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1.
Tatsuo Gondo Hedvig Hricak Evis Sala Junting Zheng Chaya S. Moskowitz Melanie Bernstein James A. Eastham Hebert Alberto Vargas 《European radiology》2014,24(12):3161-3170
Objectives
The aim of this study was to assess the diagnostic performance of pre-treatment 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) for predicting Gleason score (GS) downgrading after radical prostatectomy (RP) in patients with GS 3?+?4 prostate cancer (PCa) on biopsy.Methods
We retrospectively reviewed 304 patients with biopsy-proven GS 3?+?4 PCa who underwent mpMRI before RP. On T2-weighted imaging and three mpMRI combinations (T2-weighted imaging + diffusion-weighted imaging [DWI], T2-weighted imaging + dynamic contrast-enhanced-MRI [DCE-MRI], and T2-weighted imaging + DWI + DCE-MRI), two radiologists (R1/R2) scored the presence of a dominant tumour using a 5-point Likert scale (1 = definitely absent to 5 = definitely present). Diagnostic performance in identifying downgrading was evaluated via areas under the curves (AUCs). Predictive accuracies of multivariate models were calculated.Results
In predicting downgrading, T2-weighted imaging + DWI (AUC?=?0.89/0.85 for R1/R2) performed significantly better than T2-weighted imaging alone (AUC?=?0.72/0.73; p?0.001/p?=?0.02 for R1/R2), while T2-weighted imaging + DWI + DCE-MRI (AUC?=?0.89/0.84 for R1/R2) performed no better than T2-weighted imaging + DWI (p?=?0.48/p?>?0.99 for R1/R2). On multivariate analysis, the clinical + mpMRI model incorporating T2-weighted imaging + DWI (AUC?=?0.92/0.88 for R1/R2) predicted downgrading significantly better than the clinical model (AUC?=?0.73; p?0.001 for R1/R2).Conclusion
mpMRI improves the ability to identify a subgroup of patients with Gleason 3?+?4 PCa on biopsy who are candidates for active surveillance. DCE-MRI (compared to T2 + DWI) offered no additional benefit to the prediction of downgrading.Key Points
? Diagnostic performance of T2-weighted-imaging + DWI was better than T2-weighted-imaging alone. ? Diagnostic performance of T2-weighted-imaging + DWI was similar to T2-weighted-imaging + DWI + DCE-MRI. ? Combining clinical and T2-weighted-imaging + DWI features best predicted GS downgrading. ? mpMRI might prevent overtreatment by increasing eligibility for PCa active surveillance. 相似文献2.
Faqin Lv Yanting Ning Xuan Zhou Yukun Luo Tong Liang Yongkang Nie Tanshi Li Jie Tang 《European radiology》2014,24(10):2640-2648
Objective
To analyse the correlation between contrast-enhanced ultrasound (CEUS)-based classification of the severity of abdominal parenchymal organ trauma and clinical outcomes, and to explore CEUS in classifying patients with such trauma, expecting that the use of CEUS will potentially enhance the quality and speed of the emergency management of abdominal trauma.Methods
Three hundred six consecutive patients with blunt abdominal parenchymal organ trauma who received CEUS examination were retrospectively analysed. Two CEUS radiologists (identified as Reader A and Reader B in this study) who were not involved in the CEUS examinations of the patients were then asked to classify the patients independently according to their CEUS results. The classification results were later compared with patients’ clinical outcomes using Spearman’s rank correlation.Results
The final clinical outcomes showed that 25.5 % (78/306) of patients received conservative treatment, 52.0 % (159/306) received minimally invasive treatment, and 22.5 % (69/306) received surgery. Spearman's rank correlation coefficients between the CEUS-based classification and clinical outcome were 0.952 from Reader A and 0.960 from Reader B.Conclusions
CEUS can play an important role in the emergency management of abdominal trauma through the classification of patients for different treatment methods.Key points
? The severity of abdominal trauma was classified by contrast-enhanced ultrasound (CEUS) ? There was a high correlation between CEUS-based classification and clinical outcomes ? CEUS-based classification is helpful for surgeons in the emergency management of abdominal trauma 相似文献3.
