Characteristics and pathological mechanism on magnetic resonance diffusion-weighted imaging after chemoembolization in rabbit liver VX-2 tumor model

AIM: To investigate dynamic characteristics and pathological mechanism of signal in rabbit VX-2 tumor model on diffusion-weighted imaging (DWI) after chemoembolization. METHODS: Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity opened. Forty VX-2 tumor models from them were divided into four groups. DWI was performed periodically and respectively for each group after chemoembolization. All VX-2 tumor samples of each group were studied by pathology. The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient (ADC) values. The statistical significance between different time groups, different area groups or different b-value groups was calculated by using SPSS12.0 software. RESULTS: Under b-value of 100 s/mm2, ADC values were lowest at 16 h after chemoembolization in area of VX-2 tumor periphery, central, and normal liver parenchyma around tumor, but turned to increase with further elongation of chemoembolization treatment. The distinction of ADC between different time groups was significant respectively (F = 7.325, P < 0.001; F = 2.496, P < 0.048; F = 6.856, P < 0.001). Cellular edema in the area of VX-2 tumor periphery or normal liver parenchyma around tumor, increased quickly in sixteen h after chemoembolization but, from the 16th h to the 48th h, cellular edema in the area of normal liver parenchyma around tumor decreased gradually and that in the area of VX-2 tumor periphery decreased lightly at, and then increased continually. After chemoembolization, Cellular necrosis in the area of VX-2 tumor periphery was more significantly high than that before chemoembolization. The areas of dead cells in VX-2 tumors manifested low signal and high ADC value, while the areas of viable cells manifested high signal and low ADC value. CONCLUSION: DWI is able to detect and differentiate tumor necrotic areas from viable cellular areas before and after chemoembolization. ADC of normal liver parenchyma and VX-2 tumor are influenced by intracellular edema, tissue cellular death and microcirculation disturbance after chemoembolization.

Gene expression and MR diffusion-weighted imaging after chemoembolization in rabbit liver VX-2 tumor model

AIM: To investigate the dynamic characteristics and the correlation between PCNA, Bax, nm23, E-cadherin expression and apparent diffusion coefficient (ADC) on MR diffusion-weighted imaging (DWI) after chemoembolization in rabbit liver VX-2 tumor model. METHODS: Forty New Zealand rabbit liver VX-2 tumor models were included in the study. DWI was carried out periodically after chemoembolization. All VX-2 tumor samples in each group were examined by histopathology and Strept Avidin-Biotin Complex (SABC) immunohistochemical staining. RESULTS: The PCNA expression index in VX-2 tumors was higher than in the normal parenchyma around the tumor (P < 0.001). Nm23, Bax or E-caderin expression index in VX-2 tumors were lower than in the normal parenchyma around the tumor (all P < 0.001). PCNAand nm23 expression in the VX-2 tumor periphery first increased and then decreased (P < 0.001 and P = 0.03, respectively), while the expression of Bax and E-cadherin before and after chemoembolization was insignificant. When b-value was 100 s/mm2, there was a linear correlation between PCNA expression and ADC in the area of VX-2 tumor periphery (P < 0.001), and PCNA expression in VX-2 tumor periphery influenced the ADC. CONCLUSION: The potential of VX-2 tumor infiltrating and metastasizing decreases, while its ability to proliferate increases for a short time after chemoembolization. To some degree, the ADC value indirectly reflects the proliferation of VX-2 tumor cells.

