50例原发性肝癌动态CT扫描结果分析

分析了50例经病理和肝穿刺细胞活检证实的原发性肝细胞癌动态CT扫描结果。以平扫选择层面,静快速推注60％泛影葡胺100ml,于注药后5s,10s,15s,30s,120s,120s,300s,和350s各扫描一片。在动态扫描图像上,肝癌的时间—密度曲线峰值与主动脉的时间密度曲线峰值同步出现,说明肝癌血供主要源于肝动脉。动态增强扫描可增加肝动脉—门静脉瘘、肝静脉或门静脉侵犯、门静脉或腔静脉内瘤栓形成的检出率。这对指导手术切除治疗有较大意义。

Who needs further evaluations to diagnose upper urinary tract urothelial cancers among patients with abnormal findings by enhanced CT?

Objective:We evaluated who would need further evaluations such as retrograde pyelography(RP)and/or ureteroscopy to diagnose upper urinary tract urothelial cancers(UUTUCs)when abnormal findings for the upper urinary tract(UUT)were detected by enhanced computed tomography(CT).Methods:We retrospectively analyzed 125 patients who underwent enhanced CT for various reasons and had abnormal findings for the UUT.Patients whose tumors were suspected to be of extraureteral origin were excluded.All patients received RP and/or ureteroscopy to evaluate the UUTUCs.Results:The median age of the 125 patients was 70 years and gross hematuria(26.4%)was the most frequently observed symptoms.RP,ureteroscopy and both were performed for 121,59 and 55 patients,respectively.CT revealed tumor-like lesions in 58 patients and the other patients had non-tumor-like lesions.UUTUCs were found in 43(34.4%)of the 125 patients.All of them had tumor-like lesions on CT.In 58 patients who had tumor-like lesions on CT,univariate and multivariate analyses revealed that tumor diameter and tumor enhancement were significant predictive factors for UUTUCs.ROC curve analysis of enhanced CT to diagnose UUTUCs revealed that a tumor diameter of 18 mm was the best cutoff point.The sensitivity,specificity and accuracy were 90.0%,98.8% and 92.7% for RP and 95.5%,100% and 97.1%for ureteroscopy,respectively.Both of them had high sensitivity,specificity and accuracy.Conclusion:We should decide to evaluate the UUT according to the tumor diameter on enhanced CT.When we evaluate the UUT in patients with tumor diameters of less than 20 mm,ureteroscopy is recommended.

Correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer

Objective:To study the correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer.Methods:60 patients with advanced non-small cell lung cancer who were treated in this hospital between January 2015 and January 2017 were divided into control group(n=30)and observation group(n=30)by random number table method.Control group received conventional intravenous chemotherapy,and observation group received intravenous chemotherapy combined with radiofrequency ablation.The differences in CT dynamic enhanced scanning parameter levels and serum tumor marker contents were compared between the two groups of patients before and after treatment.Pearson test was used to evaluate the correlation between CT dynamic enhanced scanning parameters and serum tumor marker contents in patients with advanced non-small cell lung cancer.Results:Before treatment,the differences in CT dynamic enhanced scanning parameter levels,non-organ-specific tumor marker contents and vascular tumor marker contents were not statistically significant between the two groups of patients(P>0.05).After treatment,CT dynamic enhanced scanning parameters PH and perfusion value levels of observation group were lower than those of control group(P<0.05);serum non-organ specific tumor markers CA125,CA153,CEA and CYFRA21-1 contents of observation group were lower than those of control group;serum vascular tumor markers VEGF,Ang-2,HIF-1 and MMP-9 contents were lower than those of control group(P<0.05).Pearson test showed that CT dynamic enhanced scanning parameters PH and perfusion value levels in patients with non-small cell lung cancer were positively correlated with serum non-organ specific tumor marker and vascular tumor marker contents.Conclusion:Adjuvant radiofrequency ablation can significantly reduce the tumor malignancy of patients with advanced non-small cell lung cancer.

Observations on the Diagnostic Effects of CT Examination(Enhanced Scan)on Hemorrhage Corpus Luteum Cyst

Objective:To investigate the diagnostic effects of enhanced CT scan on hemorrhage corpus luteum cyst(HCLC).Methods:The clinical data of 24 patients with hemorrhage corpus luteum cyst diagnosed by surgery and pathology in our hospital were collected.All patients received enhanced CT scan to evaluate the diagnostic value of CT.Results:The average diameter of the cysts in this group of patients was 5.1cm by CT.Further detection of the ruptured cyst wall showed that there was a liquid lowdensity shadow.Some of the cysts were accompanied by signs of increased density,indicating the presence of blood clots;all patients received surgical treatment.Intraoperative ultrasound examination of the cysts had an average diameter of 5.2cm and a wall of 0.2~0.4mm.Among them,19 cases of cysts contained"coffee-colored"liquid with varying degrees of blood clots,and 5 cases had no blood clots in the cysts but there were a lot of blood clots beside the cysts.Conclusion:The application of enhanced CT scan in patients with hemorrhage corpus luteum cyst is of great value.It can provide accurate data reference for clinical treatment and is worthy of promoting its clinical application.

Neonatal Brain Abscess:Case Report of 12 Cases and Literature Review

Objective:To investigate the etiological characteristics,clinical manifestations,and early identification methods of neonatal brain abscess.Methods:The baseline characteristics,clinical manifestations,and laboratory results of 12 neonatal brain abscess cases were retrospectively analyzed.Results:The clinical manifestations were fever,convulsion,and lethargy.A small number of them had respiratory and circulatory failure.The diagnosis made was based on imaging examination.All 12 cases were confirmed by cranial enhanced computed tomography(CT)or magnetic resonance imaging(MRI).Blood cultures of 9 cases were positive,with Escherichia coli in 6 cases,β-hemolytic Streptococcus in 1 case,methicillin-resistant Staphylococcus aureus in 1 case,and Enterococcus faecium in 1 case.However,only 3 of them had positive cerebrospinal fluid(CSF)cultures.All the 12 neonates were treated with antibiotic therapy upon admission,with only 3 cases treated with surgery.Among them,4 recovered and were discharged,while the remaining 8 discontinued their therapy.Conclusion:Escherichia coli is the most common pathogen of neonatal brain abscess in our study.The clinical manifestations of neonatal brain abscess are atypical,and the prognosis is poor.Respiratory and circulatory failure in children with intracranial infection may indicate the presence of brain abscess.For children with suspected brain abscess,cranial enhanced CT or MRI should be performed as soon as possible to make an early diagnosis.The prevention of brain abscess should be prioritized;neonates with sepsis or meningitis should receive prompt and strong antibiotic therapy in an effort to prevent the development of brain abscess.