Objective: To study the accuracy between CT and MRI in delineating gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) in making radiotherapy plan. Methods: The clinical data of 39 cases pathologically proven a...Objective: To study the accuracy between CT and MRI in delineating gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) in making radiotherapy plan. Methods: The clinical data of 39 cases pathologically proven as nasopharyngeal carcinoma selected from April 2003 to September 2004 were retrospectively analyzed. All were subjected to CT and MR examination one week before treatment. CT scanning was performed with GE Light speed 16, and axial scan was parallel to the OM line routinely from soft palate to the suprasellar cistern. MR scanning was performed by GE Signa super-conducting magnetic resonance imaging system (1.5 Tesla). The standard quadrature head coil was used. Routine axial, sagittal and coronal image with SE sequence were obtained, and FLAIR was used in 10 of 21 cases. Scanned field ranged from the soft palate to the suprasellar cistern. Part of all cases underwent enhanced scanned with Ultravist in CT group or/and GD-DTPA in MR group. All data were analyzed by using the paired-samples t test. Results: The media primary tumor volume (cm3) in CT group and MR group was 32.49±19.91, 29.06±18.75, respectively, and the difference between the two groups were significant (t=5.268, P=0.000). There was significant difference between the two groups in early stage (T1+T2) and advanced stage (T3+T4) by Fuzhou Staging System (t=5.677, P=0.000; t=3.310, P=0.005, respectively). There was significant difference in stage T1, T2, T3 (P=0.005, P=0.001, P=0.004, respectively), and not in stage T4 (P=0.146) between the two groups. Conclusion: MR was more accurate than CT in delineating GTV of NPC, so, is more valuable in making radiotherapy plan.展开更多
Colorectal cancer (CRC) remains a leading cancer killer worldwide. But the disease is both curable and preventable at an early stage. Regular CRC cancer screening has been shown to reduce the risk of dying from CRC. H...Colorectal cancer (CRC) remains a leading cancer killer worldwide. But the disease is both curable and preventable at an early stage. Regular CRC cancer screening has been shown to reduce the risk of dying from CRC. However, the importance of large-scale screening is only now starting to be appreciated. This article reviews a variety of imaging procedures available for detecting ulcerative colitis (UC) and Crohn's disease (CD), polyps and CRC in their early stage and also presents details on various screening options. Detecting, staging and re-staging of patients with CRC also require multimodality, multistep imaging approaches. Staging and re-staging with conventional colonoscopy (CC), computer tomography colonography (CTC), magnetic resonance colonography (MRC) and positron emission tomography/computer tomography colonography (PET/CTC) are of paramount importance in determining the most appropriate therapeutic method and in predicting the risk of tumor recurrence and overall prognosis. The advantages and limitations of these modalities are also discussed.展开更多
AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists...AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists independently evaluated CT and MR imaging of 31 patients who had undergone lymphadenectomy (9 metastatic and 22 non-metastatic paraaortic nodes). Receiver operating characteristic (ROC) curve analysis was performed using a five point scale to compare CT with MRI. To re-define the morphologic features of metastatic nodes, we evaluated CT scans from 70 patients with 23 metastatic paraaortic nodes and 47 non-metastatic ones. The short axis diameter, ratio of the short to long axis, shape, and presence of necrosis were compared between metastatic and non-metastatic nodes by independent samples t-test and Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS:The mean area under the ROC curve for CT (0.732 and 0.646, respectively) was slightly higher than that for MRI (0.725 and 0.598, respectively) without statistical significance (P = 0.940 and 0.716,respectively). The short axis diameter of the metastatic lymph nodes (mean = 9.2 mm) was significantly larger than that of non-metastatic ones (mean = 5.17 mm, P < 0.05). Metastatic nodes had more irregular margins (44.4%) and central necrosis (22.2%) than non-metastatic ones (9% and 0%, respectively), with statistical significance (P < 0.05). CONCLUSION:The accuracy of CT scan for the characterization of paraaortic nodes is not different from that of MRI. A short axis-diameter (> 5.3 mm), irregular margin, and presence of central necrosis are the suggestive morphologic features of metastatic paraaortic nodes.展开更多
