目的探讨MRI评价腺体-脂肪界面乳腺癌对瘤周脂肪侵犯及保乳手术方式的价值。方法选取经病理确诊的253例浸润性乳腺癌(invasive breast carcinoma,IBC)患者,术前MRI检查肿瘤位于腺体-脂肪界面;分析皮下瘤周脂肪消退/萎缩、缺失,瘤周脂肪...目的探讨MRI评价腺体-脂肪界面乳腺癌对瘤周脂肪侵犯及保乳手术方式的价值。方法选取经病理确诊的253例浸润性乳腺癌(invasive breast carcinoma,IBC)患者,术前MRI检查肿瘤位于腺体-脂肪界面;分析皮下瘤周脂肪消退/萎缩、缺失,瘤周脂肪纤维化、水肿的MRI影像,评价瘤周脂肪侵犯与保乳术式选择的关系。结果33.2%的病例肿瘤直接侵犯皮肤结构,与皮肤间脂肪组织缺失;22.1%的病例轻度脂肪侵犯,44.7%的病例重度脂肪侵犯。74.3%的病例瘤周脂肪内观察到纤维化影像,85例MRI显示与肿瘤垂直索条影,41例显示沿肿瘤轮廓弧形索条影,62例两者均有。39.9%的病例显示重度、17.4%的病例显示轻度瘤周脂肪内水肿。71例腺体-脂肪界面乳腺癌中68例保乳成功,82.4%的病例为轻度脂肪侵犯,17.6%的病例为重度脂肪侵犯,27.9%的病例显示瘤周脂肪纤维化,38.2%的病例瘤周脂肪水肿。保乳手术方式主要是肿物切除及区段切除术。结论MRI是评价腺体-脂肪界面乳腺癌对瘤周脂肪侵犯的有效方法,对指导保乳手术有价值。展开更多
Preoperative prediction of the postoperative pancreatic fistula risk is critical in the current era of minimally invasive pancreatic surgeries to tailor perioperative management,thereby minimizing postoperative morbid...Preoperative prediction of the postoperative pancreatic fistula risk is critical in the current era of minimally invasive pancreatic surgeries to tailor perioperative management,thereby minimizing postoperative morbidity.Pancreatic duct diameter can be readily measured by any routine imaging used to diagnose pancreatic disease.However,radiological evaluation of pancreatic texture,an important determinant of pancreatic fistula,has not been widely used to predict the risk of postoperative pancreatic fistula.Qualitative and quantitative assessment of pancreatic fibrosis and fat fraction provides the basis for predicting pancreatic texture.Traditionally computed tomography has been utilized in identifying and characterizing pancreatic lesions and background parenchymal pathologies.With the increasing utilisation of endoscopic ultrasound and magnetic resonance imaging for evaluating pancreatic pathologies,elastography is emerging as a promising tool for predicting pancreatic texture.Also,recent studies have shown that early surgery for chronic pancreatitis is associated with better pain relief and preservation of pancreatic function.Pancreatic texture assessment can allow early diagnosis of chronic pancreatitis,facilitating early intervention.The present review outlines the current evidence in utilizing various imaging modalities for determining the pancreatic texture based on different parameters and image sequences.However,multidisciplinary investigations using strong radiologic-pathologic correlation are needed to standardize and establish the role of these non-invasive diagnostic tools in predicting pancreatic texture.展开更多
背景与目的:手术后肿瘤残余是影响胶质瘤患者生存的主要原因之一,应用术中磁共振影像(intraoperative magnetic resonance imaging,iMRI)导航手术,可达到最大程度切除肿瘤和保护神经功能的双重目的。本研究评估iMRI导航手术切除脑胶质...背景与目的:手术后肿瘤残余是影响胶质瘤患者生存的主要原因之一,应用术中磁共振影像(intraoperative magnetic resonance imaging,iMRI)导航手术,可达到最大程度切除肿瘤和保护神经功能的双重目的。本研究评估iMRI导航手术切除脑胶质瘤的近期临床疗效。方法:2006年3月至2008年6月,158例脑胶质瘤患者接受iMRI神经导航手术。结果:手术总耗时2.5～8.5h(平均5.2±1.5h)。图像质量优144例(91.1%),良9例(5.7%),差5例(3.2%)。iMRI扫描次数2～5次(平均2.5±0.7次),其中3次42例(26.6%),4次15例(9.5%),5次6例(3.2%)。39.9%的脑胶质瘤病例经iMRI发现肿瘤切除范围未达术前计划,仍需进一步切除。术后早期MRI证实肿瘤全切率达90.5%,术后严重致残率6.8%。无iMRI相关不良事件发生。结论:iMRI实时影像导航手术治疗脑胶质瘤安全有效,可实时纠正术中脑移位误差,精确定位脑胶质瘤的影像学边界,定量评估手术切除范围,有效提高肿瘤切除率。展开更多
