Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease(IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentia...Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease(IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography(CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging(MRI) and small intestine contrast enhanced ultrasonography(SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT.展开更多
The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These factors preclude the use of ordinary endoscopy and X-ray to thoroughly examine the small intestine for bleeding ...The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These factors preclude the use of ordinary endoscopy and X-ray to thoroughly examine the small intestine for bleeding of vascular malformations. Thus,the diagnosis of intestinal bleeding is very difficult. A 47-year-old man presented at the hospital 5 mo ago with dark stool. Several angiomas were detected by oral approach enteroscopy,but no active bleeding was observed. Additionally,no lesions were detected by anal approach enteroscopy;however,gastrointestinal tract bleeding still occurred for an unknown reason. We performed an abdominal vascular enhanced computed tomography examination and detected ileal vascular malformations. Ileum angioma and vascular malformation were detected by a laparoscopic approach,and segmental resection was performed for both lesions,which were confirmed by pathological diagnosis. This report systemically emphasizes the imaging findings of small intestinal vascular malformation bleeding.展开更多
Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscop...Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscopy cannot exhibit the intestinal wall and extra-luminal structure well. With the development and advancement of multi-slice spiral computed tomography and magnetic resonance imaging (MRI), computed tomography enteroclysis (CTE) and magnetic resonance enteroclysis (MRE) are widely used in the examination and diagnosis of small intestinal tumors. CTE and MRE, with three-dimensional imaging capabilities and excellent soft-tissue contrast, can analyze the abnormalities of peripheral intestinal structure as well as the tunica mucosa. In addition, these two technologies can clearly reveal the localization, appearance, degree of mesenteric infiltration and remote tumor metastasis, which increases our cognition of the imaging diagnosis for intestinal tumors. Here we review recent progress in imaging (CT and MRI) examination and diagnosis of small intestinal tumors.展开更多
In this paper, 18F-FDG PET/CT data of 19 malignant SINs (small intestinal neoplasms) were consecutively reviewed. Nnine patients accepted PET/CT scan for preoperative diagnosis and staging, while ten patients presente...In this paper, 18F-FDG PET/CT data of 19 malignant SINs (small intestinal neoplasms) were consecutively reviewed. Nnine patients accepted PET/CT scan for preoperative diagnosis and staging, while ten patients presented follow-up after treatment and restaging. The results were correlated with abdomen enhanced CT and surgical pathological findings. Abdominal pain and weight loss were the most common findings. About 16% SINs located in the duodenum, 52% in the jejunum and 32% in the ileum. Lymphoma was the most frequent neoplasms. PET/CT revealed residual or recurrent malignant SINs in 5 patients who had negative or non-definite findings by abdomen CT and demonstrated extra-abdomen metastasis in 3 patients. Clinical decisions of treatment were changed for 6 patients after PET/CT examinations. The 18F-FDG PET/CT were better than CT in accuracy, negative predictive value and positive predictive value (89.5% vs 68.4%, 100% vs 66.7%, and 81.8% vs 69.2%, respectively). Whole body 18F-FDG PET/CT may be an effective molecular imaging method for staging and restaging of malignant SINs.展开更多
Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respec...Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respectively. Multimodality treatment plays a key role in the successful management of lung cancer depending upon the histological subtype, stage of disease, and performance status. Imaging modalities play an important role in the diagnosis and accurate staging of the disease, in assessing the response to neoadjuvant therapy, and in the follow-up of the patients. Last decade has witnessed voluminous upsurge in the use of positron emission tomography-computed tomography(PET-CT); role of PET-CT has widened exponentially in the management of lung cancer. The present article reviews the role of 18-fluoro-deoxyglucose PET-CT in the management of non small cell lung cancer with emphasis on staging of the disease and the assessment of response to neoadjuvant therapy based on available literature.展开更多
