Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed...Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.展开更多
Objective:To study the correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer.Methods:60 patients with advanced non-sm...Objective:To study the correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer.Methods:60 patients with advanced non-small cell lung cancer who were treated in this hospital between January 2015 and January 2017 were divided into control group(n=30)and observation group(n=30)by random number table method.Control group received conventional intravenous chemotherapy,and observation group received intravenous chemotherapy combined with radiofrequency ablation.The differences in CT dynamic enhanced scanning parameter levels and serum tumor marker contents were compared between the two groups of patients before and after treatment.Pearson test was used to evaluate the correlation between CT dynamic enhanced scanning parameters and serum tumor marker contents in patients with advanced non-small cell lung cancer.Results:Before treatment,the differences in CT dynamic enhanced scanning parameter levels,non-organ-specific tumor marker contents and vascular tumor marker contents were not statistically significant between the two groups of patients(P>0.05).After treatment,CT dynamic enhanced scanning parameters PH and perfusion value levels of observation group were lower than those of control group(P<0.05);serum non-organ specific tumor markers CA125,CA153,CEA and CYFRA21-1 contents of observation group were lower than those of control group;serum vascular tumor markers VEGF,Ang-2,HIF-1 and MMP-9 contents were lower than those of control group(P<0.05).Pearson test showed that CT dynamic enhanced scanning parameters PH and perfusion value levels in patients with non-small cell lung cancer were positively correlated with serum non-organ specific tumor marker and vascular tumor marker contents.Conclusion:Adjuvant radiofrequency ablation can significantly reduce the tumor malignancy of patients with advanced non-small cell lung cancer.展开更多
目的观察肝硬化(HC)合并原发性肝癌(PLC)患者CT动态增强扫描变化,分析其诊断价值。方法回顾性分析2020年4月—2022年7月我院125例HC患者资料,所有受试者均行病理组织学检测及CT动态增强扫描,统计所有患者病灶大小及分布情况,CT动态增强...目的观察肝硬化(HC)合并原发性肝癌(PLC)患者CT动态增强扫描变化,分析其诊断价值。方法回顾性分析2020年4月—2022年7月我院125例HC患者资料,所有受试者均行病理组织学检测及CT动态增强扫描,统计所有患者病灶大小及分布情况,CT动态增强扫描动脉期、静脉期、延迟期病灶检出情况,以病理检查为金标准,分析CT动态增强扫描对HC患者PLC的诊断价值、HC患者与HC并PLC患者血流灌注参数大小及不同肝功能CTP分级下血流灌注参数变化。结果125例HC患者共检出161个病灶,其中直径<1 cm 8个,1~3 cm 53个,4~5 cm 63个,>5 cm 37个,肝右前叶、肝右后叶者居多,分别为45及69个;CT动态增强扫描动脉期检出病灶149个,检出率92.55%;门脉期检出病灶134个,检出率83.23%;延迟期检出病灶142个,检出率88.20%;125例HC患者中病理学检查显示75例PLC阳性,50例PLC阴性,CT动态增强扫检测HC并PLC的敏感度为94.67%,特异度为94.00%,准确率为94.40%,阳性预测值为95.95%,阴性预测值为92.16%,Kappa值为0.884,具有较高的一致性;HC组HAP、HPI值均显著低于HC并PLC组,PVP、TLP值均显著高于HC并PLC组(P<0.05);125例HC并PLC患者中CTP A级41例,CTP B级46例,CTP C级38例,CTP A级HAP、HPI值显著低于CTP B、C级(P<0.05),PVP、TLP值均显著高于CTP B、C级(P<0.05),CTP B级HPI值与CTP C级比较,差异均无统计学意义(P>0.05)。结论CT动态增强扫描可多方位多角度显示HC病灶情况,且对PLC具有较好的诊断价值,其中肝脏血流灌注参数具有一定的特征性,可为PLC诊断和肝功能分级提供参考。展开更多
OBJECTIVES: To analyze the characteristics of early hepatocellular carcinoma by using multi-phase helical CT and assess the value of this method. METHODS: Multi-phase helical CT findings were reviewed double-blindly b...OBJECTIVES: To analyze the characteristics of early hepatocellular carcinoma by using multi-phase helical CT and assess the value of this method. METHODS: Multi-phase helical CT findings were reviewed double-blindly by radiologists. RESULTS: Altogether 24 lesions were found in 21 patients. In plain CT, the lesions were seen as hypodense or isodense areas. After contrast enhancement, 87.5% of the lesions showed regular or irregular hyperdense enhancement, whereas 12.5% demonstrated tumor vessels in arterial phase, which became hypodensed or isodensed nodules in portal phase or the hypodensed in delayed phase. The prevalence of density changes showed a hypo-hyper-hypo and hypo-hypo pattern. CONCLUSIONS: Multi-phase helical CT could reflect the blood supply of early hepatocelluar carcinoma, and is also convenient for the differential diagnosis of hepatic cavernous angioma, metastatic tumor, hepatic nodulous hyperplasia, and hepatic inflammatory granuloma.展开更多
To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal vo...To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal volumes were measured on CT. The aortic contrast enhancement was inversely correlated with renal medullary volume (r = -0.52, p 0.0001), and renal cortical volume (r = -0.3, p = 0.02). Renal volume may have inverse correlation with aortic contrast enhancement on the hepatic arterial phase of dynamic CT. This might call for adjustment of contrast material dose based in part on renal volume in the future.展开更多
基金supported by the Jiangsu Province Natural Science Foundation (No. BK20161291)the Nantong Science Foundation of China (No. MS2201507)the Nantong Municipal Commission of Health and Family Planning Young Fund (No. WQ2014047)
文摘Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.
