磁共振成像在评价肝癌射频消融术效果中的运用与相应影像学特征研究

目的:探讨磁共振成像(MRI)在评价肝癌射频消融术(RFA)效果中的运用与相应影像学特征。方法:本次研究对象为2017年1月~2018年10月本院收治的50例肝癌RFA患者(共86个病灶),观察患者行RFA术后的MRI图像。结果:术后MRI图像可以观察到,术后1个月,有95.35%(82个)的病灶比术前大,术后12个月,有90.70%(78个)的病灶比术前小。术后1个月,T1WI高信号环完整病灶有80个,术后12个月,其中有12个(15.00%)病灶复发;高信号不完整病灶有6个,有6.67%(4个)的病灶复发,P<0.05;病灶病复发患者的MRI图像主要显示为DWI信号为高强度信号,T1、T2长改变,行增强扫描后发现为结节样增强。结论:给予肝癌RFA术患者MRI检查,可以准确定性原发性肝癌,有效辨别残留、复发的肿瘤组织,能为患者诊治方案的设定提供可靠的支持。     

Diagnostic Value of Sarcopenia Computed Tomography Metrics for Older Patients with or without Cancers with Gastrointestinal Disorders

ObjectivesThe diagnostic utility of poor body composition measures in sarcopenia remains unclear. We hypothesize that the skeletal muscle gauge [combination of skeletal muscle index (SMI) and skeletal muscle density (SMD); SMG = SMI × SMD] would have significant diagnostic and predictive value in certain muscle regions and populations.DesignProspective cross-sectional study.Setting and ParticipantsWe examined inpatients age ≥60 years with or without cancer and with gastrointestinal disorders.MethodsWe used computed tomography (CT) image metrics in the 12th thoracic (T12), third lumbar (L3), erector spinae muscle (ESM), and psoas muscle (PM) regions to establish correlations with the 2019 Asian Working Group for Sarcopenia Consensus and used receiver operating characteristic area under the curve (AUC) to compare differences between metrics. Associations between CT metrics and mortality were reported as relative risk after adjustments.ResultsWe evaluated 385 patients (median age, 69.0 years; 60.8% men) and found consistent trends in cancer (49.6%) and noncancer (50.4%) cohorts. SMG had a stronger correlation with muscle mass than SMD [mean rho: 0.68 (range, 0.59?0.73) vs 0.39 (range, 0.28?0.48); all P < .01] in T12, L3, and PM regions and a stronger correlation with muscle function than SMI [mean rho: 0.60 (range, 0.50?0.77) vs 0.36 (range, 0.22?0.58); all P < .05] in T12, ESM, and L3 regions. SMG outperformed SMI in diagnostic accuracy in all regions, particularly for L3 (AUC: 0.87?0.88 vs 0.80?0.82; both P < .05). PMG (PM gauge) and L3SMG did not differ, whereas EMG (ESM gauge) or T12SMG and L3SMG did (AUC: 0.80?0.82 vs 0.87?0.88; all P < .05). L3SMI, L3SMD, T12SMG, EMG, and PMG showed no association with 1-year cancer-related mortality after adjusting for confounders; however, L3SMG [relative risk = 0.92 (0.85?0.99); P = .023) was.Conclusions and ImplicationsL3SMG covers all features of sarcopenia with more diagnostic value than other metrics, allowing a complete sarcopenia assessment with CT alone and not just in populations with cancer.