BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of t...BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.展开更多
AIM To assess the value of combined acoustic radiation force impulse(ARFI) imaging, serological indexes and contrast-enhanced ultrasound(CEUS) in distinguishing between benign and malignant liver lesions. METHODS Pati...AIM To assess the value of combined acoustic radiation force impulse(ARFI) imaging, serological indexes and contrast-enhanced ultrasound(CEUS) in distinguishing between benign and malignant liver lesions. METHODS Patients with liver lesions treated at our hospital were included in this study. The lesions were divided into either a malignant tumor group or a benign tumor group according to pathological or radiological findings. ARFI quantitative detection, serological testing and CEUS quantitative detection were performed and compared. A comparative analysis of the measured indexes was performed between these groups. Receiver operating characteristic(ROC) curves were constructed to compare the diagnostic accuracy of ARFI imaging, serological indexes and CEUS, alone or in different combinations, in identifying benign and malignant liver lesions. RESULTS A total of 112 liver lesions in 43 patients were included, of which 78 were malignant and 34 were benign. Shear wave velocity(SWV) value, serum alpha-fetoprotein(AFP) content and enhancement rate were significantly higher in the malignant tumor group than in the benign tumor group(2.39 ± 1.20 m/s vs 1.50 ± 0.49 m/s, 18.02 ± 5.01 ng/m L vs 15.96 ± 4.33 ng/m L, 2.14 ± 0.21 d B/s vs 2.01 ± 0.31 d B/s; P < 0.05). The ROC curve analysis revealed that the areas under the curves(AUCs) of SWV value alone, AFP content alone, enhancement rate alone, SWV value + AFP content, SWV value + enhancement rate, AFP content + enhancement rate and SWV value + AFP content + enhancement rate were 85.1%, 72.1%, 74.5%, 88.3%, 90.4%, 82.0% and 92.3%, respectively. The AUC of SWV value + AFP content + enhancement rate was higher than those of SWV value + AFP content and SWV value + enhancement rate, and significantly higher than those of any single parameter or the combination of any two of parameters.CONCLUSION The combination of SWV, AFP and enhancement rate had better diagnostic performance in distinguishing between benign and malignant liver lesions than the use of any single parameter or the combination of any two of parameters. It is expected that this would provide a tool for the differential diagnosis of benign and malignant liver lesions.展开更多
Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in compute...Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in computed tomography. Materials and Methods: 53 cases were included in the study. Primary (n = 42, 31 benign, 11 malignant) or metastatic (n = 11) tumors were detected at various locations in the bone structure of the cervical to coccygeal vertebrae in all cases. 3D CT images taken using the same system and biopsy or post-operative histopathology findings were available for all cases. Thin section images taken retrospectively from the archives were converted to 3D images using the same program and parameters, which were then recorded in the same window settings by two radiologists. Only 3D images were then analyzed to investigate the presence or absence of the dirty interface sign. Results: Dirty interface sign was present in 17 malignant lesions and absent in the remaining 5 lesions. As for benign lesions, the sign was present in only two lesions and the remaining 29 were negative for the sign. There was a high level of consistency between the two radiologists. In conclusion, malignant and benign lesions affecting the bone spinal axis were distinguished based on the presence or absence of the dirty interface sign with 77.3% sensitivity, 93.5% specificity and 86.8% accuracy. Conclusion: When evaluated with standard bone window views, 3D views can be used successfully for the distinction of malignant and benign bone tumors. At least, 3D views generated using low dose regimes in highly developed systems can be used with similar purpose to that of diffusion weighted MRI sequences that give roughly outlined but fast and accurate information about the lesion.展开更多