目的分析原发性小肠淋巴瘤(primary small intestinal lymphoma,PSIL)的临床表现、相关辅助检查诊断及手术干预治疗效果,为提高临床诊治效果提供参考。方法回顾分析2015年5月至2020年10月山东大学齐鲁医院普通外科经手术干预及病理证实...目的分析原发性小肠淋巴瘤(primary small intestinal lymphoma,PSIL)的临床表现、相关辅助检查诊断及手术干预治疗效果,为提高临床诊治效果提供参考。方法回顾分析2015年5月至2020年10月山东大学齐鲁医院普通外科经手术干预及病理证实的30例PSIL患者的临床资料,并统计分析患者首诊情况、临床表现、影像学检查结果、手术情况及病理类型。结果30例PSIL患者中,首诊于消化内科15例,占比50.0%;首诊于普通外科11例,占比36.7%;首诊于急诊外科4例,占比13.3%。主要临床表现:腹部疼痛14例,占比46.7%;腹胀、恶心呕吐8例,占比26.7%;消化道出血5例,占比16.7%;腹部包块2例,占比6.7%;无症状1例,占比3.3%。影像学检查:27例患者行腹部CT检查均提示小肠局限性扩张、积液、肠壁增厚;13例患者行小肠镜检查提示小肠病变;2例行胶囊内镜检查提示小肠病变。手术情况:30例PSIL患者均行手术治疗,其中小肠部分切除肠吻合术23例,小肠部分切除小肠造瘘术2例,肠套叠复位+小肠部分切除术1例,小肠部分切除+左半结肠部分切除术3例,小肠部分切除+回盲部切除术1例。术后病理结果:均为非霍奇金淋巴瘤,其中弥漫大B细胞型17例,占比56.7%;T细胞型6例,占比20.0%;边缘区黏膜相关B细胞淋巴瘤3例,占比10.0%;NK/T细胞淋巴瘤2例,占比6.7%;套细胞淋巴瘤1例,占比3.3%;滤泡型淋巴瘤1例,占比3.3%。结论PSIL是较少见的消化道肿瘤,腹部CT、小肠镜检查及胶囊内镜检查均为有效检查手段,可提高诊断准确率;手术治疗是必要手段,可缓解临床症状,明确诊断,指导临床治疗。展开更多
目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imag⁃ing,DCE-MRI)+钼靶X线诊断乳腺小结节良恶性的价值。方法随机选取枣庄市市中区人民医院2020年1月—2022年12月收治的100例乳腺小结节患者作为研究对...目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imag⁃ing,DCE-MRI)+钼靶X线诊断乳腺小结节良恶性的价值。方法随机选取枣庄市市中区人民医院2020年1月—2022年12月收治的100例乳腺小结节患者作为研究对象,所有患者均接受DCE-MRI、钼靶X线检查。以病理检查结果为诊断的金标准,分析DCE-MRI、钼靶X线及两者联合诊断乳腺小结节良恶性的效果。结果病理的检查结果显示,40例为恶性结节,60例为良性结节。DCE-MRI+钼靶X线的灵敏度(95.00%)、特异度(98.33%)以及准确度(97.00%),相比于DCE-MRI、钼靶X线单独诊断更高,差异有统计学意义(χ^(2)=12.921、6.411、12.615,P均<0.05)。DCE-MRI+钼靶X线对于浸润性导管癌、导管内原位癌、乳房佩吉特病合并导管原位癌的诊断符合率相比于DCE-MRI、钼靶X线单独诊断均更高,差异有统计学意义(P均<0.05)。结论相比于DCE-MRI或钼靶X线,DCE-MRI+钼靶X线诊断恶性乳腺小结节的灵敏度、特异度以及准确度更高,可为临床提供理论参考。展开更多
文摘Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease(IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography(CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging(MRI) and small intestine contrast enhanced ultrasonography(SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT.
文摘The small intestine is approximately 5-6 m long and occupies a large area in the abdominal cavity. These factors preclude the use of ordinary endoscopy and X-ray to thoroughly examine the small intestine for bleeding of vascular malformations. Thus,the diagnosis of intestinal bleeding is very difficult. A 47-year-old man presented at the hospital 5 mo ago with dark stool. Several angiomas were detected by oral approach enteroscopy,but no active bleeding was observed. Additionally,no lesions were detected by anal approach enteroscopy;however,gastrointestinal tract bleeding still occurred for an unknown reason. We performed an abdominal vascular enhanced computed tomography examination and detected ileal vascular malformations. Ileum angioma and vascular malformation were detected by a laparoscopic approach,and segmental resection was performed for both lesions,which were confirmed by pathological diagnosis. This report systemically emphasizes the imaging findings of small intestinal vascular malformation bleeding.
基金Supported by Shanghai Leading Academic Discipline Project,No. S30203
文摘Precise examination and diagnosis of small intestinal tumors is difficult because of the curved course and overlapping canal of the small intestine. Traditional technology for intestinal canal examination and endoscopy cannot exhibit the intestinal wall and extra-luminal structure well. With the development and advancement of multi-slice spiral computed tomography and magnetic resonance imaging (MRI), computed tomography enteroclysis (CTE) and magnetic resonance enteroclysis (MRE) are widely used in the examination and diagnosis of small intestinal tumors. CTE and MRE, with three-dimensional imaging capabilities and excellent soft-tissue contrast, can analyze the abnormalities of peripheral intestinal structure as well as the tunica mucosa. In addition, these two technologies can clearly reveal the localization, appearance, degree of mesenteric infiltration and remote tumor metastasis, which increases our cognition of the imaging diagnosis for intestinal tumors. Here we review recent progress in imaging (CT and MRI) examination and diagnosis of small intestinal tumors.
