Comparison of the Imaging Manifestations and Diagnostic Values of Multi-slice Spiral CT and Enhanced MRI Scans of Primary Liver Cancer(PLC)Intrahepatic Lesions

Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September.After the patients were admitted,they were examined by multi-slice spiral CT and enhanced MRI scanning,and the pathological diagnosis results were followed up.Relevant information was reviewed and analyzed.Results:The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection.The difference was statistically significant(P<0.05).The detection rate of lesions in the arterial phase and delayed phase was not statistically significant(P>0.05);the diagnostic accuracy of multi-slice spiral CT was 85.96%,and the diagnostic accuracy of enhanced MRI scanning was 91.11%,which was not statistically significant(P>0.05).MRI scans showed the capsules of primary liver cancer better than CT,but the difference was not statistically significant(P>0.05).Conclusion:In conclusion,both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions.The diagnostic value of the two is equivalent,but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.

Critical influenza （H1N1） pneumonia： imaging manifestations and histopathological findings

Background The global outbreak of influenza A （H1N1） has led to the Ministry of Health of China listing it as one of the A-class infectious diseases. Pneumonia is the most serious complication of influenza A, commonly causing death. Populations are ordinarily susceptible to influenza A. This study aimed to investigate the imaging manifestation features of critical influenza A （H1 N1 ） pneumonia and to improve its diagnostic techniques. Methods A total of seven death cases from critical influenza A （H1N1） pneumonia were retrospectively analyzed on their imaging manifestations and autopsy data. Pulmonary CT scanning was performed for five cases, with one receiving additional chest X-ray and chest CT scanning, and chest postero-anterior position X-ray examination was performed for other two. Autopsy was performed for five cases and postmortem examinations were performed for other two cases. Results The seven cases of influenza A showed critical manifestations in 4-7 days after symptoms onset, with two having basic diseases of diabetes and one being pregnant. Extensive blurry high-density shadows of bilateral lungs were found in three cases, which were most obvious in middle and inferior parts of lungs. Pulmonary CT scanning revealed bilateral flaky parenchymal shadows in peripheral, dorsal and fundus segments of the middle-inferior parts of lungs, with one case of complicated pneumothorax, atelectasis and pleural effusion and another case of thin-walled cavity and dilated bronchi shadows in the superior parts of lungs. Conclusions Diagnostic imaging is an important assessing tool for critical influenza A （H1N1） pneumonia. The imaging manifestations are characteristic instead of being specific. The definitive diagnosis can be made in combination with clinical examinations and laboratory tests.

A Study on Clinical Characteristics and Magnetic Resonance Imaging Manifestations on Systemic Rosai-Dorfman Disease

Background： Rosai-Dorfman disease （RDD） is typically characterized by painless bilateral and symmetrical cervical lymphadenopathy, with associated fever and leukocytosis. The aim of the current study was to summarize the clinical features and imaging characteristics of RDD, in an effort to improve its diagnostic accuracy. Methods： The study was analyzed from 32 patients between January 2011 and December 2017; of these, 16 patients had pathologically diagnosed RDD, eight had pathologically diagnosed meningioma, and eight pathologically diagnosed lymphoma. All patients underwent computed tomography and magnetic resonance imaging （MRI）. Clinical features and imaging characteristics of RDD were analyzed retrospectively. The mean apparent diffusion coefficient （ADC） values of lesions at different sites were measured, and one-way analysis of variance and the least significant difference t-test were used to compare the differences between groups and draw receiver operating characteristic curves. The tumors were excised for biopsy and analyzed using immunohistochemistry. Results： The mean ADCs were （0.81 ± 0.10） × 10^-3mm^2/s for intercranial RDD, （0.73 ± 0.05） × 10^-3mm^2/s for nasopharyngeal RDD, （0.74 ± 0.11） × 10^-3mm2/s for bone RDD, and （0.71 ± 0.04） × 10^-3mm2/s for soft-tissue RDD. The optimum ADC to distinguish intracranial RDD from lymphoma was 0.79 × 10^-3mm2/s （62.5% sensitivity and 100% specificity） and to distinguish meningioma from intracranial RDD was 0.92 × 10^-3mm^2/s （62.5% sensitivity and 100% specificity）. Levels of C-reactive protein, erythrocyte sediment rate and D-dimer were significantly elevated （81%, 87%, and 75%, respectively）. On immunohistochemistry, RDD was positive for both S-100 and CD68 proteins but negative for CD1a. Conclusions： Conventional MRI, combined with diffusion-weighted imaging and ADC mapping, is an important diagnostic tool in evaluating RDD patients. An accurate diagnosis of RDD should consider the clinical features, imaging characteristics, and the pathological findings.

