Multi-slice computed tomography manifestations of hepatic epithelioid angiomyolipoma

AIM:To explore the characteristics of multi-slice computed tomography(CT)manifestations of hepatic epithelioid angiomyolipoma(HEA),improve the rate of accurate diagnosis,and reduce the misdiagnostic rate.METHODS:The multi-slice CT manifestations in five patients who were diagnosed with HEA definitely by postoperative pathological examination were analysed retrospectively.Three female patients and two male patients were included.Before operation,four patients received plain CT scanning and dynamic enhancement scanning,and the other patient only received enhancement scanning,with immunohistochemical analysis conducted after postoperative pathological examination.Four patients were misdiagnosed by CT,including three patients misdiagnosed with hepatic cell carcinoma and one patient with focal nodular hyperplasia.RESULTS:Upper abdominal multi-slice spiral CT scanning and three-stage enhancement scanning were conducted in five patients with HEA before operation.HEA had certain characteristic CT manifestations:low density masses,a few relatively high-density masses or fatdensity masses diffusely shown in foci,clear boundary,round or oval and large focus,and tumour size ranging from 3.1 cm×2.5 cm to 7.0 cm×5.2 cm.During enhancement scanning,the foci were significantly enhanced uniformly or non-uniformly during the arterial phase,while during the venous and equilibrium phases,the foci were enhanced continuously or showed obvious low-density masses.Obviously enhanced and widened vessels could be found adjacent to foci or in the central area of foci during the arterial phase.CONCLUSION:CT manifestations of HEA have certain characteristics.Primary diagnosis can be obtained by combining CT findings with clinical data,but pathological examination is still needed for a definite diagnosis.

Application value of multi-slice spiral computed tomography for imaging determination of metastatic lymph nodes of gastric cancer

AIM:To evaluate the application value of multi-slice spiral computed tomography(MSCT)for imaging determination of metastatic lymph nodes of gastric cancer and to explore reasonable diagnostic criteria.METHODS:Sixty patients with gastric cancer underwent 64 MSCT scans before operation.Gastric cancer samples and perigastric lymph nodes were obtained after operation,formalin fixation and haematoxylineosin staining.The metastatic conditions of gastric cancer and perigastric lymph nodes were determined under a light microscope.A total of 605 lymph nodes were grouped and assessed according to distribution,size,shape and degree of lymph node enhancement.Then,the findings were compared with the postoperative pathological results.RESULTS:Among 605 lymph nodes,358 were confirmed as metastatic,accounting for 59.2%.A total of535 lymph nodes were detected in original axis images combined with multiplanar reconstruction images of MSCT.The metastatic lymph nodes had specific signs in computed tomography.This study showed that the long diameter of lymph nodes≥8 mm indicated metastasis;the sensitivity and specificity were 79.6%and78.8%,respectively.The difference of the mean value of lymph node enhancement density≥80 Hu indicated metastasis;the sensitivity and specificity were81.6%and 75.6%,respectively.The ratio of short diameter to long diameter of lymph nodes≥0.7 indicated metastasis;the sensitivity and specificity were85.6%and 71.8%,respectively.CONCLUSION:MSCT is a non-invasive and reliable method for preoperative examination of gastric cancer.Sensitivity and specificity for prediction of lymph node metastasis are high.