AIM:To investigate the sonographic features and diagnostic value of endoscopic ultrasonography (EUS) for duodenal lipomas (DLs).METHODS:A total of eight consecutive patients with DL diagnosed pathologically were inclu...AIM:To investigate the sonographic features and diagnostic value of endoscopic ultrasonography (EUS) for duodenal lipomas (DLs).METHODS:A total of eight consecutive patients with DL diagnosed pathologically were included in the study.One EUS expert reviewed the ultrasonic images for all lesions,including the original layer of the duodenal wall,the echo intensity and the echo homogeneity.The size of the lesions and the perifocal structures were also investigated.The diagnosis by EUS was compared with the histological results.RESULTS:Using routine endoscopy,only one case was correctly diagnosed as DL.Four cases were classified as submucosal tumors,and three cases were mistaken for stromal tumors.All tumors appeared as round or oval intensive hyperechoic lesions with distinct anterior borders that originated from the submucosal layer on EUS.Tumors ranged from 8 to 36 mm in size,with an average size of 16 mm.Homogeneous echogenicity was seen in all cases except one that had a tubular structure inside the tumor.Echo attenuation was observed only in the area behind the tumors in five cases,and it was observed both inside and behind the tumors in three cases in which the posterior border was obscure or invisible.Seven (87.5%) cases were correctly diagnosed as DL,and one (12.5%) was mistaken as Brunner's gland adenoma by EUS.Pathologically,all tumors originated from the submucosal layer and consisted of mature fat cells without heteromorphism.Among the fat cells,there was a small amount of thick-wall vessels infiltrating the lymphocytes,and abundant fibrous connective tissues.CONCLUSION:On EUS,DL is featured as an intensive homogeneous hyperechoic submucosal lesion with marked echo attenuation and without involvement of the mucosa.展开更多
Objective To quantitatively compare and determine the best pancreatic tumor contrast to noise ratio (CNR) in different dual-energy derived datasets. Methods In this retrospective, single center study, 16 patients (9 m...Objective To quantitatively compare and determine the best pancreatic tumor contrast to noise ratio (CNR) in different dual-energy derived datasets. Methods In this retrospective, single center study, 16 patients (9 male, 7 female, average age 59.4±13.2 years) with pathologically diagnosed pancreatic cancer were enrolled. All patients received an abdominal scan using a dual source CT scanner 7 to 31 days before biopsy or surgery. After injection of iodine contrast agent, arterial and pancreatic parenchyma phase were scanned consequently, using a dual-energy scan mode (100 kVp/230 mAs and Sn 140 kVp/178 mAs) in the pancreatic parenchyma phase. A series of derived dual-energy datasets were evaluated including non-liner blending (non-linear blending width 0-500 HU; blending center -500 to 500 HU), mono-energetic (40-190 keV), 100 kVp and 140 kVp. On each datasets, mean CT values of the pancreatic parenchyma and tumor, as well as standard deviation CT values of subcutaneous fat and psoas muscle were measured. Regions of interest of cutaneous fat and major psoas muscle of 100 kVp and 140 kVp images were calculated. Best CNR of subcutaneous fat (CNR F ) and CNR of the major psoas muscle (CNR M ) of non-liner blending and mono-energetic datasets were calculated with the optimal mono-energetic keV setting and the optimal blending center/width setting for the best CNR. One Way ANOVA test was used for comparison of best CNR between different dual-energy derived datasets. Results The best CNR F (4.48±1.29) was obtained from the non-liner blending datasets at blending center -16.6±103.9 HU and blending width 12.3±10.6 HU. The best CNR F (3.28±0.97) was obtained from the mono-energetic datasets at 73.3±4.3 keV. CNR F in the 100 kVp and 140 kVp were 3.02±0.91 and 1.56±0.56 respectively. Using fat as the noise background, all of these images series showed significant differences (P<0.01) except best CNR F of mono-energetic image sets vs. CNR F of 100 kVp image (P=0.460). Similar results were found using muscle as the noise background (mono-energetic image vs. 100 kVp image: P=0.246; mono-energetic image vs. non-liner blending image: P=0.044; others: P<0.01). Conclusion Compared with mono-energetic datasets and low kVp datasets, non-linear blending image at automatically chosen blending width/window provides better tumor to the pancreas CNR, which might be beneficial for better detection of pancreatic tumors.展开更多
It is very innovative significance that Chinese Literary Anthropology invents the Great Tradition in the new century and puts forward series of theoretical propositions and academic points based on it. The new Great T...It is very innovative significance that Chinese Literary Anthropology invents the Great Tradition in the new century and puts forward series of theoretical propositions and academic points based on it. The new Great Tradition transforms the opposition between the Great and Little Tradition of American anthropology, and makes the new concepts gain the legitimacy of the cultural values transferred from the old terms. It dates the second coded significance of the written culture from the material narrative and the image narrative of the oral tradition, and highlights the generative and primary of the symbolic significance. It also questions the authenticity of the written representation, endows the truth and credibility to the material and image representation, and manifests the imaginative and expression of the early human culture. Though its theoretical innovation inverts the binary opposition structure, and it wants to jump out of knowledge limits of dual structure such as structure and destruction, objective and subjective, material and spiritual.展开更多
