AIM:To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).METHODS: A total of 20 patients with pathologically-...AIM:To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).METHODS: A total of 20 patients with pathologically-confirmed intraductal papillary mucinous neoplasms (IPMNs) were included in this study. Axial MDCT images combined with CT angiography (CTA) and multiplanar volume reformations (MPVR) or curved reformations (CR) were preoperatively acquired. Two radiologists (Tan L and Wang DB) reviewed all the images in consensus using an interactive picture archiving and communication system. The disputes in readings were resolved through consultation with a third experienced radiologist (Chen KM). Finally, the findings and diagnoses were compared with the pathologic results.RESULTS: The pathological study revealed 12 malignant IPMNs and eight benign IPMNs. The diameters of the cystic lesions and main pancreatic ducts (MPDs) were significantly larger in malignant IPMNs compared with those of the benign IPMNs (P<0.05). The combined-type IPMNs had a higher rate of malignancy than the other two types of IPMNs (P<0.05). Tumors with mural nodules and thick septa had a significantly higher incidence of malignancy than tumors without these features (P<0.05). Communication of side-branch IPMNs with the MPD was present in nine cases at pathologic examination. Seven of them were identified from CTA and MPVR or CR images. From comparison with the pathological diagnosis, the sensitivity, specificity, and accuracy of MDCT in characterizing the malignancy of IPMN of the pancreas were determined to be 100%, 87.5% and 95%, respectively.CONCLUSION: MDCT with CTA and MPVR or CR techniques can elucidate the imaging features of IPMNs and help predict the malignancy of these tumors.展开更多
Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric can...Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric cancer in young people (14–35 years). Results: The clinical manifestations of gastric carcinoma in young people show no specificity, and the initial symptoms were diverse, with discomfort in the upper abdomen as the main symptom. There are four causes of difficulty in early detection: (1) The previous physician relied on antacids and did not use or analyze the results of gastroscopic examination and barium meal examination of the upper digestive tract; (2) The physician performing the endoscopic examination did not strictly follow the standards in the biopsy of fine pathological changes in suspected early cancer; (3) The physician lacked a good understanding of the clinical progress of ulcerating-healing-ulcerating in the ulcerating type of early gastric cancer; (4) Lacked a good understanding of precancerous lesions in the gastric mucosa. Conclusion: Early gastroscopy and pathological examina- tion must be conducted for people who above 20 years of age with one or more of the following symptoms: dull pain in the upper abdomen, anorexia, fatigue, tarry stool and vomiting of unknown origin. The results of gastroscopic examination should be taken into consideration for patients with recurrent ulcer, and biopsy should be standardized. Biopsy specimens should be taken from several loci in the suspected lesions, and should be repeated if necessary. Precancerous lesions of gastric mucosa should be closely followed up using gastroscopy.展开更多
基金Supported by Shanghai Leading Academic Discipline Project,No.S30203
文摘AIM:To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).METHODS: A total of 20 patients with pathologically-confirmed intraductal papillary mucinous neoplasms (IPMNs) were included in this study. Axial MDCT images combined with CT angiography (CTA) and multiplanar volume reformations (MPVR) or curved reformations (CR) were preoperatively acquired. Two radiologists (Tan L and Wang DB) reviewed all the images in consensus using an interactive picture archiving and communication system. The disputes in readings were resolved through consultation with a third experienced radiologist (Chen KM). Finally, the findings and diagnoses were compared with the pathologic results.RESULTS: The pathological study revealed 12 malignant IPMNs and eight benign IPMNs. The diameters of the cystic lesions and main pancreatic ducts (MPDs) were significantly larger in malignant IPMNs compared with those of the benign IPMNs (P<0.05). The combined-type IPMNs had a higher rate of malignancy than the other two types of IPMNs (P<0.05). Tumors with mural nodules and thick septa had a significantly higher incidence of malignancy than tumors without these features (P<0.05). Communication of side-branch IPMNs with the MPD was present in nine cases at pathologic examination. Seven of them were identified from CTA and MPVR or CR images. From comparison with the pathological diagnosis, the sensitivity, specificity, and accuracy of MDCT in characterizing the malignancy of IPMN of the pancreas were determined to be 100%, 87.5% and 95%, respectively.CONCLUSION: MDCT with CTA and MPVR or CR techniques can elucidate the imaging features of IPMNs and help predict the malignancy of these tumors.
文摘Objective: To summarize the causes of difficulty in gastric cancer diagnosis in young people and explore potential methods of improving diagnostic accuracy. Methods: We retrospectively analyzed 78 cases of gastric cancer in young people (14–35 years). Results: The clinical manifestations of gastric carcinoma in young people show no specificity, and the initial symptoms were diverse, with discomfort in the upper abdomen as the main symptom. There are four causes of difficulty in early detection: (1) The previous physician relied on antacids and did not use or analyze the results of gastroscopic examination and barium meal examination of the upper digestive tract; (2) The physician performing the endoscopic examination did not strictly follow the standards in the biopsy of fine pathological changes in suspected early cancer; (3) The physician lacked a good understanding of the clinical progress of ulcerating-healing-ulcerating in the ulcerating type of early gastric cancer; (4) Lacked a good understanding of precancerous lesions in the gastric mucosa. Conclusion: Early gastroscopy and pathological examina- tion must be conducted for people who above 20 years of age with one or more of the following symptoms: dull pain in the upper abdomen, anorexia, fatigue, tarry stool and vomiting of unknown origin. The results of gastroscopic examination should be taken into consideration for patients with recurrent ulcer, and biopsy should be standardized. Biopsy specimens should be taken from several loci in the suspected lesions, and should be repeated if necessary. Precancerous lesions of gastric mucosa should be closely followed up using gastroscopy.