PRELIMINARY STUDY OF FEASIBILITY OF WHOLE BODY DIFFUSION WEIGHTED IMAGING IN DIAGNOSIS OF METASTASIS OF TUMOR

Objective To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in the diagnosis of metastatic tumor. Methods Fifty-six patients (40 males and 16 females, age ranging from 29 to 84 years with a mean age of 57 years) with a variety of primary tumors were investigated by whole body DWI combined with computed tomography (CT) and/or conventional magnetic resonance imaging (MRI) scans. Twelve patients underwent positron emission tomography. The final diagnosis was made on the basis of CT or high resolution CT result for lung lesion and MRI or CT result for skull, abdomen and other parts. All tumors were classified into four groups by their diameter: below 1.0 cm, 1.0-1.9 cm, 2.0-2.9 cm, and above 3.0 cm. The sensitivity and specificity of whole body DWI in the detection of metastatic tumor were analyzed. Results The sensitivities of whole body DWI for screening metastasis of the four groups were 38%, 75%, 97%, and 100%, respectively. Whole body DWI showed the highest sensitivity and specificity for detecting metastasis of the skeletal system. It was difficult to find metastatic tumor whose diameter was below 1.0 cm, or lymph nodes located in the pelvis with diameter below 2.0 cm. Conclusions Whole body DWI is a promising method in the diagnosis of metastastic tumors. With the perfection of scanning parameter, whole body DWI should be a new effective whole body technique for tumor detection.

DIAGNOSTIC VALUE OF WHOLE BODY DIFFUSION WEIGHTED IMAGING FOR SCREENING PRIMARY TUMORS OF PATIENTS WITH METASTASES

Objective To evaluate the values of whole body diffusion weighted imaging (DWI) in screening primary unknown tumor in patients with metastases. Methods Totally, 34 patients with metastases of primary unknown tumors were scanned with whole body DWI, and conventional magnetic resonance (MR) imaging was performed if suspected lesions were detected. All the metastases including 27 cases of osseous metastases, 2 brain metastases, 2 liver metastases, 1 pulmonary multiple metastasis, 1 neck metastasis and 1 malignant ascites, were diagnosed by computed tomography, single photon emission computed tomography, or MR imaging. For the proven primary tumors diagnosed by biopsy or pathology of surgical specimens, apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively. The sensitivity and specificity of this technique for screening primary tumors were evaluated. Results We found 24 cases with suspected primary lesions, in which 23 lesions were proved to be primary tumors, and 1 was proved to be benign lesion. And no definite primary lesion was found in 10 cases on whole body DWI, but in which 1 case was diagnosed with primary tumor by biopsy later, and the other 9 cases remained unknown within follow-up of over half a year. The difference was not significant in ADC values between primary and metastatic lesions (P>0.05). The sensitivity and specificity of whole body DWI for searching primary tumors was 95.8% and 90.0%, respectively. Conclusion Combined with conventional MR scanning, whole body DWI can help to search primary lesions of patients with metastases.

MR diffusion-weighted imaging of rabbit liver VX-2 tumor

AIM: To investigate the implanting method of rabbit liver VX-2 tumor and its MR diffusion-weighted imaging (DWI) characteristics.METHODS: Thirty-five New Zealand rabbits were included in the study. VX-2 tumor was implanted subcutaneously in 14 rabbits and intrahepatically in 6 for pre-experiments. VX-2 tumor was implanted intrahepatically in 12 rabbits for experiment and three were used as the control group. DWI, T1- and T2-weighted of MR1 were performed periodically in 15 rabbits for experiment before and after implantation. The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient (ADC) values. The statistical significance was calculated byanalysis of variance (ANOVA) of the randomized block design using SPSS10.0 software. RESULTS: The successful rate of subcutaneous implantation of VX-2 tumor was 29% (4/14) while that of intrahepatic implantation of it was 33% (2/6) in the preexperiment. The successful rate of intrahepatic implantation of VX-2 tumor in the experiment was 83% (10/12) and 15 tumors grew in 10 successfully implanted rabbits. The DWT signal of VX-2 tumor was high and became lower when the b value increased step by step. The signal of VX-2 tumor on the map of ADC was low. When the b value was 100 or 300 s/mm2, the ADC value of normal group and VX-2 tumor group was respectively 2.57±0.26, 1.73±0.31, 1.87±0.25 and 1.57±0.23 mm2/s. Their distinction was significant (F= 43.26, P＜0.01), the tumor ADC value between b values 100 and 300 s/mm2 wassignificant (Tukey HSP, P＜0.05) and the ADC value between VX-2 tumor and normal liver was also significant (Tukey HSP, P＜0.01). VX-2 tumor developed quickly and metastasized early to all body, especially to the lung, liver, lymph nodes of mediastinum, etc.CONCLUSION: The DWI signal of rabbit VX-2 tumor has its characteristics on MR DWI and DWI plays an important role in diagnosing and discovering VX-2 tumor.