A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preop...A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preoperatively diagnosing a benign liver schwannoma.A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver.A malignant tumor was suspected,and a right hepatectomy was performed.After this,the diagnosis of a primary benign schwannoma of the liver was made through pathological examination.Contrast-enhanced ultrasonography(CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase;most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells.In the postvascular phase,CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas;most likely due to aggregation of siderophores.Because discriminating between a benign and malignant schwannoma of the liver is difficult,surgery is generally recommended.However,the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores.展开更多
Objective schwannomas in various locations To clarify the clinical, morphological and radiological features of extraaxial Methods A total of 87 patients with schwannoma were analyzed in this report. Locations of tumo...Objective schwannomas in various locations To clarify the clinical, morphological and radiological features of extraaxial Methods A total of 87 patients with schwannoma were analyzed in this report. Locations of tumors included salivary gland （ n = 13 ） , tongue （ n = 2 ） , neck soft tissue （ n = 32 ）, trunk wall （ n =4 ）, mediastinum （ n = 10）, liver （ n = 1 ） , stomach （ n = 1 ）, retroperitoneum （ n = 8） , and extremities （ n = 16）. Fifty-nine contrasted CT examinations, and 38 MRI examinations were available before surgery. Results Sixty-nine percent of tumors （ 60 out of 87） were either fusiform or ovoid shaped. Well-delineated margins were observed in all 87 （100%） tumors. In this report, patterns of enhancement were diversified. The 38 MRI examinations revealed that 4 （11%） cases showed target sign; 8 （21%） cases presented fascicular sign; and 20 （53%） cases showed split fat sign. No contrast enhanced cystic or necrotic areas were observed in 52 of 87 cases （60%）. Conclusion Most schwannomas showed non-specific imaging appearances. However, recognition of the fusiform or ovoid shape, well-delineated margin of the tumor, the three signs on MRI images （ the target sign, the fascicular sign and the split fat sign）, and the cystic or necrotic areas in tumors could be helpful for diagnosis.展开更多
We present the gray-scale ultrasonography （GSUS）, power Doppler ultrasonography （PDUS）, abdominal computed tomography （CT）, and magnetic resonance imaging （MRI） findings for a case of splenic hamartoma in a 27...We present the gray-scale ultrasonography （GSUS）, power Doppler ultrasonography （PDUS）, abdominal computed tomography （CT）, and magnetic resonance imaging （MRI） findings for a case of splenic hamartoma in a 27-year-old man, showing a φ 50 mm homogeneous, iso- and hypo-echoic splenic mass with evidence of a small plural cystic lesion. This splenic hamartoma showed increased vascularity on power Doppler sonograms. PDUS showed multiple circular blood flow signals inside the mass （i.e. a basket pattern）, which was consistent with the small plural cystic lesion shown by GSUS. Spectral analysis also confirmed arterial and venous flow. CT scans showed that the mass had lowdensity relative to the normal spleen and MRI showed that the mass was isodense, relative to the normal spleen. Therefore, CT and MRI are not useful for the diagnosis of splenic hamartoma. Ultrasonography can be used to diagnose splenic hamartoma without administration of a contrast matedal and therefore is an indispensable method for the diagnosis of splenic hamartoma.展开更多
OBJECTIVE To summarize and analyze the clinical manifestations features of imaging diagnosis,and therapeutic efficacy of surgical treatment for intracranial cavernous hemangioma(CH). METHODS Data from 86 cases with in...OBJECTIVE To summarize and analyze the clinical manifestations features of imaging diagnosis,and therapeutic efficacy of surgical treatment for intracranial cavernous hemangioma(CH). METHODS Data from 86 cases with intracranial CH from the Department of Neurosurgery of Tianjin Huanhu Hospital,Tianjin, China,during a period from 2000 to 2007,were retrospectively analyzed,and pertinent literature cited. RESULTS Epilepsy,headache,dizziness,sensory disability and limb-kinetic apraxia were the most commonly seen clinical manifestations of the intracranial CH cases.MRI was one of the preferred ways to diagnose CH.All 86 patients were treated with microsurgery,among which neuronavigator-guided surgery was conducted in 16,a second surgical procedure was performed in 3 due to a postoperative intracranial hematoma,and death occurred in 1.All the other 85 patients had a good prognosis. CONCLUSION MRI was the most sensitive diagnostic means for intracranial CH.Microsurgery was the main method to treat intracranial CH.展开更多
基金This work was supported by a grant from the National Natural Science Foundation of China (No. 30470525).
