AIM:To evaluate 99mTc-ciprofloxacin scintigraphy compared with computed tomography(CT)for detecting secondary infections associated with severe acute pancreatitis(SAP)in swine.METHODS:Six healthy swine were assigned t...AIM:To evaluate 99mTc-ciprofloxacin scintigraphy compared with computed tomography(CT)for detecting secondary infections associated with severe acute pancreatitis(SAP)in swine.METHODS:Six healthy swine were assigned to a normal control group(group A,n = 6).SAP was induced in group B(n = 9)and C(n = 18),followed by inoculation of the resulting pancreatic necroses with inactive Escherichia coli(E.coli)(group B)and active E.coli(group C),respectively.At 7 d after inoculation,a CT scan and a series of analyses using infecton imaging(at 0.5,1,2,3,4 and 6 h after the administration of 370 MBq of intravenous infecton)were performed.The scintigrams were visually evaluated and semi-quantitatively analyzed using region of interest assignments.The differences in infecton uptake and changes in the lesion-background radioactive count ratios(L/B)in the 3 groups were recorded and compared.After imaging detection,histopathology and bacterial examinations were performed,and infected SAP was regarded as positive.The imaging findings were compared with histopathological and bacteriological results.RESULTS:In group A,6 animals survived without infection in the pancreas.In group B,7/9 swine survived and one suffered from infection.In group C,15/18 animals survived with infection.Hence,the number of normal,non-infected and infected SAP swine was 6,6 and 16,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the infecton method were 93.8%(15/16),91.7%(11/12),92.9%(26/28),93.8%(15/16)and 91.7%(11/12),whereas these values for CT were 12.5%(2/16),100.0%(12/12),50.0%(14/28),100.0%(2/2)and 46.2%(12/26),respectively.The changes in L/B for the infected SAP were significantly different from those of the non-infected and normal swine(P < 0.001).The mean L/B of the infectious foci at 0.5,1,2,3,4 and 6 h was 1.17 ± 0.10,1.71 ± 0.30,2.46 ± 0.45,3.36 ± 0.33,2.04 ± 0.37 and 1.1988 ± 0.09,respectively.At 3 h,the radioactive counts(2350.25 ± 602.35 k)and the mean L/B of the infectious foci were significantly higher than that at 0.5 h(P = 0.000),1 h(P = 0.000),2 h(P = 0.04),4 h(P = 0.000)and 6 h(P = 0.000).CONCLUSION:99m Tc-ciprofloxacin scintigraphy may be an effective procedure for detecting SAP secondary infections with higher sensitivity and accuracy than CT.展开更多
Background:Patients with mass-forming pancreatitis(MFP)or pancreatic ductal adenocarcinoma(PDAC)presented similar clinical symptoms,but required different treatment approaches and had different survival outcomes.This ...Background:Patients with mass-forming pancreatitis(MFP)or pancreatic ductal adenocarcinoma(PDAC)presented similar clinical symptoms,but required different treatment approaches and had different survival outcomes.This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound(CEUS)and contrast-enhanced computed tomography(CECT)in differentiating MFP from PDAC.Methods:A literature search was performed in the PubMed,EMBASE(Ovid),Cochrane Library(CENTRAL),China National Knowledge Infrastructure(CNKI),Weipu(VIP),and WanFang databases to identify original studies published from inception to August 20,2021.Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included.The meta-analysis was performed with Stata 15.0 software.The outcomes included the pooled sensitivity,specificity,positive likelihood ratio(+LR),negative likelihood ratio(-LR),diagnostic odds ratio(DOR),and summary receiver operating characteristic(SROC)curves of CEUS and CECT.Meta-regression was conducted to investigate heterogeneity.Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.Results:Twenty-six studies with 2115 pancreatic masses were included.The pooled sensitivity and specificity of CEUS for MFP were 82%(95%confidence interval[CI],73%-88%;I^(2)=0.00%)and 95%(95%CI,90%-97%;I^(2)=63.44%),respectively;the overall+LR,-LR,and DOR values were 15.12(95%CI,7.61-30.01),0.19(95%CI,0.13-0.29),and 78.91(95%CI,30.94-201.27),respectively;and the area under the SROC curve(AUC)was 0.90(95%CI,0.87-92).However,the overall sensitivity and specificity of CECT were 81%(95%CI,75-85%;I^(2)=66.37%)and 94%(95%CI,90-96%;I^(2)=74.87%);the overall+LR,-LR,and DOR values were 12.91(95%CI,7.86-21.20),0.21(95%CI,0.16-0.27),and 62.53(95%CI,34.45-113.51),respectively;and,the SROC AUC was 0.92(95%CI,0.90-0.94).The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC(relative DOR 1.26,95%CI[0.42-3.83],P>0.05).Conclusions:CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC,and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.展开更多