Recent Progress of Diffusion Weighted Magnetic Resonance Imaging in Assessment of Tumor in the Body

In the last couple of years,as the development ofnew imaging techniques,diffusion-weighted magnetic resonanceimaging (DW-MRI) has been applied increasingly in the evaluationof various diseases in the body,and has been adopted frequentlyas an imaging tool in clinical tumor assessment.As a completelynon-invasive,highly sensitive,well-tolerated and relatively lowcost technique,diffusion-weighted imaging (DWI) can supplyboth quantitative and qualitative information at the cellular levelby exploring irregular diffusion motion of water molecules withintissues in the body.In this article,we summarized the recentapplication and reliability of DWI in tumor evaluation includingtumor detection,tumor features,and outcome of early treatmentresponse.

对比增强SWI对不同病理类型肺癌脑转移瘤的诊断价值

目的:探讨对比增强磁敏感加权成像(CE-SWI)与常规对比增强T 1WI成像(CE-T 1WI)对不同病理类型肺癌脑转移瘤的检出率差异,分析脑转移瘤内出现对比剂诱导相移(CIPS)与原发性肺癌病理类型间的关联性。方法:搜集经病理证实的79例原发性肺癌患者,其中腺癌组40例,鳞癌组18例,小细胞癌组21例,均行颅脑MR常规平扫、SWI、CE-T 1WI及CE-SWI检查,比较CE-SWI与CE-T 1WI检出的脑转移瘤数目及转移瘤内是否存在CIPS,转移灶经3个月后随访证实。结果:CE-T 1WI与CE-SWI对腺癌脑转移瘤的检出率差异有统计学意义(χ^(2)=5.05,P=0.025),对鳞癌(χ^(2)=0.00,P=1.000)与小细胞癌(χ^(2)=0.27,P=0.603)脑转移瘤的检出率差异无统计学意义。腺癌组、鳞癌组、小细胞癌组三组间CIPS阳性率差异有统计学意义(χ^(2)=11.13,P=0.004),其中鳞癌组与腺癌组(χ^(2)=11.08,P=0.001)、鳞癌组与小细胞癌组(χ^(2)=8.26,P=0.004)间差异有统计学意义,腺癌组与小细胞癌组间差异无统计学意义(χ^(2)=0.131,P=0.717)。结论:CE-SWI对肺腺癌脑转移瘤的检出较CE-T 1WI更有优势。肺腺癌、小细胞癌脑转移瘤的CIPS阳性率较鳞癌显著增高,CE-SWI可为肺癌脑转移瘤MRI检查常规序列的有利补充,为临床诊疗提供更多重要参考信息。

鳖甲煎丸对肝癌大鼠黏着斑激酶/雷帕霉素靶蛋白通路的影响

目的:探讨鳖甲煎丸对肝癌模型大鼠肝组织病理特征及FAK/mTORC1通路的影响。方法:HepG2(1×10^(7))细胞注射于大鼠右腋皮下,建立肝癌模型,分为模型组、5-氟尿嘧啶组、鳖甲煎丸低剂量组、鳖甲煎丸高剂量组,另设正常组。各药物组给予相应药物灌胃,持续给药4周,正常组、模型组给予等体积的0.9%氯化钠溶液。实验结束后,测定肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、肝癌FAK、mTORC1水平、肝癌VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白水平。结果:与正常组比较,模型组肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白、肝癌FAK、mTORC1 mRNA和蛋白表达升高(均P<0.05)。与模型组比较,5-氟尿嘧啶组、鳖甲煎丸低剂量组、鳖甲煎丸高剂量组肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白、肝癌FAK、mTORC1 mRNA和蛋白表达降低(均P<0.05)。鳖甲煎丸高剂量组肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白、肝癌FAK、mTORC1 mRNA和蛋白表达低于鳖甲煎丸低剂量组(均P<0.05)。结论:鳖甲煎丸对大鼠肝癌具有明显抑制作用,能减轻大鼠肝癌所致的病理损伤,其机制可能与鳖甲煎丸抑制肝癌FAK、mTORC1表达,诱导肝癌细胞凋亡,降低炎症反应有关。