基金Supported by the Bureau of Public Health of Xiamen City Funds for Young Creative Research (Grant No. WQK0704)the Health Department of Fujian Province Funds for Young Scholars (Grant No. 2008-1-49)
文摘In this paper, 18F-FDG PET/CT data of 19 malignant SINs (small intestinal neoplasms) were consecutively reviewed. Nnine patients accepted PET/CT scan for preoperative diagnosis and staging, while ten patients presented follow-up after treatment and restaging. The results were correlated with abdomen enhanced CT and surgical pathological findings. Abdominal pain and weight loss were the most common findings. About 16% SINs located in the duodenum, 52% in the jejunum and 32% in the ileum. Lymphoma was the most frequent neoplasms. PET/CT revealed residual or recurrent malignant SINs in 5 patients who had negative or non-definite findings by abdomen CT and demonstrated extra-abdomen metastasis in 3 patients. Clinical decisions of treatment were changed for 6 patients after PET/CT examinations. The 18F-FDG PET/CT were better than CT in accuracy, negative predictive value and positive predictive value (89.5% vs 68.4%, 100% vs 66.7%, and 81.8% vs 69.2%, respectively). Whole body 18F-FDG PET/CT may be an effective molecular imaging method for staging and restaging of malignant SINs.
文摘Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respectively. Multimodality treatment plays a key role in the successful management of lung cancer depending upon the histological subtype, stage of disease, and performance status. Imaging modalities play an important role in the diagnosis and accurate staging of the disease, in assessing the response to neoadjuvant therapy, and in the follow-up of the patients. Last decade has witnessed voluminous upsurge in the use of positron emission tomography-computed tomography(PET-CT); role of PET-CT has widened exponentially in the management of lung cancer. The present article reviews the role of 18-fluoro-deoxyglucose PET-CT in the management of non small cell lung cancer with emphasis on staging of the disease and the assessment of response to neoadjuvant therapy based on available literature.
文摘目的分析原发性小肠淋巴瘤(primary small intestinal lymphoma,PSIL)的临床表现、相关辅助检查诊断及手术干预治疗效果,为提高临床诊治效果提供参考。方法回顾分析2015年5月至2020年10月山东大学齐鲁医院普通外科经手术干预及病理证实的30例PSIL患者的临床资料,并统计分析患者首诊情况、临床表现、影像学检查结果、手术情况及病理类型。结果30例PSIL患者中,首诊于消化内科15例,占比50.0%;首诊于普通外科11例,占比36.7%;首诊于急诊外科4例,占比13.3%。主要临床表现:腹部疼痛14例,占比46.7%;腹胀、恶心呕吐8例,占比26.7%;消化道出血5例,占比16.7%;腹部包块2例,占比6.7%;无症状1例,占比3.3%。影像学检查:27例患者行腹部CT检查均提示小肠局限性扩张、积液、肠壁增厚;13例患者行小肠镜检查提示小肠病变;2例行胶囊内镜检查提示小肠病变。手术情况:30例PSIL患者均行手术治疗,其中小肠部分切除肠吻合术23例,小肠部分切除小肠造瘘术2例,肠套叠复位+小肠部分切除术1例,小肠部分切除+左半结肠部分切除术3例,小肠部分切除+回盲部切除术1例。术后病理结果:均为非霍奇金淋巴瘤,其中弥漫大B细胞型17例,占比56.7%;T细胞型6例,占比20.0%;边缘区黏膜相关B细胞淋巴瘤3例,占比10.0%;NK/T细胞淋巴瘤2例,占比6.7%;套细胞淋巴瘤1例,占比3.3%;滤泡型淋巴瘤1例,占比3.3%。结论PSIL是较少见的消化道肿瘤,腹部CT、小肠镜检查及胶囊内镜检查均为有效检查手段,可提高诊断准确率;手术治疗是必要手段,可缓解临床症状,明确诊断,指导临床治疗。
文摘目的探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imag⁃ing,DCE-MRI)+钼靶X线诊断乳腺小结节良恶性的价值。方法随机选取枣庄市市中区人民医院2020年1月—2022年12月收治的100例乳腺小结节患者作为研究对象,所有患者均接受DCE-MRI、钼靶X线检查。以病理检查结果为诊断的金标准,分析DCE-MRI、钼靶X线及两者联合诊断乳腺小结节良恶性的效果。结果病理的检查结果显示,40例为恶性结节,60例为良性结节。DCE-MRI+钼靶X线的灵敏度(95.00%)、特异度(98.33%)以及准确度(97.00%),相比于DCE-MRI、钼靶X线单独诊断更高,差异有统计学意义(χ^(2)=12.921、6.411、12.615,P均<0.05)。DCE-MRI+钼靶X线对于浸润性导管癌、导管内原位癌、乳房佩吉特病合并导管原位癌的诊断符合率相比于DCE-MRI、钼靶X线单独诊断均更高,差异有统计学意义(P均<0.05)。结论相比于DCE-MRI或钼靶X线,DCE-MRI+钼靶X线诊断恶性乳腺小结节的灵敏度、特异度以及准确度更高,可为临床提供理论参考。
