm and cell membrane, while Ki67 protein was expressed on nucleus. All of them presented as brown finely granular precipitations. Statistically significant differences in the amount of Bax, Bcl-2 and Ki67 protein expression existed between each other among the four groups (P< 0.05). The positive expression rate of Bax protein in the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, while the positive expression rate of Bcl-2 and Ki67 protein was significantly lower than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, and the differences were statistically significant (P < 0.05). Conclusion The combination use of GNRs@SiO2-FA and 125I seeds can more effectively induce the apoptosis of HepG2 cells. This effect may be accomplished through increasing the expression of Bax protein and inhibiting the expression of Bcl-2 and Ki67 proteins.