文摘Objective: To study the accuracy between CT and MRI in delineating gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) in making radiotherapy plan. Methods: The clinical data of 39 cases pathologically proven as nasopharyngeal carcinoma selected from April 2003 to September 2004 were retrospectively analyzed. All were subjected to CT and MR examination one week before treatment. CT scanning was performed with GE Light speed 16, and axial scan was parallel to the OM line routinely from soft palate to the suprasellar cistern. MR scanning was performed by GE Signa super-conducting magnetic resonance imaging system (1.5 Tesla). The standard quadrature head coil was used. Routine axial, sagittal and coronal image with SE sequence were obtained, and FLAIR was used in 10 of 21 cases. Scanned field ranged from the soft palate to the suprasellar cistern. Part of all cases underwent enhanced scanned with Ultravist in CT group or/and GD-DTPA in MR group. All data were analyzed by using the paired-samples t test. Results: The media primary tumor volume (cm3) in CT group and MR group was 32.49±19.91, 29.06±18.75, respectively, and the difference between the two groups were significant (t=5.268, P=0.000). There was significant difference between the two groups in early stage (T1+T2) and advanced stage (T3+T4) by Fuzhou Staging System (t=5.677, P=0.000; t=3.310, P=0.005, respectively). There was significant difference in stage T1, T2, T3 (P=0.005, P=0.001, P=0.004, respectively), and not in stage T4 (P=0.146) between the two groups. Conclusion: MR was more accurate than CT in delineating GTV of NPC, so, is more valuable in making radiotherapy plan.
文摘Colorectal cancer (CRC) remains a leading cancer killer worldwide. But the disease is both curable and preventable at an early stage. Regular CRC cancer screening has been shown to reduce the risk of dying from CRC. However, the importance of large-scale screening is only now starting to be appreciated. This article reviews a variety of imaging procedures available for detecting ulcerative colitis (UC) and Crohn's disease (CD), polyps and CRC in their early stage and also presents details on various screening options. Detecting, staging and re-staging of patients with CRC also require multimodality, multistep imaging approaches. Staging and re-staging with conventional colonoscopy (CC), computer tomography colonography (CTC), magnetic resonance colonography (MRC) and positron emission tomography/computer tomography colonography (PET/CTC) are of paramount importance in determining the most appropriate therapeutic method and in predicting the risk of tumor recurrence and overall prognosis. The advantages and limitations of these modalities are also discussed.
文摘AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists independently evaluated CT and MR imaging of 31 patients who had undergone lymphadenectomy (9 metastatic and 22 non-metastatic paraaortic nodes). Receiver operating characteristic (ROC) curve analysis was performed using a five point scale to compare CT with MRI. To re-define the morphologic features of metastatic nodes, we evaluated CT scans from 70 patients with 23 metastatic paraaortic nodes and 47 non-metastatic ones. The short axis diameter, ratio of the short to long axis, shape, and presence of necrosis were compared between metastatic and non-metastatic nodes by independent samples t-test and Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS:The mean area under the ROC curve for CT (0.732 and 0.646, respectively) was slightly higher than that for MRI (0.725 and 0.598, respectively) without statistical significance (P = 0.940 and 0.716,respectively). The short axis diameter of the metastatic lymph nodes (mean = 9.2 mm) was significantly larger than that of non-metastatic ones (mean = 5.17 mm, P < 0.05). Metastatic nodes had more irregular margins (44.4%) and central necrosis (22.2%) than non-metastatic ones (9% and 0%, respectively), with statistical significance (P < 0.05). CONCLUSION:The accuracy of CT scan for the characterization of paraaortic nodes is not different from that of MRI. A short axis-diameter (> 5.3 mm), irregular margin, and presence of central necrosis are the suggestive morphologic features of metastatic paraaortic nodes.