Anti-N-methyl-D-aspartate-receptor antibody encephalitis combined with syphilis:A case report

BACKGROUND Anti-N-methyl-D-aspartate-receptor(NMDAR)encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations.The pathogenesis of the disease is unclear.Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms.There are few reports of anti-NMDAR encephalitis with syphilis,and the association between them is unknown;both diseases are related to immune system damage.We report a case of anti-NMDAR encephalitis with syphilis.CASE SUMMARY A 32-year-old man was admitted to our hospital with complaints of cognitive decline,diplopia,and walking instability during the previous 6 mo.He developed dysarthria,difficulty swallowing,and involuntary shaking of his head,neck,and limbs during the month prior to presentation.Cranial magnetic resonance imaging showed symmetrical abnormal signals in the pons,midbrain,and bilateral basal ganglia,and inflammatory demyelination was considered.The diagnosis of syphilis was confirmed based on the syphilis diagnosis test and the syphilis rapid test.He was given anti-syphilis treatment,but the above symptoms gradually worsened.Anti-NMDAR antibody was positive in cerebrospinal fluid but was negative in serum.Due to the cerebrospinal fluid findings,anti-NMDAR encephalitis was a consideration.According to the patient’s weight,he was treated with intravenous methylprednisolone 1 g QD for 5 d,with the dose gradually decreased for 6 mo,and immunoglobulin 25 g QD for 5 d;his symptoms improved after treatment.CONCLUSION This case shows that anti-NMDAR encephalitis may be combined with syphilis,which should be recognized to avoid misdiagnosis and treatment delay.

Hyperglycemic hemianopia:A case report

BACKGROUND Nonketotic hyperglycemia(NKH)is characterized by hyperglycemia with little or no ketoacidosis.Diverse neurological symptoms have been described in NKH patients,including choreoathetosis,hemiballismus,seizures,and coma in severe cases.Homonymous hemianopia,with or without occipital seizures,caused by hyperglycemia is less readily recognized.CASE SUMMARY We describe a 54-year-old man with NKH,who reported seeing round,colored flickering lights with right homonymous hemianopia.Cranial magnetic resonance imaging demonstrated abnormalities in the left occipital lobe,with decreased T2 signal of the white matter,restricted diffusion,and corresponding low signal intensity in the apparent diffusion coefficient map.He responded to rehydration and a low-dose insulin regimen,with improvements of his visual field defect.CONCLUSION Patients with NKH may present focal neurologic signs.Hyperglycemia should be taken into consideration when making an etiologic diagnosis of homonymous hemianopia.

Acquired immunodeficiency syndrome associated disseminated Penicillium Marneffei infection: report of 8 cases

Penicillinosis Marneffei （PSM） is a rare fungal disease caused by systemic infection of Penicillium Mameffei （PM）. Disseminated PSM is one of the most common opportunistic infections in patients with acquired immunodeficiency syndrome （AIDS） living in Southeastern region during the endstage of disease. Sporadic and individual cases have been reported recently in China and there appeared a tendency of increase of PM infections because of the increase of AIDS cases. To improve our understanding of this disease, we report here 8 cases of AIDS associated PSM.

The chest X-ray image features of patients with severe SARS: a preliminary study

Objective To study the chest X ray image features of patients with severe SARS Methods Chest X ray image features in 36 patients with severe SARS were retrospectively analyzed The image characteristics were compared with those of 224 patients with common SARS Results The important chest X ray imaging features of 36 patients with severe SARS included small patch of infiltration (n=27, 75 0%), large patch of infiltration (n=22, 61 1%), large area of lung consolidation (n=10, 27 3%), interstitial lung lesion (n=26, 72 2%), ground glass shadow (n=28, 77 8%), irregular linear opacity (n=15, 41 7%), diffuse lung lesion (n=12, 33 3%), with single lung involved (n=9, 25 0%), and both lungs involved (n=32, 88 9%) The rates of large patch of infiltration, large area of lung consolidation, ground glass shadow, diffuse lung lesion and involvement of both lungs in patients with severe SARS were significantly higher than those in patients with common type of SARS (all P <0 01) Out of the 11 severe SARS patients who died, nine had large area of ground glass shadow with air bronchogram in both lungs before death Conclusions Large patch of infiltration, large area of consolidation, ground glass shadow, diffuse lung lesion and involvement of both lungs were the main X ray image characteristics of patients with severe SARS Large area of ground glass shadow with air bronchogram in both lungs indicated a bad prognosis