文摘目的探讨MRI评价腺体-脂肪界面乳腺癌对瘤周脂肪侵犯及保乳手术方式的价值。方法选取经病理确诊的253例浸润性乳腺癌(invasive breast carcinoma,IBC)患者,术前MRI检查肿瘤位于腺体-脂肪界面;分析皮下瘤周脂肪消退/萎缩、缺失,瘤周脂肪纤维化、水肿的MRI影像,评价瘤周脂肪侵犯与保乳术式选择的关系。结果33.2%的病例肿瘤直接侵犯皮肤结构,与皮肤间脂肪组织缺失;22.1%的病例轻度脂肪侵犯,44.7%的病例重度脂肪侵犯。74.3%的病例瘤周脂肪内观察到纤维化影像,85例MRI显示与肿瘤垂直索条影,41例显示沿肿瘤轮廓弧形索条影,62例两者均有。39.9%的病例显示重度、17.4%的病例显示轻度瘤周脂肪内水肿。71例腺体-脂肪界面乳腺癌中68例保乳成功,82.4%的病例为轻度脂肪侵犯,17.6%的病例为重度脂肪侵犯,27.9%的病例显示瘤周脂肪纤维化,38.2%的病例瘤周脂肪水肿。保乳手术方式主要是肿物切除及区段切除术。结论MRI是评价腺体-脂肪界面乳腺癌对瘤周脂肪侵犯的有效方法,对指导保乳手术有价值。
文摘Preoperative prediction of the postoperative pancreatic fistula risk is critical in the current era of minimally invasive pancreatic surgeries to tailor perioperative management,thereby minimizing postoperative morbidity.Pancreatic duct diameter can be readily measured by any routine imaging used to diagnose pancreatic disease.However,radiological evaluation of pancreatic texture,an important determinant of pancreatic fistula,has not been widely used to predict the risk of postoperative pancreatic fistula.Qualitative and quantitative assessment of pancreatic fibrosis and fat fraction provides the basis for predicting pancreatic texture.Traditionally computed tomography has been utilized in identifying and characterizing pancreatic lesions and background parenchymal pathologies.With the increasing utilisation of endoscopic ultrasound and magnetic resonance imaging for evaluating pancreatic pathologies,elastography is emerging as a promising tool for predicting pancreatic texture.Also,recent studies have shown that early surgery for chronic pancreatitis is associated with better pain relief and preservation of pancreatic function.Pancreatic texture assessment can allow early diagnosis of chronic pancreatitis,facilitating early intervention.The present review outlines the current evidence in utilizing various imaging modalities for determining the pancreatic texture based on different parameters and image sequences.However,multidisciplinary investigations using strong radiologic-pathologic correlation are needed to standardize and establish the role of these non-invasive diagnostic tools in predicting pancreatic texture.
文摘背景与目的:手术后肿瘤残余是影响胶质瘤患者生存的主要原因之一,应用术中磁共振影像(intraoperative magnetic resonance imaging,iMRI)导航手术,可达到最大程度切除肿瘤和保护神经功能的双重目的。本研究评估iMRI导航手术切除脑胶质瘤的近期临床疗效。方法:2006年3月至2008年6月,158例脑胶质瘤患者接受iMRI神经导航手术。结果:手术总耗时2.5～8.5h(平均5.2±1.5h)。图像质量优144例(91.1%),良9例(5.7%),差5例(3.2%)。iMRI扫描次数2～5次(平均2.5±0.7次),其中3次42例(26.6%),4次15例(9.5%),5次6例(3.2%)。39.9%的脑胶质瘤病例经iMRI发现肿瘤切除范围未达术前计划,仍需进一步切除。术后早期MRI证实肿瘤全切率达90.5%,术后严重致残率6.8%。无iMRI相关不良事件发生。结论:iMRI实时影像导航手术治疗脑胶质瘤安全有效,可实时纠正术中脑移位误差,精确定位脑胶质瘤的影像学边界,定量评估手术切除范围,有效提高肿瘤切除率。