磁共振脑灌注成像在鉴别颅内肿瘤性病变与非肿瘤性病变的应用研究

目的探讨磁共振脑灌注成像鉴别颅内肿瘤性病变与非肿瘤性病变的价值。方法选取临沂市人民医院2020年2月至2024年2月收治并经病理证实的33例颅内肿瘤患者作为肿瘤组,患者均为星形细胞瘤,按照肿瘤级别分为低级别组(15例)及高级别组(18例),选取同期收治的40例颅内非肿瘤性病变患者作为对照组。经磁共振常规序列及脑灌注成像扫描后,计算出肿瘤的最大脑血流量(CBF)最大脑血容量(CBV)。比较各组别的CBF、CBV值,分析影像学表现。结果肿瘤组中,高级别组的CBF、CBV值均高于低级别组,差异有统计学意义(P<0.05);肿瘤组的CBF、CBV值高于对照组,差异有统计学意义(P<0.05);图像显示,星形细胞瘤、脑炎及脱髓鞘患者的CBF、CBV值高于对侧的正常组织,可见明显高灌注表现。结论当星形细胞瘤表现不典型时,可行脑灌注成像检查,以期提高颅内肿瘤性病变及非肿瘤性病变诊断符合率。出现灌注明显升高时,应考虑肿瘤性病变。

T_(1)-mapping鉴别腮腺常见肿瘤的初探

目的:探讨T_(1)-mapping和分段读出DWI(RESOLVE-DWI)在腮腺常见肿瘤鉴别诊断中的价值。方法:回顾性分析2018年6月-2022年8月经病理证实的169例腮腺常见肿瘤患者的T_(1)-mapping及分段读出DWI资料。其中,多形性腺瘤85例,Warthin瘤32例,恶性肿瘤52例。测量并比较三组肿瘤的T_(1)及ADC值,运用受试者工作特征(ROC)曲线评价T_(1)、ADC及二者联合(T_(1)+ADC)对腮腺肿瘤的鉴别诊断价值。采用Delong检验比较各参数的AUC的差异。结果:三组肿瘤的T_(1)值和ADC值的差异均有统计学意义(P<0.001);组间两两比较,差异均有统计学意义(P<0.001);多形性腺瘤的T_(1)值及ADC值最高;恶性肿瘤次之,Warthin瘤最低。T_(1)和ADC鉴别多形性腺瘤与Warthin瘤、多形性腺瘤与恶性肿瘤、Warthin瘤与恶性肿瘤的AUC分别为0.914和0.997、0.664和0.869、0.835和0.695,Delong检验显示2个参数AUC的差异均无统计学意义(P>0.05)。T_(1)+ADC鉴别多形性腺瘤与Warthin瘤、多形性腺瘤与恶性肿瘤的AUC均显著高于T_(1)(1.000 vs.0.914、0.873 vs.0.664,P均<0.001);T_(1)+ADC鉴别Warthin瘤与恶性肿瘤的AUC显著高于T_(1)(0.895 vs.0.835,P<0.001)和ADC(0.895 vs.0.695,P<0.001)。结论:T_(1)-mapping和RESOLVE-DWI有助于鉴别诊断腮腺常见肿瘤,二者联合诊断可提高鉴别诊断效能。

