Objective To review the value of imaging assessment of stem cell transplantation in treatment for liver cirrhosis.Methods The related literatures in recent years were collected,and the applications of different radiological techniques and strategies of stem cell transplantation in treatment for liver cirrhosis were summarized.Results Stem cell transplantation in treatment for liver cirrhosis was feasible and effective. Radiological assessment could supply the prompt and accurate information for clinic to choose the proper therapeutic method.The curative effect could also be accurately assessed by radiological techniques.Conclusion Radiological examination is important for the assessment of stem cell transplantation in treatment for liver cirrhosis.
ObjectiveTo explore performances of functional magnetic resonance imaging (MRI) in evaluation of hepatic warm ischemia-reperfusion injury.MethodThe relative references about the principle of functional MRI and its application in the assessment of hepatic warm ischemia-reperfusion injury were reviewed and summarized.ResultsThe main functional MRI techniques for the assessment of hepatic warm ischemia-reperfusion injury included the diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM), diffusion tensor imaging (DTI), blood oxygen level dependent (BOLD), dynamic contrast enhancement MRI (DCE-MRI), and T2 mapping, etc.. These techniques mainly used in the animal model with hepatic warm ischemia-reperfusion injury currently.ConclusionsFrom current results of researches of animal models, functional MRI is a non-invasive tool to accurately and quantitatively evaluate microscopic information changes of liver tissue in vivo. It can provide a useful information on further understanding of mechanism and prognosis of hepatic warm ischemia-reperfusion injury. With development of donation after cardiac death, functional MRI will play a more important role in evaluation of hepatic warm ischemia-reperfusion injury.
目的:探討5·12汶川大地震致脊椎外傷傷員的影像學表現特點。方法:回顧性分析自2008年5月12日至6月12日因地震性脊柱外傷在我院行放射檢查者,共320例。其中行X線檢查310例,CT檢查38例,MRI檢查15例。結果:148例傷員影像學檢查為陽性,陽性率為46.25%。30～39歲年齡組傷員人數最多,為68例,其中女性40例。陽性傷員中,多發傷有80例(54.05%)。單一椎體骨折98例,多發椎體骨折42例,椎體脫位12例。椎體壓縮骨折114個,爆裂骨折26個,附件骨折31個。310例傷員中,共累及182個椎體,即頸椎15個,胸椎59個,腰椎100個,骶椎8個。結論:地震致脊椎外傷受累人群主要為30～39歲青年女性,多發傷多見。單一椎體骨折相對多見,骨折損傷類型以壓縮性骨折為主,腰椎為最常見受傷部位。影像學檢查有助于脊柱外傷的及時準確診斷。
Objective To discuss the CT appearances and clinicopathologic features of gastrointestinal neuroendocrine neoplasms (GI-NENs). Method The clinical and CT materials of 33 cases of GI-NENs who treated in our hospital from Jan. 2013 to Dec. 2015 were retrospectively analyzed. Results Of the 33 cases, 25 males and 8 females were enrolled. The median age was 62-year old (27–78 years), and the age at diagnosis mainly focused in the 50–70 years period. GI-NENs situation: 12 cases in the stomach, 11 cases in the rectum, 3 cases in the esophagus and colon respectively, 2 cases in the duodenum and appendix respectively. The main clinical symptoms included: abdominal pain in 13 cases, dysphagia and obstruction in 9 cases, hematemesis and hematochezia in 8 cases, abdominal distention in 5 cases, stool and bowel habits change in 5 cases, subxyphoid pain in 3 cases, belching in 2 cases, diarrhea in 1 case, protrusion of the neoplasm when defecation in 1 case, obstructive jaundice in 1 case. Seven cases of G1 grade, 6 cases of G2 grade, 15 cases of G3 grade, and 5 cases of mixed adenoneuroendocrine carcinomas were found according to pathologic grading. The immunohistochemical marker: synaptophsin was positive in 31 cases, cytokeratin A was positive in 23 cases, and cytokeratin was positive in 9 cases. The CT appearances of GI-NENs were mainly thickening of the walls and formation of nodules or masses in local area. Moderately homogeneous enhancement (in 20 cases) and irregularly heterogeneous enhancement (in 13 cases) were both commonly seen. In addition, 13 cases of lymphadenophathy, 6 cases of liver metastasis, and 3 cases of lung metastasis were also detected by CT. Conclusions GI-NENs have a preference for elderly male. The most common site of onset is the stomach. Its clinical symptoms and CT appearances are nonspecific, however, the enhancement pattern of the tumors has a certain characteristic.