基金Health and Family Planning Commission of Zigong(No.2017wZCS09)
文摘Objective:To study the correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer.Methods:60 patients with advanced non-small cell lung cancer who were treated in this hospital between January 2015 and January 2017 were divided into control group(n=30)and observation group(n=30)by random number table method.Control group received conventional intravenous chemotherapy,and observation group received intravenous chemotherapy combined with radiofrequency ablation.The differences in CT dynamic enhanced scanning parameter levels and serum tumor marker contents were compared between the two groups of patients before and after treatment.Pearson test was used to evaluate the correlation between CT dynamic enhanced scanning parameters and serum tumor marker contents in patients with advanced non-small cell lung cancer.Results:Before treatment,the differences in CT dynamic enhanced scanning parameter levels,non-organ-specific tumor marker contents and vascular tumor marker contents were not statistically significant between the two groups of patients(P>0.05).After treatment,CT dynamic enhanced scanning parameters PH and perfusion value levels of observation group were lower than those of control group(P<0.05);serum non-organ specific tumor markers CA125,CA153,CEA and CYFRA21-1 contents of observation group were lower than those of control group;serum vascular tumor markers VEGF,Ang-2,HIF-1 and MMP-9 contents were lower than those of control group(P<0.05).Pearson test showed that CT dynamic enhanced scanning parameters PH and perfusion value levels in patients with non-small cell lung cancer were positively correlated with serum non-organ specific tumor marker and vascular tumor marker contents.Conclusion:Adjuvant radiofrequency ablation can significantly reduce the tumor malignancy of patients with advanced non-small cell lung cancer.
文摘目的观察肝硬化(HC)合并原发性肝癌(PLC)患者CT动态增强扫描变化,分析其诊断价值。方法回顾性分析2020年4月—2022年7月我院125例HC患者资料,所有受试者均行病理组织学检测及CT动态增强扫描,统计所有患者病灶大小及分布情况,CT动态增强扫描动脉期、静脉期、延迟期病灶检出情况,以病理检查为金标准,分析CT动态增强扫描对HC患者PLC的诊断价值、HC患者与HC并PLC患者血流灌注参数大小及不同肝功能CTP分级下血流灌注参数变化。结果125例HC患者共检出161个病灶,其中直径<1 cm 8个,1~3 cm 53个,4~5 cm 63个,>5 cm 37个,肝右前叶、肝右后叶者居多,分别为45及69个;CT动态增强扫描动脉期检出病灶149个,检出率92.55%;门脉期检出病灶134个,检出率83.23%;延迟期检出病灶142个,检出率88.20%;125例HC患者中病理学检查显示75例PLC阳性,50例PLC阴性,CT动态增强扫检测HC并PLC的敏感度为94.67%,特异度为94.00%,准确率为94.40%,阳性预测值为95.95%,阴性预测值为92.16%,Kappa值为0.884,具有较高的一致性;HC组HAP、HPI值均显著低于HC并PLC组,PVP、TLP值均显著高于HC并PLC组(P<0.05);125例HC并PLC患者中CTP A级41例,CTP B级46例,CTP C级38例,CTP A级HAP、HPI值显著低于CTP B、C级(P<0.05),PVP、TLP值均显著高于CTP B、C级(P<0.05),CTP B级HPI值与CTP C级比较,差异均无统计学意义(P>0.05)。结论CT动态增强扫描可多方位多角度显示HC病灶情况,且对PLC具有较好的诊断价值,其中肝脏血流灌注参数具有一定的特征性,可为PLC诊断和肝功能分级提供参考。
文摘OBJECTIVES: To analyze the characteristics of early hepatocellular carcinoma by using multi-phase helical CT and assess the value of this method. METHODS: Multi-phase helical CT findings were reviewed double-blindly by radiologists. RESULTS: Altogether 24 lesions were found in 21 patients. In plain CT, the lesions were seen as hypodense or isodense areas. After contrast enhancement, 87.5% of the lesions showed regular or irregular hyperdense enhancement, whereas 12.5% demonstrated tumor vessels in arterial phase, which became hypodensed or isodensed nodules in portal phase or the hypodensed in delayed phase. The prevalence of density changes showed a hypo-hyper-hypo and hypo-hypo pattern. CONCLUSIONS: Multi-phase helical CT could reflect the blood supply of early hepatocelluar carcinoma, and is also convenient for the differential diagnosis of hepatic cavernous angioma, metastatic tumor, hepatic nodulous hyperplasia, and hepatic inflammatory granuloma.
文摘To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal volumes were measured on CT. The aortic contrast enhancement was inversely correlated with renal medullary volume (r = -0.52, p 0.0001), and renal cortical volume (r = -0.3, p = 0.02). Renal volume may have inverse correlation with aortic contrast enhancement on the hepatic arterial phase of dynamic CT. This might call for adjustment of contrast material dose based in part on renal volume in the future.