全容积ADC直方图分析联合ADC值术前预测直肠癌肿瘤沉积的价值

目的探讨基于肿瘤全容积表观扩散系数(apparent diffusion coefficient,ADC)直方图参数联合ADC值在术前预测直肠癌肿瘤沉积(tumor deposits,TDs)中的应用价值。材料与方法回顾性分析苏州大学附属第一医院2016年6月至2023年6月术前行直肠MRI检查且经病理确诊的111例直肠癌患者的临床及影像学资料,依据病理结果将其分为TDs阳性组(n=30)和TDs阴性组(n=81),在ADC图像上手动勾画每一层肿瘤病灶感兴趣区(region of iterest,ROI)并提取ADC直方图参数,包括第10百分位数(ADC_(10%))、第90百分位数(ADC_(90%))、最大值(ADC_(max))、最小值(ADC_(min))、均数(ADC_(mean))、中位数(ADC_(median))、峰度及偏度;同时测量肿瘤最大层面的平均ADC值。分析比较两组患者间ADC值及ADC直方图参数的差异,将差异具有统计学意义的参数纳入多因素logistic回归分析构建联合模型,利用ROC曲线分析ADC值、全容积ADC直方图参数及两者联合模型的预测效能。采用DeLong检验比较各AUC间的差异。结果ADC值、ADC_(10%)、ADC_(90%)、ADC_(max)、ADC_(mean)、ADC_(median)及峰度在TDs阳性组和阴性组间差异具有统计学意义(P<0.05),以ADC_(90%)的预测效能最高(AUC、敏感度、特异度分别为0.778、80.0%、65.4%)。由ADC值、ADC_(10%)、ADC_(90%)、ADC_(mean)构建的联合模型AUC、敏感度、特异度分别为0.940、86.7%、93.8%,其诊断效能优于ADC值(AUC为0.645)及各全容积ADC直方图参数(AUC为0.649~0.778),差异均有统计学意义(P<0.05)。结论全容积ADC直方图参数及肿瘤最大层面的ADC值可用于术前预测直肠癌TDs,尤其当两者联合时具有较高的预测效能。

动态对比增强磁共振成像及弥散加权成像参数与乳腺癌肿瘤突变负荷的相关性

目的探讨动态对比增强磁共振成像(DCE-MRI)及弥散加权成像(DWI)参数与乳腺癌肿瘤突变负荷(TMB)的相关性,评价DCE-MRI及DWI在乳腺癌免疫治疗中的潜在价值。方法回顾性分析山西医科大学附属运城医院暨第八临床医学院2019~2021年共100例乳腺癌患者的临床资料和术前MRI检查结果。根据TMB值的中位数(5.4/Mb),将100例患者分为TMB高表达组(TMB≥5.4/Mb,n=28)和TMB低表达组(TMB<5.4/Mb,n=72)。提取DCE-MRI及DWI的影像特征,计算表观扩散系数(ADC)和动态增强曲线类型等参数。采用高通量测序技术检测肿瘤组织中的基因突变情况,计算TMB值。分析DCE-MRI及DWI参数与TMB值之间的相关性,以及与乳腺癌病理指标[雌激素受体、孕激素受体、人表皮生长因子受体2、Ki67]之间的关系。采用单因素和多因素Logistic回归分析筛选影响TMB值的独立危险因素。结果DCE-MRI及DWI参数中,ADC值、动态增强曲线类型、峰值信号强度、时间-信号强度曲线斜率等与TMB值呈负相关关系(P<0.05),而峰时、时间-信号强度曲线下面积等与TMB值呈正相关关系(P<0.05)。乳腺癌病理指标中,雌激素受体、孕激素受体、人表皮生长因子受体2、Ki67的表达与TMB值均无相关性(P>0.05)。多因素Logistic回归分析显示,ADC值、动态增强曲线类型和峰时是影响TMB值的独立危险因素。结论DCEMRI及DWI参数与乳腺癌TMB值存在显著相关性,可作为评估乳腺癌免疫治疗效果的辅助手段。

全身磁共振弥散加权成像联合多层螺旋CT对多发性骨髓瘤的诊断价值

目的 探究全身磁共振弥散加权成像(WB-DWI)联合多层螺旋CT对多发性骨髓瘤的诊断价值。方法 选取2019年6月~2023年1月于我院收治的80例多发性骨髓瘤患者为研究对象,并按照检测方式将其分为WB-DWI组(n=25)、多层螺旋CT组(n=25)、联合组(n=30)。分析WB-DWI、多层螺旋CT单一及联合对患者累及部位的检出率,分析两种检查方式单一及联合对多发性骨髓瘤的检出情况,通过ROC曲线分析WB-DWI、多层螺旋CT联合诊断多发性骨髓瘤的临床价值。结果 检测结果主要与Durie-Salmon分期、国际骨髓瘤分期相关(P<0.05)。与WB-DWI、多层螺旋CT单一检测对比,联合检测患者累及部位的检出率较高(P<0.05)。在多发性骨髓瘤诊断中WB-DWI、多层螺旋CT联合检测高于单一检测(P<0.05)。与WB-DWI、多层螺旋CT单项诊断对比,两项联合诊断多发性骨髓瘤的敏感度、特异性、准确性均较高(P<0.05)。结论 相较于WB-DWI、多层螺旋CT单项检测,联合检测可有效提升患者病理检出情况,提高对多发性骨髓瘤的诊断价值。