文摘A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preoperatively diagnosing a benign liver schwannoma.A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver.A malignant tumor was suspected,and a right hepatectomy was performed.After this,the diagnosis of a primary benign schwannoma of the liver was made through pathological examination.Contrast-enhanced ultrasonography(CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase;most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells.In the postvascular phase,CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas;most likely due to aggregation of siderophores.Because discriminating between a benign and malignant schwannoma of the liver is difficult,surgery is generally recommended.However,the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores.
文摘Objective schwannomas in various locations To clarify the clinical, morphological and radiological features of extraaxial Methods A total of 87 patients with schwannoma were analyzed in this report. Locations of tumors included salivary gland （ n = 13 ） , tongue （ n = 2 ） , neck soft tissue （ n = 32 ）, trunk wall （ n =4 ）, mediastinum （ n = 10）, liver （ n = 1 ） , stomach （ n = 1 ）, retroperitoneum （ n = 8） , and extremities （ n = 16）. Fifty-nine contrasted CT examinations, and 38 MRI examinations were available before surgery. Results Sixty-nine percent of tumors （ 60 out of 87） were either fusiform or ovoid shaped. Well-delineated margins were observed in all 87 （100%） tumors. In this report, patterns of enhancement were diversified. The 38 MRI examinations revealed that 4 （11%） cases showed target sign; 8 （21%） cases presented fascicular sign; and 20 （53%） cases showed split fat sign. No contrast enhanced cystic or necrotic areas were observed in 52 of 87 cases （60%）. Conclusion Most schwannomas showed non-specific imaging appearances. However, recognition of the fusiform or ovoid shape, well-delineated margin of the tumor, the three signs on MRI images （ the target sign, the fascicular sign and the split fat sign）, and the cystic or necrotic areas in tumors could be helpful for diagnosis.
文摘We present the gray-scale ultrasonography （GSUS）, power Doppler ultrasonography （PDUS）, abdominal computed tomography （CT）, and magnetic resonance imaging （MRI） findings for a case of splenic hamartoma in a 27-year-old man, showing a φ 50 mm homogeneous, iso- and hypo-echoic splenic mass with evidence of a small plural cystic lesion. This splenic hamartoma showed increased vascularity on power Doppler sonograms. PDUS showed multiple circular blood flow signals inside the mass （i.e. a basket pattern）, which was consistent with the small plural cystic lesion shown by GSUS. Spectral analysis also confirmed arterial and venous flow. CT scans showed that the mass had lowdensity relative to the normal spleen and MRI showed that the mass was isodense, relative to the normal spleen. Therefore, CT and MRI are not useful for the diagnosis of splenic hamartoma. Ultrasonography can be used to diagnose splenic hamartoma without administration of a contrast matedal and therefore is an indispensable method for the diagnosis of splenic hamartoma.
文摘OBJECTIVE To summarize and analyze the clinical manifestations features of imaging diagnosis,and therapeutic efficacy of surgical treatment for intracranial cavernous hemangioma(CH). METHODS Data from 86 cases with intracranial CH from the Department of Neurosurgery of Tianjin Huanhu Hospital,Tianjin, China,during a period from 2000 to 2007,were retrospectively analyzed,and pertinent literature cited. RESULTS Epilepsy,headache,dizziness,sensory disability and limb-kinetic apraxia were the most commonly seen clinical manifestations of the intracranial CH cases.MRI was one of the preferred ways to diagnose CH.All 86 patients were treated with microsurgery,among which neuronavigator-guided surgery was conducted in 16,a second surgical procedure was performed in 3 due to a postoperative intracranial hematoma,and death occurred in 1.All the other 85 patients had a good prognosis. CONCLUSION MRI was the most sensitive diagnostic means for intracranial CH.Microsurgery was the main method to treat intracranial CH.