Sven-Ola Hietala Herbert Silfvenius Jan Aasly Magnus Olivecrona Lars Jonsson 《European journal of nuclear medicine and molecular imaging》1990,16(8-10):683-687
Technetium (99mTc) hexamethyl propylene amine oxime (HM-PAO) was injected into the internal carotid artery in ten epileptic patients after the end of amobarbital speech-memory tests. The cerebral perfusion as visualized from SPET was compared to cerebral angiographies, which showed unilateral filling of intracranial vessels in seven patients. SPET revealed cross-flow between the hemispheres in four of these seven patients. In three patients in whom the angiograms had shown bilateral contrast filling, SPET showed cross-flow in only two. It is concluded that99mTc-HM-PAO SPET examinations provide valuable information for correct interpretation of amobarbital tests on cognitive hemisphere functions. The SPET technique may help to explain atypical speech and memory responses caused by unusual intracranial vascularization. 相似文献
4.
Gijsbert J. Blokhuis Chantal P. Bleeker-Rovers Marije G. Diender Wim J. G. Oyen Jos M. Th. Draaisma Lioe-Fee de Geus-Oei 《European journal of nuclear medicine and molecular imaging》2014,41(10):1916-1923
Purpose
Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression.Methods
All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis.Results
FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively.Conclusions
FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. 相似文献5.
Kai-Hsiung Ko Hsian-He Hsu Tsai-Wang Huang Hong-Wei Gao Daniel H. Y. Shen Wei-Chou Chang Yi-Chih Hsu Tsun-Hou Chang Chi-Ming Chu Ching-Liang Ho Hung Chang 《European journal of nuclear medicine and molecular imaging》2014,41(10):1889-1897
Purpose
The identification of the mutation status of the epidermal growth factor receptor (EGFR) is important for the optimization of treatment in patients with pulmonary adenocarcinoma. The acquisition of adequate tissues for EGFR mutational analysis is sometimes not feasible, especially in advanced-stage patients. The aim of this study was to predict EGFR mutation status in patients with pulmonary adenocarcinoma based on 18F-fluorodeoxyglucose (FDG) uptake and imaging features in positron emission tomography/computed tomography (PET/CT), as well as on the serum carcinoembryonic antigen (CEA) level.Methods
We retrospectively reviewed 132 pulmonary adenocarcinoma patients who underwent EGFR mutation testing, pretreatment FDG PET/CT and serum CEA analysis. The associations between EGFR mutations and patient characteristics, maximal standard uptake value (SUVmax) of primary tumors, serum CEA level and CT imaging features were analyzed. Receiver-operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors.Results
EGFR mutations were identified in 69 patients (52.2 %). Patients with SUVmax ≥6 (p?=?0.002) and CEA level ≥5 (p?=?0.013) were more likely to have EGFR mutations. The CT characteristics of larger tumors (≥3 cm) (p?=?0.023) and tumors with a nonspiculated margin (p?=?0.026) were also associated with EGFR mutations. Multivariate analysis showed that higher SUVmax and CEA level, never smoking and a nonspiculated tumor margin were the most significant predictors of EGFR mutation. The combined use of these four criteria yielded a higher area under the ROC curve (0.82), suggesting a good discrimination.Conclusion
The combined evaluation of FDG uptake, CEA level, smoking status and tumor margins may be helpful in predicting EGFR mutation status in patients with pulmonary adenocarcinoma, especially when the tumor sample is inadequate for genetic analysis or genetic testing is not available. Further large-scale prospective studies are needed to validate these results. 相似文献6.
