AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a popul...AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer （CRC）. METHODS： From April 2006 to April 2007, 43 290 individuals （age range 50-70） who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects （4.3%）. 1463 （77.7%） of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 （7.2%） were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep （polyethyleneglycole） in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Perlesion and per-segment positive predictive values （PPV） were calculated. RESULTS： Twenty-one （50%） of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION： In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.展开更多
We report a case of primary gastrointestinal stromal tumor （GIST） of the liver. A 17-year-old man with a solid mass in the anterior segment of the right liver was asymptomatic with negative laboratory examinations w...We report a case of primary gastrointestinal stromal tumor （GIST） of the liver. A 17-year-old man with a solid mass in the anterior segment of the right liver was asymptomatic with negative laboratory examinations with the exception of positive HBV. Contrast-enhanced ultrasound （CEUS） revealed a hypervascular lesion in the arterial phase and hypoechoic features during the portal and late phases. However, enhanced spiral computed tomography （CT） showed hypoattenuation in all three phases. Following biopsy, immunohistochemical evaluation demonstrated positive CDl17. Different imaging features of primary GISTs of the liver are due to pathological properties and different working systems between CEUS and enhanced spiral CT.展开更多
Objective To probe the mechanism of pathological changes of intraventricular hemorrhage(IVH). Methods The evaluation of neurological status,serial CT scans and pathological examination were applied on the canine model...Objective To probe the mechanism of pathological changes of intraventricular hemorrhage(IVH). Methods The evaluation of neurological status,serial CT scans and pathological examination were applied on the canine model of IVH. The ventricular volume and blood clot volume were measured based on the CT images. Results The normal adult canine ventricle tend to be slitlike. After injection, the ventricle was obviously dilated by the blood clot. The linear regression of ventricular volume against blood clot volume was significant in the first week. From then on, however, while the clots continued to shrink, the ventricular volume showed progressive enlargement. The clots were lysed completely within 3 to 4 weeks. The linear regression of the degree of ventricular dilatation against the first clot volume was also significant. In the pathological examination, we found the ependymal lining of ventricular system was destroyed and neurons in the subependymal areas developed acidophil necrosis, which was prominent around Sylvian aqueduct. Conclusion Hemorrhagic ventricular dilatation(HVD) is a prominent feature of IVH and also is a strong indicator for poor prognosis. Ischemic changes of periventricular neurons in some important structures may be the most direct cause for poor outcome of IVH. It may be induced by periventricular vascular structures compressed by HVD, increased intracranial pressure, cerebral vasospasm and others.展开更多
Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponad...Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography （CT）. Only a few studies are reported in literature involving post-mortem （PM） cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.展开更多
文摘AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer （CRC）. METHODS： From April 2006 to April 2007, 43 290 individuals （age range 50-70） who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects （4.3%）. 1463 （77.7%） of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 （7.2%） were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep （polyethyleneglycole） in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Perlesion and per-segment positive predictive values （PPV） were calculated. RESULTS： Twenty-one （50%） of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION： In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.
文摘We report a case of primary gastrointestinal stromal tumor （GIST） of the liver. A 17-year-old man with a solid mass in the anterior segment of the right liver was asymptomatic with negative laboratory examinations with the exception of positive HBV. Contrast-enhanced ultrasound （CEUS） revealed a hypervascular lesion in the arterial phase and hypoechoic features during the portal and late phases. However, enhanced spiral computed tomography （CT） showed hypoattenuation in all three phases. Following biopsy, immunohistochemical evaluation demonstrated positive CDl17. Different imaging features of primary GISTs of the liver are due to pathological properties and different working systems between CEUS and enhanced spiral CT.
文摘Objective To probe the mechanism of pathological changes of intraventricular hemorrhage(IVH). Methods The evaluation of neurological status,serial CT scans and pathological examination were applied on the canine model of IVH. The ventricular volume and blood clot volume were measured based on the CT images. Results The normal adult canine ventricle tend to be slitlike. After injection, the ventricle was obviously dilated by the blood clot. The linear regression of ventricular volume against blood clot volume was significant in the first week. From then on, however, while the clots continued to shrink, the ventricular volume showed progressive enlargement. The clots were lysed completely within 3 to 4 weeks. The linear regression of the degree of ventricular dilatation against the first clot volume was also significant. In the pathological examination, we found the ependymal lining of ventricular system was destroyed and neurons in the subependymal areas developed acidophil necrosis, which was prominent around Sylvian aqueduct. Conclusion Hemorrhagic ventricular dilatation(HVD) is a prominent feature of IVH and also is a strong indicator for poor prognosis. Ischemic changes of periventricular neurons in some important structures may be the most direct cause for poor outcome of IVH. It may be induced by periventricular vascular structures compressed by HVD, increased intracranial pressure, cerebral vasospasm and others.
文摘Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography （CT）. Only a few studies are reported in literature involving post-mortem （PM） cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.
