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611.
Identification of masked polycythemia vera from patients with idiopathic marked thrombocytosis by endogenous erythroid colony assay 总被引:1,自引:4,他引:1
We used the methylcellulose-culture technique to determine the utility of the erythroid progenitor growth in vitro from nonadherent T-depleted bone marrow and peripheral blood cells in distinguishing polycythemia vera (PV) from essential thrombocythemia. Thirty patients with PV (group A) and 30 patients who presented with idiopathic marked thrombocytosis with platelet count greater than 1,000 x 10(9)/L and a normal or reduced hemoglobin (Hb) level (group B) were studied at initial presentation. Endogenous (erythropoietin-independent) erythroid colonies (EEC) were found in all patients in group A and 13 in group B. The numbers of EEC were comparable between patients in group A and the 13 patients with EEC in group B, 11 of whom with initial Hb levels ranging between 6.4 g/dL and 12.6 g/dL were found to have PV 2 to 45 months after initial evaluation. The number of EEC did not correlate with the time to the progression of polycythemia, whereas myelosuppression delayed the subsequent development of PV. Of the two patients with EEC in group B who did not develop PV, both received chemotherapy soon after presentation, which might preclude the evidence of polycythemia evolution. None of the other patients in group B who did not form EEC developed PV with a median follow-up of 24 months. This study indicates that the assessment of EEC in bone marrow or blood is helpful in early identification of PV or prediction of polycythemia evolution in patients with marked thrombocytosis in whom polycythemia has been initially masked or anemia is present. 相似文献
612.
613.
目的 探讨胰岛素瘤MSCT动态三期增强及18F-FDG PET/CT显像的影像学特点。方法 回顾性分析我院6例经手术病理证实的胰岛素瘤的临床资料和18F-FDG PET/CT及同机MSCT动态三期增强影像资料。结果 6例患者均有不同程度低血糖发作病史和典型的惠普尔三联征,其中2例以精神症状首诊。全部病例空腹或发作时血糖均<2.8 mmol/L,胰岛素释放指数均>0.3。6例胰岛素瘤均为单发,1例位于胰尾,2例位于胰体,3例位于胰头,肿瘤直径0.8 cm×0.9 cm~3.0 cm×3.8 cm,平均1.6 cm×1.6 cm。CT平扫肿瘤呈均匀等或稍低密度,边界不清;增强扫描动脉期呈明显均匀强化,静脉期及延迟期强化程度逐渐减低,动脉期强化最为显著。6例患者中,5例肿瘤局部18F-FDG摄取未见增高,1例多发性内分泌肿瘤1型(MEN 1)相关胰岛素瘤局部18F-FDG摄取增高,SUVmax=4.8。结论 MSCT动态三期增强扫描可清晰显示肿瘤的形态和位置,18F-FDG PET/CT对本病诊断价值有限。 相似文献
614.
615.
心脏冠状动脉多排CT临床应用专家共识 总被引:7,自引:1,他引:6
中华放射学杂志心脏冠状动脉多排CT临床应用协作组 《中华放射学杂志》2011,45(1)
多排CT(multi-detector computed tomography,MDCT)近5年来发展极为迅速.2004年底全球首次推出64排CT,并迅速应用于临床心脏和冠状动脉成像,目前在诊断和排查冠心病方面已经成为临床重要的无创影像检查手段. 相似文献
616.
目的探讨薄层CT扫描技术在小儿气管及支气管异物诊断中的应用价值。方法气管内异物1例;右侧支气管内异物5例;左侧支气管内异物6例。金属异物1例;黄豆1例;豌豆1例;爆米花1例;果冻1例;蚕豆2例;花生米2例;瓜子3例。所有病例均行薄层CT扫描检查。所获图像经3位不同资历医师观察。所有病例均为纤维支气管镜取出异物证实。结果薄层CT扫描均能显示异物,术前正确诊断,无一例漏诊。但异物性质未定,仅能区别为不透X线和透X线异物。结论薄层CT扫描技术在小儿气管支气管异物诊断中,可明确异物诊断,可作为小儿透X线气管异物的常规检查。 相似文献
617.
618.