基金Supported by Medical and Health Research Fund of Zhejiang Province,China,No. 491010-W10495
文摘AIM:To investigate the sonographic features and diagnostic value of endoscopic ultrasonography (EUS) for duodenal lipomas (DLs).METHODS:A total of eight consecutive patients with DL diagnosed pathologically were included in the study.One EUS expert reviewed the ultrasonic images for all lesions,including the original layer of the duodenal wall,the echo intensity and the echo homogeneity.The size of the lesions and the perifocal structures were also investigated.The diagnosis by EUS was compared with the histological results.RESULTS:Using routine endoscopy,only one case was correctly diagnosed as DL.Four cases were classified as submucosal tumors,and three cases were mistaken for stromal tumors.All tumors appeared as round or oval intensive hyperechoic lesions with distinct anterior borders that originated from the submucosal layer on EUS.Tumors ranged from 8 to 36 mm in size,with an average size of 16 mm.Homogeneous echogenicity was seen in all cases except one that had a tubular structure inside the tumor.Echo attenuation was observed only in the area behind the tumors in five cases,and it was observed both inside and behind the tumors in three cases in which the posterior border was obscure or invisible.Seven (87.5%) cases were correctly diagnosed as DL,and one (12.5%) was mistaken as Brunner's gland adenoma by EUS.Pathologically,all tumors originated from the submucosal layer and consisted of mature fat cells without heteromorphism.Among the fat cells,there was a small amount of thick-wall vessels infiltrating the lymphocytes,and abundant fibrous connective tissues.CONCLUSION:On EUS,DL is featured as an intensive homogeneous hyperechoic submucosal lesion with marked echo attenuation and without involvement of the mucosa.
文摘Objective To quantitatively compare and determine the best pancreatic tumor contrast to noise ratio (CNR) in different dual-energy derived datasets. Methods In this retrospective, single center study, 16 patients (9 male, 7 female, average age 59.4±13.2 years) with pathologically diagnosed pancreatic cancer were enrolled. All patients received an abdominal scan using a dual source CT scanner 7 to 31 days before biopsy or surgery. After injection of iodine contrast agent, arterial and pancreatic parenchyma phase were scanned consequently, using a dual-energy scan mode (100 kVp/230 mAs and Sn 140 kVp/178 mAs) in the pancreatic parenchyma phase. A series of derived dual-energy datasets were evaluated including non-liner blending (non-linear blending width 0-500 HU; blending center -500 to 500 HU), mono-energetic (40-190 keV), 100 kVp and 140 kVp. On each datasets, mean CT values of the pancreatic parenchyma and tumor, as well as standard deviation CT values of subcutaneous fat and psoas muscle were measured. Regions of interest of cutaneous fat and major psoas muscle of 100 kVp and 140 kVp images were calculated. Best CNR of subcutaneous fat (CNR F ) and CNR of the major psoas muscle (CNR M ) of non-liner blending and mono-energetic datasets were calculated with the optimal mono-energetic keV setting and the optimal blending center/width setting for the best CNR. One Way ANOVA test was used for comparison of best CNR between different dual-energy derived datasets. Results The best CNR F (4.48±1.29) was obtained from the non-liner blending datasets at blending center -16.6±103.9 HU and blending width 12.3±10.6 HU. The best CNR F (3.28±0.97) was obtained from the mono-energetic datasets at 73.3±4.3 keV. CNR F in the 100 kVp and 140 kVp were 3.02±0.91 and 1.56±0.56 respectively. Using fat as the noise background, all of these images series showed significant differences (P<0.01) except best CNR F of mono-energetic image sets vs. CNR F of 100 kVp image (P=0.460). Similar results were found using muscle as the noise background (mono-energetic image vs. 100 kVp image: P=0.246; mono-energetic image vs. non-liner blending image: P=0.044; others: P<0.01). Conclusion Compared with mono-energetic datasets and low kVp datasets, non-linear blending image at automatically chosen blending width/window provides better tumor to the pancreas CNR, which might be beneficial for better detection of pancreatic tumors.
文摘It is very innovative significance that Chinese Literary Anthropology invents the Great Tradition in the new century and puts forward series of theoretical propositions and academic points based on it. The new Great Tradition transforms the opposition between the Great and Little Tradition of American anthropology, and makes the new concepts gain the legitimacy of the cultural values transferred from the old terms. It dates the second coded significance of the written culture from the material narrative and the image narrative of the oral tradition, and highlights the generative and primary of the symbolic significance. It also questions the authenticity of the written representation, endows the truth and credibility to the material and image representation, and manifests the imaginative and expression of the early human culture. Though its theoretical innovation inverts the binary opposition structure, and it wants to jump out of knowledge limits of dual structure such as structure and destruction, objective and subjective, material and spiritual.