Objective: The aim of our study was to demonstrate the CT features of solid pseudopapillary tumor of the pancreas (SPTP) so as to improve the imaging diagnostic abilities. Methods: The CT materials of 10 cases with su...Objective: The aim of our study was to demonstrate the CT features of solid pseudopapillary tumor of the pancreas (SPTP) so as to improve the imaging diagnostic abilities. Methods: The CT materials of 10 cases with surgery and pathology proved SPTP were retrospectively analyzed, including 8 females and 2 males, their age ranged from 12 to 54 years (average being 27.2 years). All of the 10 cases underwent spiral CT scan and also with contrast enhancement before surgery. Results: All of the 10 cases were isolated mass. They were located at the head (n = 5), tail (n = 4), and body (n = 1) of the pancreas. Their shapes were round (n = 3), oval (n = 4), and irregular (n = 3). The long-axis diameter ranged from 2.1-8.6 cm (mean 6.5 cm). All of neoplasms consisted of solid and cystic components. Mostly solid components in 5 cases, nearly the same proportion of solid and cystic part in 3 cases, and mostly cystic components in 2 cases. After dynamic contrast-enhanced, the solid parts of the lesion showed progressive enhancement and the cystic parts of the lesion showed no enhancement. Calcification was noted in 5 cases, such as the spot, line-like, small nodules or patchy calcification. Fluid-debris level and "floating cloud" sign were noted in one case. In one case of mostly cystic components, patchy area of high attenuation were shown on CT imaging which then was proved as old hemorrhage by pathologic evaluation. Seven cases were completely encapsulated and made more remarkable on post-contrast images. Three cases had incomplete capsules, and adhesion to the surrounding tissues could be seen during operation, including one case in which invasion to the adjacent adipose tissues near the inferior vena cava and walls of the duodenum could be seen under the microscope. Pancreatic duct broadening or hepatic duct dilatation was caused by tumor each in 1 case. All of the 10 cases had no enlargement of the intra-abdominal lymph nodes or distant organ metastasis. Conclusion: SPTP occurs mainly in young women and has comparatively characteristic CT imaging features: a large solid and cystic tumor of pancreas, sharp edges, the solid parts of the lesion showed progressive enhancement, a few with hemorrhage and calcification.展开更多
基金Supported by The National Natural Science Foundation of China,No. 81170435 and 30570535Natural Science Foundation of Zhejiang Province,No. LY13H070008+4 种基金Medicine and Health Science and Technology Project of Zhejiang Province,2013KYA182 and 2012KYB176Natural Science Foundation of Ningbo,2010A610052the Dawn Program of the Shanghai Education Committee,06SG41the Scientific Research Foundation of the Shanghai Municipal Public Health Bureau,2007JG0069China Postdoctoral Science Foundation,20100480545
文摘AIM:To evaluate 99mTc-ciprofloxacin scintigraphy compared with computed tomography(CT)for detecting secondary infections associated with severe acute pancreatitis(SAP)in swine.METHODS:Six healthy swine were assigned to a normal control group(group A,n = 6).SAP was induced in group B(n = 9)and C(n = 18),followed by inoculation of the resulting pancreatic necroses with inactive Escherichia coli(E.coli)(group B)and active E.coli(group C),respectively.At 7 d after inoculation,a CT scan and a series of analyses using infecton imaging(at 0.5,1,2,3,4 and 6 h after the administration of 370 MBq of intravenous infecton)were performed.The scintigrams were visually evaluated and semi-quantitatively analyzed using region of interest assignments.The differences in infecton uptake and changes in the lesion-background radioactive count ratios(L/B)in the 3 groups were recorded and compared.After imaging detection,histopathology and bacterial examinations were performed,and infected SAP was regarded as positive.The imaging findings were compared with histopathological and bacteriological results.RESULTS:In group A,6 animals survived without infection in the pancreas.In group B,7/9 swine survived and one suffered from infection.In group C,15/18 animals survived with infection.Hence,the number of normal,non-infected and infected SAP swine was 6,6 and 16,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the infecton method were 93.8%(15/16),91.7%(11/12),92.9%(26/28),93.8%(15/16)and 91.7%(11/12),whereas these values for CT were 12.5%(2/16),100.0%(12/12),50.0%(14/28),100.0%(2/2)and 46.2%(12/26),respectively.The changes in L/B for the infected SAP were significantly different from those of the non-infected and normal swine(P < 0.001).The mean L/B of the infectious foci at 0.5,1,2,3,4 and 6 h was 1.17 ± 0.10,1.71 ± 0.30,2.46 ± 0.45,3.36 ± 0.33,2.04 ± 0.37 and 1.1988 ± 0.09,respectively.At 3 h,the radioactive counts(2350.25 ± 602.35 k)and the mean L/B of the infectious foci were significantly higher than that at 0.5 h(P = 0.000),1 h(P = 0.000),2 h(P = 0.04),4 h(P = 0.000)and 6 h(P = 0.000).CONCLUSION:99m Tc-ciprofloxacin scintigraphy may be an effective procedure for detecting SAP secondary infections with higher sensitivity and accuracy than CT.