Mariam Alsharif MD Klint Kjeldahl CT Colleen Curran CT Shelby Miller CT H. Evin Gulbahce MD Stefan E. Pambuccian MD 《Cancer cytopathology》2009,117(2):92-100
BACKGROUND:
The diagnosis of low‐grade squamous intraepithelial lesion (LSIL), cannot exclude high‐grade squamous intraepithelial lesion (LSIL‐H) was not included in the 2001 Bethesda System. It is used in some institutions to diagnose cases that fulfill criteria for both the diagnosis of LSIL and atypical squamous cells, cannot exclude high‐grade squamous intraepithelial lesion (ASC‐H). In this study, the authors reviewed their experience with cases reported as LSIL‐H during a 4‐year interval.METHODS:
Clinical information and histologic follow‐up data were retrieved for Papanicolaou (Pap) tests (PTs) that were diagnosed as LSIL‐H, LSIL, ASC‐H and high‐grade squamous intraepithelial lesion (HSIL) from January 1, 2004 to December 31, 2007.RESULTS:
Of 235,645 PTs (97% SurePath) that were processed during the study period, the laboratory diagnosed 0.52% as ASC‐H, 2% as LSIL, 0.30% as LSIL‐H, and 0.39% as HSIL. Biopsy follow‐up was available for 47%, 49%, 56.7% and 74% of these cases, respectively. Cervical intraepithelial neoplasia 2 (CIN‐2) and CIN‐3 or more severe lesions (CIN‐3+) were identified on follow‐up cervical biopsy more often in women who had diagnoses of LSIL‐H and ASC‐H (33.14% and 26.33%, respectively) than in women who had a diagnosis of LSIL (16.11%).CONCLUSIONS:
The similarity of histologic follow‐up results between LSIL‐H and ASC‐H suggested that the management of women who have a diagnosis of LSIL‐H should be similar to the management of women who have a diagnosis of ASC‐H. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society. 相似文献619.
BACKGROUND:
The ThinPrep Imaging System (TIS) was implemented at Brooke Army Medical Center (BAMC) in February 2006 and has been a crucial part of the ability of the Department of Pathology and Laboratory Services ability to improve efficiency and turnaround times for Papanicolaou (Pap) test reporting. The increased detection rate of squamous abnormalities, specifically high‐grade squamous intraepithelial lesions (HSIL), has been well documented by many studies. In addition, the TIS has increased productivity for many laboratories. The objective of this study was to evaluate the effects of implementing the TIS at BAMC, a tertiary military medical center. Specifically, the following were assessed: 1) whether the detection of squamous abnormalities was increased with the TIS, 2) how the rate of high‐risk human papillomavirus (HR‐HPV) detection in atypical squamous cells (ASC) of undetermined significance (ASC‐US) cases changed (or did not change) before and after implementation of the TIS, and 3) how the TIS influenced productivity.METHODS:
All gynecologic cytology at BAMC has been collected and processed using the ThinPrep system since 2002. Before February 2006 and before implementation of the TIS, Pap tests were screened manually by the cytotechnologists. Detection rates of squamous abnormalities were compared between the period from February 2005 to December 2005 (manual screening) and the period from February 2006 to December 2006 (image‐assisted screening). Squamous abnormalities included ASC‐US; ASC, cannot rule out HSIL (ASC‐H); low‐grade squamous intraepithelial lesion (LSIL); HSIL; glandular abnormalities; and malignancies (squamous or glandular). In addition, the rates of HR‐HPV‐positive, HR‐HPV‐negative, and HR‐HPV‐quantity not sufficient were compared for the same periods. During both periods, testing for HR‐HPV was performed only on ASC‐US Pap tests. HR‐HPV was tested with Digene Hybrid Capture 2 methodology. Productivity was calculated as the change in average slides screened per hour before and after imager implementation.RESULTS:
In total, 107,647 Pap tests were analyzed in the 2005 (54,438 Pap tests) and 2006 (53,209 Pap tests) timeframes. Increases in the detection of ASC‐H, atypical glandular cells (AGC), LSIL, and HSIL were statistically significant. The proportion of negative for intraepithelial lesion or malignancy (NILM) and unsatisfactory cases decreased significantly with implementation of the TIS. The ASC to squamous intraepithelial lesion (ASC:SIL) ratio decreased from 1.5 to 1.0 after TIS implementation. Decreases in the ASC‐US HR‐HPV‐positive proportion and increases in the ASC‐US HR‐HPV‐negative proportion after implementation of the TIS were statistically significant. In our laboratory, a 60% increase in productivity was noted with use of the TIS.CONCLUSIONS:
Implementation of the TIS at BAMC significantly increased the detection of ASC‐H, AGC, LSIL, and HSIL but had no significant impact on the ASC‐US detection rate. Although the ASC‐US rate did not change, both the HR‐HPV‐positive rate and the ASC:SIL ratio decreased. The data from the current study suggested that, at least initially, the use of imager‐directed screening may increase the number of clinically insignificant ASC‐US Pap tests. Cancer (Cancer Cytopathol) 2009. Published 2009 by the American Cancer Society. 相似文献620.
Tarik M. Elsheikh MD Joseph L. Kirkpatrick CT Dan Fischer CT Kristi D. Herbert CT Andrew A. Renshaw MD 《Cancer cytopathology》2010,118(1):41-46