Yanjun Zhang Wei Huang Jiahuang Jiang Jing Xie Chunmin Xu Chunli Wang Lin Yin Li Yang Kevin Zhou Peter Chen KL Paul Sung 《Knee surgery, sports traumatology, arthroscopy》2014,22(9):1997-2006
Purpose
It was reported that not only ACL but also the synovium may be the major regulator of matrix metalloproteinases (MMPs) in synovial fluids after ACL injury. In order to further confirm whether synovium is capable of regulating the microenvironment in the process of ACL injury, the complicated microenvironment of joint cavity after ACL injury was mimicked and the combined effects of mechanical injury and inflammatory factor [tumour necrosis factor-α (TNF-α)] on expressions of lysyl oxidases (LOXs) and MMPs in synovial fibroblasts derived from normal human synovium were studied.Methods
Human normal knee joint synovial fibroblasts were stimulated for 1–6 h with mechanical stretch and inflammatory factor (TNF-α). Total RNA was harvested, reverse transcribed and assessed by real-time polymerase chain reaction for the expression of LOXs and MMP-1, 2, 3 messenger RNAs. MMP-2 activity was assayed from the collected culture media samples using zymography.Results
Compared to control group, our results showed that 6 % physiological stretch increased MMP-2 and LOXs (except LOXL-3), decreased MMP-1 and MMP-3; injurious stretch (12 %) decreased LOXs (except LOXL-2)and increased MMP-1, 2 and 3; the combination of injurious stretch and TNF-α decreased LOXs and increased MMP-1, 2 and 3 in synovial fibroblasts in a synergistical manner.Conclusion
This study demonstrated that combination of mechanical injury and inflammatory factors up-regulated the expressions of MMPs and down-regulated the expressions of LOXs in synovial fibroblasts, eventually alter the balance of tissue healing. Thus, synovium may be involved in regulating the microenvironment of joint cavity. Based on the mechanism, early interventions to inhibit the production of MMPs or promote the production of LOXs in the synovial fibroblasts should be performed to facilitate the healing of tissue. 相似文献7.
Otilia C. Nasui Michael W. Chan George Nathanael Adrian Crawley Elka Miller Jaques Belik Hai-Ling Cheng Andrea Kassner Tammy Rayner Ruth Weiss Garry Detzler Anguo Zhong Rahim Moineddin Roland Jong Marianne Rogers Andrea S. Doria 《European radiology》2014,24(11):2766-2778
Objective
Our aim was to test the feasibility of blood oxygen level dependent magnetic resonance imaging (BOLD MRI) and dynamic contrast-enhanced (DCE) MRI to monitor periarticular hypoxic/inflammatory changes over time in a juvenile rabbit model of arthritis.Methods
We examined arthritic and contralateral nonarthritic knees of 21 juvenile rabbits at baseline and days 1,14, and 28 after induction of arthritis by unilateral intra-articular injection of carrageenin with BOLD and DCE MRI at 1.5 Tesla (T). Nine noninjected rabbits served as controls. Associations between BOLD and DCE-MRI and corresponding intra-articular oxygen pressure (PO2) and blood flow [blood perfusion units (BPU)] (polarographic probes, reference standards) or clinical–histological data were measured by correlation coefficients.Results
Percentage BOLD MRI change obtained in contralateral knees correlated moderately with BPU on day 0 (r?=??0.51, p?=?0.02) and excellently on day 28 (r?=??0.84, p?=?0.03). A moderate correlation was observed between peak enhancement DCE MRI (day 1) and BPU measurements in arthritic knees (r?=?0.49, p?=?0.04). In acute arthritis, BOLD and DCE MRI highly correlated (r?=?0.89, p?=?0.04; r?=?1.0, p?0.0001) with histological scores in arthritic knees.Conclusion
The proposed techniques are feasible to perform at 1.5 T, and they hold potential as surrogate measures to monitor hypoxic and inflammatory changes over time in arthritis at higher-strength MRI fields.Key points
? BOLD and DCE MRI detect interval perisynovial changes in a rabbit knee ? BOLD and DCE MRI act as surrogate markers of physiologic changes in arthritis ? BOLD MRI signal represents oxygen extraction compared with intra-articular PO 2 ? DCE MRI measurements estimate physiologic periarticular vascular properties ? In rabbit knees with acute arthritis, BOLD/DCE MRI highly correlated with histological scores 相似文献8.
