Objective To evaluate the sensitivity and accuracy of SPIO-enhanced MR Imaging in the detection of focal hepatic lesions. Methods We searched MEDLINE (1966 to 2004), EMBSAE (1984 to 2004), The Cochrane Library (Issue 1, 2004), CBMdisc (Jan.1978 to Jul. 2004), CMCC (1994 to 2004), “Radiology”, “AJR” and “European Radiology” database. Data from pharmaceutical companies and our research were also added. Related journals published from 1985 to 2003 were handsearched. Participants were clinically suspected of focal hepatic lesions. The quality of studies was assessed, and descriptive systematic review was applied to evaluate the detection sensitivity and accuracy of the imaging modality. Results Ten studies (418 patients with 1 037 focal hepatic lesions) were included. Because the data of sensitivity and specificity could not be extracted from any of the 10 included studies, it was impossible to do the meta-analysis using SROC curve. The sensitivity of SPIO-enhanced MRI ranged from 66% to 100%; accuracy ranged from 76% to 97%. Conclusions At present, there is no evidence to ascertain that SPIO-enhanced MRI has a considerably high accuracy in the detection of focal hepatic lesions. More studies with good methodology are needed.
ObjectiveTo investigate the value of ultrasound contrast in the differential diagnosis for hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia (FNH). MethodsTwenty-three HCC patients and 23 cases hepatic FNH patients from January 1, 2012 to January 1, 2014 in our hospital were selected, all of them were underwent ultrasound contrast examination before operation. The ultrasound contrast results of 2 groups patients were comparative analyzed. ResultsIn HCC group, the contrast arrival time was (3.8±1.9) s, peak time was (21.8±11.9) s, and peak strength was (28.8 ±3.1) dB; in hepatic FNH group, these indicators was (2.3±1.4) s, (35.3±14.8) s, and (22.3±7.9) dB, respectively. These indicators of HCC group was longer or shorter or higher than those of hepatic FNH group, respectively (P < 0.05). The sensitivity, specificity, and accuracy of ultrasound contrast diagnosed HCC was 91.3% (21/23), 87.0% (20/23), and 95.7% (22/23), and diagnosed hepatic FHN was 87.0% (20/23), 91.3% (21/23), and 91.3% (21/23), respectively, the difference were not statistically significant between the two groups (P > 0.05). ConclusionUltrasound contrast has very important application value in the differential diagnosis of HCC and hepatic FNH, can be used in clinical application.
Tumor chemotherapy is a treatment method that employs chemotherapeutic drugs to eradicate cancer cells. These drugs are cytotoxic, meaning they can affect both tumor cells and normal cells. In recent years, there has been a gradual increase in chemotherapy-induced liver injury. Chemotherapy-induced parenchymal liver injury often manifests as diffuse lesions, although focal lesions can occasionally be observed. There is a diversity in the pathogenesis and pathological changes of chemotherapy-induced focal liver disease. Radiologically, there is often challenging in differentiating chemotherapy-induced focal liver disease from hepatic metastases. Therefore, early and accurate diagnosis of this condition poses a certain challenge in clinical practice. This article presents the radiological findings of a case of chemotherapy-induced focal liver disease induced by chemotherapy for gastric cancer, and summarizes the radiological features and differential diagnostic points of chemotherapy-induced focal liver disease, aiming to enhance the understanding of this type of lesion among radiologists and clinicians and reduce related missed diagnoses and misdiagnoses.
Objective To summarize manifestation, imaging characteristics, and treatment of hepatic focal nodular hyperplasia (FNH). Methods From January 2007 to December 2016, the patients pathologically confirmed hepatic FNH were included in this study. The clinical features and imaging characteristics were analyzed retrospectively. Results Twenty-two cases were pathologically diagnosed as hepatic FNH with an age of (36.8±11.2) years (range from 20 to 61 years). Ten were males and 12 were females. Three patients had abdominal pain and 19 patients had no symptoms. The diameter of the lesions was (4.16±1.92) cm (range from 1.0 to 7.8 cm) and approximately 9 (40.9%) lesions were more than 5.0 cm. The diagnosis rates of CT and MRI were 64.70% (11/17) and 84.21% (16/19), respectively. All the patients underwent hepatectomy successfully and recovered without severe complications. No recurrence and metastasis happened during following-up of 1–103 months. Conclusions Hepatic FNH is more common in young patients and has no typical symptoms. MRI is useful in diagnosis of hepatic FNH.
【Abstract】Objective To compare radiologists’ performance on combined unenhanced and feridexs-enhanced MR imaging （MRI） with their performance on helical CT enhanced, unenhanced MRI, and feridexs-enhanced MR alone imaging for the characteristics of local hepatic lesions. Methods MR images and CT scans obtained in 26 patients with 57 local hepatic lesions were analyzed with reviewer operator characteristic (ROC) curve analysis. The imaging of patient were divided into 4 groups including combined unenhanced and feridexs-enhanced MRI group, helical CT enhanced group, unenhanced MRI group, and feridexsenhanced MR alone group. Results The combined approach resulted in larger area under the ROC curve (Az=0.926 0) and accuracy (86.8%),P＜0.05，as compared with the others methods. There were no significant differences among the other three methods. Conclusion Feridexs-enhanced MRI was more accurate than enhanced helical CT scan in characterization of local hepatic lesion. The combined analysis of unenhanced and feridexs-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of feridexs-enhanced images alone.