基金Science and Technology Department of Sichuan Province(No.2018FZ0044)National Natural Science Foundation of China(No.81571697)
文摘Background:Patients with mass-forming pancreatitis(MFP)or pancreatic ductal adenocarcinoma(PDAC)presented similar clinical symptoms,but required different treatment approaches and had different survival outcomes.This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound(CEUS)and contrast-enhanced computed tomography(CECT)in differentiating MFP from PDAC.Methods:A literature search was performed in the PubMed,EMBASE(Ovid),Cochrane Library(CENTRAL),China National Knowledge Infrastructure(CNKI),Weipu(VIP),and WanFang databases to identify original studies published from inception to August 20,2021.Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included.The meta-analysis was performed with Stata 15.0 software.The outcomes included the pooled sensitivity,specificity,positive likelihood ratio(+LR),negative likelihood ratio(-LR),diagnostic odds ratio(DOR),and summary receiver operating characteristic(SROC)curves of CEUS and CECT.Meta-regression was conducted to investigate heterogeneity.Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.Results:Twenty-six studies with 2115 pancreatic masses were included.The pooled sensitivity and specificity of CEUS for MFP were 82%(95%confidence interval[CI],73%-88%;I^(2)=0.00%)and 95%(95%CI,90%-97%;I^(2)=63.44%),respectively;the overall+LR,-LR,and DOR values were 15.12(95%CI,7.61-30.01),0.19(95%CI,0.13-0.29),and 78.91(95%CI,30.94-201.27),respectively;and the area under the SROC curve(AUC)was 0.90(95%CI,0.87-92).However,the overall sensitivity and specificity of CECT were 81%(95%CI,75-85%;I^(2)=66.37%)and 94%(95%CI,90-96%;I^(2)=74.87%);the overall+LR,-LR,and DOR values were 12.91(95%CI,7.86-21.20),0.21(95%CI,0.16-0.27),and 62.53(95%CI,34.45-113.51),respectively;and,the SROC AUC was 0.92(95%CI,0.90-0.94).The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC(relative DOR 1.26,95%CI[0.42-3.83],P>0.05).Conclusions:CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC,and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.
文摘Objective: The aim of our study was to demonstrate the CT features of solid pseudopapillary tumor of the pancreas (SPTP) so as to improve the imaging diagnostic abilities. Methods: The CT materials of 10 cases with surgery and pathology proved SPTP were retrospectively analyzed, including 8 females and 2 males, their age ranged from 12 to 54 years (average being 27.2 years). All of the 10 cases underwent spiral CT scan and also with contrast enhancement before surgery. Results: All of the 10 cases were isolated mass. They were located at the head (n = 5), tail (n = 4), and body (n = 1) of the pancreas. Their shapes were round (n = 3), oval (n = 4), and irregular (n = 3). The long-axis diameter ranged from 2.1-8.6 cm (mean 6.5 cm). All of neoplasms consisted of solid and cystic components. Mostly solid components in 5 cases, nearly the same proportion of solid and cystic part in 3 cases, and mostly cystic components in 2 cases. After dynamic contrast-enhanced, the solid parts of the lesion showed progressive enhancement and the cystic parts of the lesion showed no enhancement. Calcification was noted in 5 cases, such as the spot, line-like, small nodules or patchy calcification. Fluid-debris level and "floating cloud" sign were noted in one case. In one case of mostly cystic components, patchy area of high attenuation were shown on CT imaging which then was proved as old hemorrhage by pathologic evaluation. Seven cases were completely encapsulated and made more remarkable on post-contrast images. Three cases had incomplete capsules, and adhesion to the surrounding tissues could be seen during operation, including one case in which invasion to the adjacent adipose tissues near the inferior vena cava and walls of the duodenum could be seen under the microscope. Pancreatic duct broadening or hepatic duct dilatation was caused by tumor each in 1 case. All of the 10 cases had no enlargement of the intra-abdominal lymph nodes or distant organ metastasis. Conclusion: SPTP occurs mainly in young women and has comparatively characteristic CT imaging features: a large solid and cystic tumor of pancreas, sharp edges, the solid parts of the lesion showed progressive enhancement, a few with hemorrhage and calcification.