Objective To explore the correlation between liver volume variation of posthepatitic cirrhosis patients and the severity of the disease. Methods One hundred and eleven patients with normal livers and 74 posthepatitic cirrhosis patients underwent volume CT scan. The relation between normal liver volume and body height, body weight and body surface area was studied by linear regression and correlation method, the standard liver volume equation was deduced. The change ratio of liver volume in cirrhotic patients was calculated and compared with Child classification. Results The mean normal liver volume of Chinese adults was （1 225.15±216.23） cm3, there was a positive correlation between liver volume and body height, body weight 〔liver volume (cm3)=12.712×body weight (kg)+450.44〕 and body surface area 〔liver volume (cm3)=876.02×body surface area (m2)-297.17〕. The mean liver volume of Child A, B and C patients were （1 077.77±347.01） cm3, (1 016.35±348.60) cm3 and (805.73±208.85) cm3 respectively. The liver volume and liver volume index was significantly smaller in Child C patients than those in Child A and B patients (P＜0.05); while liver volume change ratio was higher in Child C patients (P＜0.05). Conclusion Liver volume variation of cirrhotic patients can be quantitatively assessed by 16 slices helical CT volume measurement and standard liver volume equation. The change of the liver volume is correlated with the severity of liver cirrhosis.
【摘要】 目的 探討汶川大地震傷員胸部外傷的影像學表現特點。 方法 對2008年5月12日-6月21日因地震胸部外傷在我院放射科檢查的687例患者（年齡1～96歲）的臨床資料進行回顧性分析。將患者按10歲為一個年齡組劃分。所有患者均行胸部X線片檢查，38例行CT檢查。 結果 687例患者中，256例檢查結果為陽性，陽性率為37.26%。年齡以30~79歲年齡組為主。在陽性傷員中，98例（38.28%）為多系統多發傷，159例（62.11%）為多種類型胸部傷同時存在，肋骨骨折198例（約77.34%），肺挫裂傷49例(約19.14%)。 結論 本組地震傷員多系統多發傷、多類型胸部傷常見，肋骨骨折及肺挫裂傷為主要損傷表現。影像學檢查有助于胸部外傷的及時和準確診斷。【Abstract】 Objective To explore the imaging features of thoracic trauma in patients injured in Wenchuan earthquake. Methods The radiological data of 687 patients (aged from 1 to 96 years) with thoracic trauma who underwent radiological examinations between 12 May and 21 June 2008 were retrospectively analyzed. The patients were divided into subgroups according to the age. All patients underwent X-ray plain film examination, in whom 38 underwent CT examination. Results In 687 patients, the results of the examination were positive in 256 with a positive rate of 37.26%; the major injured patients were in the 30-79 years old group. In the patients with positive findings, 98 (38.28%) were accompanied by multi-system injuries, 159 (62.11%) were comprised of several types of thoracic trauma. There were 198 patients (about 77.34%) with rib fracture and 49 patients (19.14%) with lung contusion. Conclusions Multi-system injuries and several types of thoracic trauma are common in the patients injured in the earchquake. The main traumatic manifestations are rib facture and lung contusion. Imaging examination is very helpful in the diagnosis of thoracic trauma.