摘要:目的: 分析肝臟局灶性結節增生(FNH)的MRI表現和病理特點,探討兩者的相關性,提高FNH診斷的準確率。 方法 :回顧性分析23例(共28個病灶)經手術切除病理證實為FNH的MRI平掃及增強表現,與其病理特點進行對照。 結果 :25個病灶在平掃T1WI上呈等或稍低信號,T2WI上呈等或稍高信號,3個病灶在平掃T1WI及T2WI上均呈稍高信號,增強后所有28病灶動脈期可見明顯強化,門脈期及延遲期呈稍高、等或稍低信號,其中12個病灶可見中心纖維瘢痕延遲強化。FNH組織病理上表現為富血供的實質性腫塊,腫物內部組織較均勻,沒有異型細胞,中心可見纖維瘢痕。 結論 :肝臟MRI平掃及增強檢查能很好的反映FNH的組織病理及血供特點,能為FNH的診斷及鑒別診斷提供可靠證據。Abstract: Objective: To analyze the MRI manifestations and pathology characteristic of hepatic focal nodular hyperplasia(FNH),and to investigate their correlation. Methods : A retrospective analysis was made on the unenhanced and dynamic enhanced MR images of 23 patients (totally 28 lesions) with surgical and pathological proved FNH. Results :25 FNH lesions demonstrated isointensity or slightly hypointense on unenhanced T1WI,and isointensity or slightly hyperintense on unenhanced T2WI,3 FNH demonstrated hyperintense on both unenhanced T1WI and T2WI. 28 FNHs were markediyhyperintense in the arterial phase of dynamic contrast enhanced MRI, and isointense or slightly hyperintense in the portal and delayed phase．The seals were shown in 12 lesions, and enhanced in delayed phase．FNH is solid mass with vast blood supply,its inside structure is homogemeous. Typical seal can be found by microscopic examination．〖WTHZ〗Conclusion : MRI could disclose the pathologic features of FNH and its blood supply and improve the accuracy 0f its diagnosis．
Objective To analyze the relationship between the epidermal growth factor receptor(EGFR) gene mutation and malignant pulmonary focal ground-glass lesion (fGGL). Methods We retrospectively collected the clinical data of 86 patients with surgical treatment in the department of cardiothoracic surgery of Changzheng Hospital from August 2012 to February 2015. There were 26 males and 60 females with a mean age of 56.14±10.55 years. We analyzed the relationship between the EGFR gene mutation and the related clinical data. Results Postoperative pathology showed atypical adenomatous hyperplasia (AAH) combined with focal adenocarcinoma in situ (AIS) or AIS in 10 patients, minimally invasive adenocarcinoma (MIA) in 15, and lepidic predominant adenocarcinoma (LPA) in 61. The EGFR gene mutation reports showed the exon 19 19-del mutation in 14 patients, exon 21 L858R mutation in 27, and exon 21 L861Q mutation in 2. There was no difference between the mutation of EGFR gene and clinical factors except age and smoking (P>0.05). Till June 30, 2015, all patients were alive and follow-up was 440.48±186.61 days. Conclusion The EGFR gene in patients with malignant pulmonary fGGL shows a higher mutation rate, which provides important clinical reference data for the basic research and the clinical treatment.
ObjectiveThrough neuropsychological assessment, explore the factors that may cause cognitive impairment in patients with focal epilepsy.MethodsCollected 53 epilepsy patients in outpatients and inpatients of Tianjin Medical University General Hospital from March 2016 to January 2020, including 25 males and 28 females, with an average age of (23.58±13.24) years old, and the course of disease (6.49±7.39), all met the 2017 ILEA diagnostic criteria for focal epilepsy, and there was no history of progressive brain disease or brain surgery. Carry out relevant cognitive assessments for the enrolled patients, use SPSS statistical software to conduct Spearman correlation analysis on the cognitive functions of the study subjects, and further analyze the related factors of cognition through Logistic regression analysis to clarify the factors related to cognition whether it may be a risk factor for cognitive impairment in patients with focal epilepsy.Results Spearman correlation analysis showed that the FIQ of patients with focal epilepsy was related to education level, age of onset, seizure pattern, total number of seizures, AEDs and EEG interval discharge side (P<0.05). Binary Logistic regression analysis shows that among all cognitive-related factors, only the number of AEDs (P=0.003) and EEG interval discharge (P=0.013) are the risk of cognitive impairment in patients with focal epilepsy factor.ConclusionIn the clinical treatment of epilepsy, seizures should be actively controlled, but the types of drugs should be minimized. When there are more than 3 kinds of drugs, surgical treatment or other non-surgical treatments can be considered. At the same time, the EEG should be reviewed regularly to understand the changes in epileptiform discharges between episodes.