弥散加权成像在CT引导下肺肿块穿刺活检的临床应用

目的 探讨磁共振弥散加权成像(DWI)在CT引导下肺肿块穿刺活检术的应用价值。方法 回顾性分析2022年10月~2023年10月在陕西中医药大学附属医院行CT引导下肺肿块穿刺的152例患者,根据术前有无胸部DWI检查分为A组(无DWI检查,n=85),B组(有DWI检查,n=67)。比较两组患者的一般资料、病理阳性率、调针次数、靶皮距、套管针在肺内长度和并发症。结果 A组病理诊断为恶性肿瘤65例,良性病变9例,未明确诊断11例;B组病理诊断为恶性肿瘤57例,良性病变8例,未明确诊断2例;A组和B组病理阳性率分别为87.06%和97.01%,差异有统计学意义(P=0.029)。2组总体并发症发生率及气胸发生率的差异无统计学意义(P>0.05),但A、B组出血发生率分别为30.59%、13.43%,差异有统计学意义(P<0.05)。结论 CT引导下肺肿块穿刺活检前行胸部DWI检查,有助于指导穿刺靶点的选择,提高病理诊断阳性率,减少穿刺相关出血事件发生,具有较好临床实用价值。

非增强下DWI结合syMRI对乳腺良恶性肿瘤的鉴别诊断价值

目的:探讨弥散加权成像(DWI)结合合成磁共振成像(syMRI)对乳腺良恶性肿瘤的鉴别诊断价值。方法:选取2020年5月—2022年3月桂林医学院附属医院收治的69例乳腺肿瘤患者。所有患者术前均行MRI检查,包括平扫、DWI和syMRI MAGiC序列(组织T_(1)、T_(2)和PD值快速定量)。绘制受试者工作特征(ROC)曲线,分析表观弥散系数(ADC)值和syMRI值及两参数联合对乳腺良恶性疾病的诊断效率。结果:69例乳腺肿瘤患者中恶性53例(76.8%),良性16例(23.2%)。良恶性肿瘤ADC值与T_(1)、T_(2)值比较,差异有统计学意义(P<0.05)。经ROC曲线分析独立参数ADC、T_(1)、T_(2)和联合参数的曲线下面积分别为0.903、0.703、0.818、0.956。联合参数(ADC值和T_(1)、T_(2)值)的诊断效率高于单参数ADC值(P<0.05)。结论:DWI联合syMRI可提高乳腺良恶性肿瘤的鉴别效率。

原发性肠系膜神经内分泌肿瘤MRI表现一例

本研究遵守《赫尔辛基宣言》,并经过青海大学附属医院医学伦理委员会批准,免除受试者知情同意,批准文号:YJ-SL-2017。患者女,51岁。主诉下腹部疼痛不适3个月余。患者于3个月前开始左下腹疼痛不适,无胸骨后疼痛,无心悸、呼吸困难,无腹泻、腹胀、黑便等症状。专科检查:患者神志清,精神可。双肺呼吸音清,双肺未闻及干湿性啰音,未闻及胸膜摩擦音。

常规磁共振成像联合弥散加权成像诊断直肠癌术前分期的准确性及漏诊误诊原因

目的 针对常规磁共振成像(MRI)联合弥散加权成像(DWI)诊断直肠癌术前分期的准确性及漏诊、误诊的原因进行探讨。方法 回顾性选取我院收治的58例直肠癌患者作为研究对象,选取时间为2020年1月至2023年2月。所有患者均接受常规MRI序列联合DWI检查、病理检查,金标准为病理检查结果。比较所有患者经术前常规MRI联合DWI、病理检查对肿瘤侵犯的深度(T分期)、淋巴结转移情况(N分期)的检出结果;统计术前常规MRI联合DWI成像检查T、N分期的诊断效能,并对相关影像学图片进行分析。结果 病理结果显示,58例直肠癌患者中T1分期13例,T2分期16例,T3分期19例,T4分期10例;N0分期24例,N1分期18例,N2a分期7例,N2b分期9例。常规MRI联合DWI成像检查结果显示,58例直肠癌患者中T1分期10例,T2分期15例,T3分期17例,T4分期16例;N0分期22例,N1分期20例,N2a分期8例,N2b分期8例,其结果均与病理结果较为接近;患者术前应用常规MRI联合DWI成像检查T分期、N分期总体的特异度、灵敏度、准确度均较高。结论 临床可根据常规MRI联合DWI诊断结果及影像学特点综合评估直肠癌患者术前肿瘤分期。