摘要:目的:探討5·12汶川8.0級地震中顱面部外傷的影像學表現特點。方法: 回顧性分析自2008年5月12~31日因地震顱面部外傷在我院行CT、MRI檢查的傷員251例,其中CT檢查248例,MRI檢查16例。結果:放射檢查陽性162例,陽性率為64.54%,以40～49歲年齡組最多,為53例,其中男性41例。在放射檢查陽性中,多發傷112例(約69.13%),多類型顱面部外傷同時并存103例(約63.58%)。主要損傷發生率依次為軟組織損傷(35.50%),骨折(22.94%),腦挫裂傷(21.21%),硬膜下及硬膜外血腫(10.40%),其它(共約9.92%)。結論: 地震造成顱面部外傷人群主要為40～49歲中年男性,多發傷、多類型顱面部外傷多見,并以軟組織損傷、骨折、腦挫裂傷、硬膜下及硬膜外血腫較常見。Abstract: Objective: To describe the imaging features of head and face injured patients after the Wenchuan earthquake. Methods: The radiological information of 251 victims who were suspicious of head and face injury and underwent CT or MRI examinations from 12 May to 31 May 2008 was analysed retrospectively. There were 248 and 16 cases underwent CT or MRI examinations respectively. Results: One hundred and sixtytwo cases(64.54% )were positive. There were 53 cases in the 4049 years old age group, of which 41 were male. In patients with positive findings, 112 cases (about 63.58%) were comprised of several types of head and face injury. The incidence of the main injury type included: soft tissue injury (35.50%), fracture (22.94%), cerebral contusion (21.21%), subdural and epidural hematoma (12.40%), others (9.92%). Conclusions: The males with head and face injury in 4049 years old group were the major injured people in this earthquake. Head and face injury accompanied by multiple system injuries, the existence of several types of head and face injury at the same time were common. Among all the injury types, soft tissue injury, fracture, contusion, subdural and epidural hematoma were relatively commom.
ObjectiveTo systematically review the efficacy and safety of Salvia miltiorrhiza injection in the treatment of acute ischemic stroke (AIS). MethodsPubMed, EMbase, The Cochrane Library, Web of Science, VIP, WanFang Data, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of Salvia miltiorrhiza injection in treatment of AIS from inception to February 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using Stata 16.0 software and RevMan 5.3 software. ResultsA total of 160 RCTs were included. The measures included 7 Chinese medicine injections and 8 treatment measures, covering Danhong injection combined with conventional treatment (DH+CT), Danshen injection combined with conventional treatment (DS+CT), Danshen ligustrazine injection combined with conventional treatment (DSCXQ+CT), Danshen polyphenolic acid for injection combined with conventional treatment (DSDFS+CT), compound Danshen injection combined with conventional treatment (FFDS+CT), Danshen polyphenolate for injection combined with conventional treatment (SI+CT), and Sodium Tanshinone ⅡA Sulfonate injection combined with conventional treatment (STS+CT) and conventional treatment (CT). Results of network meta-analysis showed that for the total effective rate, the rank of cumulative probability was: DSDFS+CT (93.0%) > DH+CT (80.5%) > STS+CT (66.7%) > DSCXQ+CT (66.4%) > SI+CT (50.0%)> DS+CT (26.7%)> FFDS+CT (16.7%)> CT (0.1%). In terms of NIHSS, the rank of cumulative probability was: STS+CT (95.5%) >DH+CT (80.9%)> DSCXQ+CT (70.1%) > SI+CT (64.7%) > DSDFS+CT (42.0%) > FFDS+CT (24.4%) > DS+CT (20.1%) > CT (2.4%). In the aspect of Barthel index, the rank of cumulative probability was: DH+CT (76.2%) > DSCXQ+CT (74.3%) > STS+CT (64.1%) > DSDFS+CT (62.2%) > FFDS+CT (51.8%) > SI+CT (46.0 %) > DS+CT (21.7%)> CT (3.8%). ConclusionCurrent evidence shows that, for patients with AIS, DSDFS has an improved effect on the total effective rate, while STS and DH show advantages in NIHSS score and Barthel index. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo explore value of CT imaging features in differentiating pathological grades of pancreatic neuroendocrine neoplasms (pNENs). MethodsThe patients with pNENs admitted to the Sichuan Provincial People’s Hospital from October 2017 to December 2023 were retrospectively collected. The enrolled patients were assigned into a low-grade (G1+G2) pNENs and high-grade (G3+neuroendocrine carcinoma) pNENs. Then, the differences in gender, age, presence of neuroendocrine symptoms, tumor location, tumor diameter, clarity of the tumor boundary, cystic change, capsule, dilation of the biliary and pancreatic ducts, pancreatic parenchymal atrophy, vascular invasion, liver metastasis, lymph node metastasis, tumor enhancement pattern, Ct values in each phase, and the ratio of Ct value of the tumor to that of the normal pancreas (T/N value) between the low-grade pNENs and high-grade pNENs were compared. Subsequently, the multivariate logistic regression analysis was used to screen the CT imaging features with statistical significance and the receiver operating characteristic (ROC) curve was use to differentiate high-grade from low-grade pNENs. ResultsA total of 47 pNENs patients were enrolled, including 36 low-grade and 11 high-grade cases. Compared with the low-grade pNENs, the patients with high-grade pNENs had higher proportions of pancreaticobiliary duct dilation (χ2=9.124, P=0.003) and vascular invasion (χ2=10.967, P=0.001), more mild enhancement (χ2=9.192, P=0.010), larger tumor diameter (Z=–2.378, P=0.017), and lower Ct values and T/N ratios in the arterial and venous phases (P=0.001, P=0.032, P=0.006, P=0.018). The multivariate logistic regression analysis showed that the pancreaticobiliary duct dilation, vascular invasion, and decreased Ct value in the arterial phase were the predictive factors for the high-grade pNENs. The areas under the ROC curves of these three indicators for distinguishing low-grade from high-grade pNENs were 0.760, 0.749, and 0.843, respectively, the Ct value in the arterial phase had the strongest discriminatory ability, and its cutoff value was 78 HU. ConclusionsThe results of this study suggest that pancreatic ductal dilation, vascular invasion, and Ct value in arterial phase play important roles in differentiating high-grade pNENs from low-grade pNENs. Ct value in arterial phase has the greatest diagnostic efficiency.
ObjectiveTo investigate the value of proton magnetic resonance spectroscopy (1H-MRS), gradient dual-echo, and triple-echo sequences in the quantitative evaluation of treatment effect of fatty liver at 3.0T MR.MethodsThirty patients with fatty liver diagnosed by CT or ultrasound who admitted in Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital between August 2017 and May 2018, were enrolled and undergone gradient dual-echo, triple-echo, and 1H-MRS examination before and 3 months after treatment. The fat index (FI) and relative lipid content (RLC) were measured. Fatty liver index (FLI) was calculated from blood biochemical indicators, waist circumference, and BMI at the same time. With the reference standard of FLI, the results before and after treatment measured from MRI were analyzed.ResultsThere were significantly differences of FLI, FIdual, FItriple, and RLC before and after treatment (t=5.281, P<0.001; Z=–3.651, P<0.001; Z=–3.630, P<0.001; Z=–4.762, P<0.001), all indexes decreased after treatment. FIdual and FItriple were positively correlated with FLI before (rs=0.413, P=0.023; rs=0.396, P=0.030) and after treatment (rs=0.395, P=0.031; rs=0.519, P=0.003), the highest correlation factor was FItriple to FLI after treatment. There were no significant correlation between RLC and FLI before and after treatment (P>0.05).ConclusionsIt is feasible to quantitatively evaluate the treatment effect of fatty liver by using 1H-MRS, gradient dual-echo, and triple-echo sequences. Gradient triple-echo sequences has better accuracy, which is technically easy to implement and more suitable for clinical development.