目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数联合小视野弥散加权成像在甲状腺良恶性结节鉴别中的应用价值。材料与方法收集2022年1月至2023年10月于滨州医学院附属医院诊...目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数联合小视野弥散加权成像在甲状腺良恶性结节鉴别中的应用价值。材料与方法收集2022年1月至2023年10月于滨州医学院附属医院诊治并经手术病理证实为甲状腺结节的患者38例(52个结节),将其分为良性结节组和恶性结节组。术前患者均行3.0 T MRI扫描,包括常规MRI、小视野弥散加权成像(b值取0、800 s/mm^(2))和DCE-MRI检查,并测量其表观弥散系数(apparent diffusion coefficient,ADC)值和DCE-MRI定量参数,包括对比剂容积转运常数(volume transport constant,K^(trans))、速率常数(rate constant,K_(ep))、血管外细胞外间隙容积分数(extravascular extracellular volume fraction,V_(e))。对甲状腺良恶性结节组的ADC、K_(ep)、V_(e)、K^(trans)采用独立样本t检验分析,以P<0.05为差异有统计学意义,后将差异有统计学意义的变量进行逐步logistic回归模型分析,得到甲状腺良恶性结节的独立预测因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析ADC、K^(trans)独立诊断模型及ADC与K^(trans)联合诊断模型的诊断效能。结果良性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.659±0.370)×10^(-3)mm^(2)/s、(0.427±0.214)min^(-1)、(0.966±0.225)min^(-1),恶性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.182±0.195)×10^(-3)mm^(2)/s、(0.178±0.073)min^(-1)、(0.600±0.248)min^(-1)。良性结节组的ADC、K^(trans)、K_(ep)值均高于恶性结节组,差异均有统计学意义(P<0.001)。经过独立样本t检验及逐步logistic回归分析显示,ADC值和K^(trans)差异具有统计学意义(P<0.05),是鉴别甲状腺结节良恶性的独立预测因子。单独ADC值曲线下面积(area under the curve,AUC)为0.915、单独K^(trans)值AUC为0.827。ADC值与K^(trans)联合诊断模型AUC为0.973,较二者单独应用明显增高,联合诊断模型诊断效能最高。经DeLong检验,联合诊断模型与单独K^(trans)诊断差异存在统计学意义(P<0.05)。ADC值与K^(trans)联合诊断模型在鉴别甲状腺良恶性结节中敏感度为97.3%,较ADC、K^(trans)更高,特异度为84.6%,较ADC值更高。结论ADC值和K^(trans)是鉴别甲状腺良恶性结节的重要参数,两者联合诊断可提高临床诊断准确性,为术前诊断提供重要依据。展开更多
Objective To investgate the value of various parameters obtained from monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the differential diagnosis of breast lesions.Methods A...Objective To investgate the value of various parameters obtained from monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the differential diagnosis of breast lesions.Methods A retrospective study was performed in 54 patients with pathologically confirmed malignant tumors(n=30),benign lesions(n=34)and normal fibroglandular展开更多
文摘BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.
基金Supported by Yangpu District Health and Family Planning Commission,Yangpu District Science and Technology Commission,No.YP15M18Research Project of Shanghai Municipal Commission of Health and Family Planning,No.201540032
文摘AIM To assess the value of combined acoustic radiation force impulse(ARFI) imaging, serological indexes and contrast-enhanced ultrasound(CEUS) in distinguishing between benign and malignant liver lesions. METHODS Patients with liver lesions treated at our hospital were included in this study. The lesions were divided into either a malignant tumor group or a benign tumor group according to pathological or radiological findings. ARFI quantitative detection, serological testing and CEUS quantitative detection were performed and compared. A comparative analysis of the measured indexes was performed between these groups. Receiver operating characteristic(ROC) curves were constructed to compare the diagnostic accuracy of ARFI imaging, serological indexes and CEUS, alone or in different combinations, in identifying benign and malignant liver lesions. RESULTS A total of 112 liver lesions in 43 patients were included, of which 78 were malignant and 34 were benign. Shear wave velocity(SWV) value, serum alpha-fetoprotein(AFP) content and enhancement rate were significantly higher in the malignant tumor group than in the benign tumor group(2.39 ± 1.20 m/s vs 1.50 ± 0.49 m/s, 18.02 ± 5.01 ng/m L vs 15.96 ± 4.33 ng/m L, 2.14 ± 0.21 d B/s vs 2.01 ± 0.31 d B/s; P < 0.05). The ROC curve analysis revealed that the areas under the curves(AUCs) of SWV value alone, AFP content alone, enhancement rate alone, SWV value + AFP content, SWV value + enhancement rate, AFP content + enhancement rate and SWV value + AFP content + enhancement rate were 85.1%, 72.1%, 74.5%, 88.3%, 90.4%, 82.0% and 92.3%, respectively. The AUC of SWV value + AFP content + enhancement rate was higher than those of SWV value + AFP content and SWV value + enhancement rate, and significantly higher than those of any single parameter or the combination of any two of parameters.CONCLUSION The combination of SWV, AFP and enhancement rate had better diagnostic performance in distinguishing between benign and malignant liver lesions than the use of any single parameter or the combination of any two of parameters. It is expected that this would provide a tool for the differential diagnosis of benign and malignant liver lesions.