磁共振扩散加权成像鉴别颅内孤立性纤维瘤和不同级别脑膜瘤的研究进展

颅内孤立性纤维瘤(solitary fibrous tumor,SFT)具有易复发和手术中出血概率高的特点,必须积极地进行周密的术前与术中准备及系统的术后治疗,而与之影像学表现相似的脑膜瘤多为良性,术中不易出血且预后较好,因此手术或治疗前准确区分SFT和脑膜瘤至关重要。本文系统综述了磁共振扩散加权成像在区分颅内SFT和高级别脑膜瘤、低级别脑膜瘤以及血管瘤型脑膜瘤中的研究进展以及病理生理机制,深入探讨该序列在提高鉴别诊断准确性等方面的优势和价值,为后续研究提供参考思路,并在术前评估及术中决策方面为临床医生提供有效的帮助,以期提高患者的预后和生活质量。

低分子肝素钙联合逐级加压弹力袜预防妇科恶性肿瘤患者术后下肢深静脉血栓的临床研究

目的探讨低分子肝素钙联合逐级加压弹力袜预防妇科恶性肿瘤患者术后下肢深静脉血栓(DVT)的临床效果。方法选取2022年1—12月于赣南医学院第一附属医院经外科手术治疗的180例妇科肿瘤患者作为研究对象,按照随机数字表法分为对照组与研究组,每组90例。对照组予低分子肝素钙进行常规治疗,研究组在对照组基础上联合逐级加压弹力袜治疗。比较两组血清学指标、凝血功能指标、血流速度、下肢周径及术后DVT发生情况。结果干预后,研究组血小板计数、纤维蛋白原、D-二聚体水平均低于对照组,差异有统计学意义(P<0.05)。干预后,研究组活化部分凝血活酶时间、凝血酶原时间、凝血酶时间均长于对照组,下肢血流峰速、血流平均速度均快于对照组,差异有统计学意义(P<0.05)。干预后,研究组下肢周径短于对照组,术后下肢DVT发生率低于对照组,差异有统计学意义(P<0.05)。结论低分子肝素钙联合逐级加压弹力袜治疗经外科手术的妇科肿瘤患者,有助于预防术后DVT形成,改善机体血流状态,值得临床推广应用。

恶性肿瘤合并糖尿病健康教育路径的临床研究

目的 探讨健康教育路径在恶性肿瘤合并糖尿病患者中的应用。方法 选取2021年4月至2023年3月四川省肿瘤医院普通内科收治的恶性肿瘤合并糖尿病患者216例,其中2021年4月至2022年3月入院患者100例作为对照组,2022年4月至2023年3月入院患者116例作为干预组。对照组给予常规护理,干预组在对照组基础上联合健康教育路径表,使用糖尿病自我管理及障碍问卷(PDQ)进行测评与分析,比较两组患者入院及出院时的空腹血糖、餐后2 h血糖、体重和两组患者入院、出院、出院后一个月时的自我管理行为。结果 两组患者在出院及出院后一个月自我管理行为较入院时均有改善,干预组PDQ评分项目中的饮食知识与技能、膳食决策较对照组明显提高(P<0.05),饮食问题以及饮食、运动、血糖监测障碍较对照组明显下降(P<0.05),出院时干预组体重无明显下降,对照组下降明显(P<0.05);两组患者空腹及餐后2 h血糖均达标,差异无统计学意义(P>0.05)。结论 恶性肿瘤合并糖尿病患者在实施健康教育路径后取得较好的效果,明显提高了患者自我管理行为,对肿瘤患者治疗期间稳定体重有不可忽视的作用,是一项有效的干预方法,值得临床推广。