文摘Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in computed tomography. Materials and Methods: 53 cases were included in the study. Primary (n = 42, 31 benign, 11 malignant) or metastatic (n = 11) tumors were detected at various locations in the bone structure of the cervical to coccygeal vertebrae in all cases. 3D CT images taken using the same system and biopsy or post-operative histopathology findings were available for all cases. Thin section images taken retrospectively from the archives were converted to 3D images using the same program and parameters, which were then recorded in the same window settings by two radiologists. Only 3D images were then analyzed to investigate the presence or absence of the dirty interface sign. Results: Dirty interface sign was present in 17 malignant lesions and absent in the remaining 5 lesions. As for benign lesions, the sign was present in only two lesions and the remaining 29 were negative for the sign. There was a high level of consistency between the two radiologists. In conclusion, malignant and benign lesions affecting the bone spinal axis were distinguished based on the presence or absence of the dirty interface sign with 77.3% sensitivity, 93.5% specificity and 86.8% accuracy. Conclusion: When evaluated with standard bone window views, 3D views can be used successfully for the distinction of malignant and benign bone tumors. At least, 3D views generated using low dose regimes in highly developed systems can be used with similar purpose to that of diffusion weighted MRI sequences that give roughly outlined but fast and accurate information about the lesion.
文摘目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量参数联合小视野弥散加权成像在甲状腺良恶性结节鉴别中的应用价值。材料与方法收集2022年1月至2023年10月于滨州医学院附属医院诊治并经手术病理证实为甲状腺结节的患者38例(52个结节),将其分为良性结节组和恶性结节组。术前患者均行3.0 T MRI扫描,包括常规MRI、小视野弥散加权成像(b值取0、800 s/mm^(2))和DCE-MRI检查,并测量其表观弥散系数(apparent diffusion coefficient,ADC)值和DCE-MRI定量参数,包括对比剂容积转运常数(volume transport constant,K^(trans))、速率常数(rate constant,K_(ep))、血管外细胞外间隙容积分数(extravascular extracellular volume fraction,V_(e))。对甲状腺良恶性结节组的ADC、K_(ep)、V_(e)、K^(trans)采用独立样本t检验分析,以P<0.05为差异有统计学意义,后将差异有统计学意义的变量进行逐步logistic回归模型分析,得到甲状腺良恶性结节的独立预测因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析ADC、K^(trans)独立诊断模型及ADC与K^(trans)联合诊断模型的诊断效能。结果良性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.659±0.370)×10^(-3)mm^(2)/s、(0.427±0.214)min^(-1)、(0.966±0.225)min^(-1),恶性结节组平均ADC值、K^(trans)值、K_(ep)值分别为(1.182±0.195)×10^(-3)mm^(2)/s、(0.178±0.073)min^(-1)、(0.600±0.248)min^(-1)。良性结节组的ADC、K^(trans)、K_(ep)值均高于恶性结节组,差异均有统计学意义(P<0.001)。经过独立样本t检验及逐步logistic回归分析显示,ADC值和K^(trans)差异具有统计学意义(P<0.05),是鉴别甲状腺结节良恶性的独立预测因子。单独ADC值曲线下面积(area under the curve,AUC)为0.915、单独K^(trans)值AUC为0.827。ADC值与K^(trans)联合诊断模型AUC为0.973,较二者单独应用明显增高,联合诊断模型诊断效能最高。经DeLong检验,联合诊断模型与单独K^(trans)诊断差异存在统计学意义(P<0.05)。ADC值与K^(trans)联合诊断模型在鉴别甲状腺良恶性结节中敏感度为97.3%,较ADC、K^(trans)更高,特异度为84.6%,较ADC值更高。结论ADC值和K^(trans)是鉴别甲状腺良恶性结节的重要参数,两者联合诊断可提高临床诊断准确性,为术前诊断提供重要依据。
文摘Objective To investgate the value of various parameters obtained from monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the differential diagnosis of breast lesions.Methods A retrospective study was performed in 54 patients with pathologically confirmed malignant tumors(n=30),benign lesions(n=34)and normal fibroglandular