Carlos Caicedo Maria Jose Garcia-Velloso Maria Dolores Lozano Tania Labiano Carmen Vigil Diaz Jose Maria Lopez-Picazo Alfonso Gurpide Javier Zulueta Jose Angel Richter Echevarria Jose Luis Perez Gracia 《European journal of nuclear medicine and molecular imaging》2014,41(11):2058-2065
Purpose
The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [18F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC.Methods
Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [18F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [18F]FDG PET/CT for predicting KRAS mutation.Results
From 102 patients staged using [18F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [18F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p?0.001). No significant differences were observed in [18F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p?0.001). The multivariate analysis showed a sensitivity and specificity of 78.6 % and 62.2 %, respectively, and the AUC was 0.773.Conclusion
NSCLC patients with tumours harbouring KRAS mutations showed significantly higher [18F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC. 相似文献9.
Jihyun Kim Junshik Hong Seog Gyun Kim Kyung Hoon Hwang Minsu Kim Hee Kyung Ahn Sun Jin Sym Jinny Park Eun Kyung Cho Dong Bok Shin Jae Hoon Lee 《Nuclear Medicine and Molecular Imaging》2014,48(3):187-195
Purpose
The purpose of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-containing immunochemotherapy.Methods
Patients with newly diagnosed DLBCL who underwent pre-treatment torso FDG-PET/CT scan taken within 10 days before treatment were included. MTV was defined as the volume of hypermetabolic tissue with a standardized uptake value (SUV) greater than a threshold value of 2.5 and calculated using volume viewer software. Association of MTV with patient characteristics and survival were compared.Results
A total of 96 patients were evaluated. During a median follow-up period of 27.8 months, 3-year event-free survival (EFS) and overall survival was 69.5 % and 72.9 %, respectively. The Ann Arbor staging showed a limitation of prognosis because there was no difference of EFS between patients with Ann Arbor stage II and those with stage III. On the contrary, among patients with Ann Arbor stage II or III disease (n?=?53), the higher MTV group showed significantly inferior EFS compared with the lower MTV group.Conclusions
In the current study, we identified the pre-treatment MTV measured by FDG-PET/CT as a potential predictor of survival in patients with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), at least in Ann Arbor stage II and III disease. 相似文献10.
Damien Mandry Alexis Tatopoulos Elodie Chevalier-Mathias Jérémie Lemarié Pierre-Edouard Bollaert Véronique Roch Pierre Olivier Pierre-Yves Marie Sébastien Gibot 《European journal of nuclear medicine and molecular imaging》2014,41(10):1924-1930
Purpose
Timely identification of septic foci is critical in patients with severe sepsis or septic shock of unknown origin. This prospective pilot study aimed to assess 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), combined with whole-body computed tomographic angiography (CTA), in patients with suspected severe sepsis and for whom the prior diagnostic workup had been inconclusive.Methods
Patients hospitalized in an intensive care unit with a suspected severe sepsis but no definite diagnosis after 48 h of extensive investigations were prospectively included and referred for a whole body FDG-PET/CTA. Results from FDG-PET/CTA were assessed according to the final diagnosis obtained after follow-up and additional diagnostic workup.Results
Seventeen patients were prospectively included, all on mechanical ventilation and 14 under vasopressor drugs. The FDG-PET/CTA exam 1) was responsible for only one desaturation and one hypotension, both quickly reversible under treatment; 2) led to suspect 16 infectious sites among which 13 (81 %) could be confirmed by further diagnostic procedures; and 3) triggered beneficial changes in the medical management of 12 of the 17 study patients (71 %). The FDG-PET/CTA images showed a single or predominant infectious focus in two cases where CTA was negative and in three cases where CTA exhibited multiple possible foci.Conclusion
Whole-body FDG-PET/CTA appears to be feasible, relatively safe, and provides reliable and useful information, when prospectively planned in patients with suspected severe sepsis and for whom prior diagnostic workup had been inconclusive. The FDG-PET images are particularly helpful when CTA exhibits no or multiple possible sites. 相似文献11.
Jim O’Doherty CSci PhD Bruno Rojas Fisher CSci MSc Jonathan Mark Price MSc Kshama Wechalekar MBBS DRM DNB 《Journal of nuclear cardiology》2014,21(5):944-953
Background
The technique of SPECT-RNV (radionuclide ventriculography) offers a greater amount of clinically usable data than its planar counterpart (P-RNV). In transitioning from planar to SPECT-only acquisition methodologies, reprojection of the SPECT data can provide a planar dataset which can be used as an interim technique. The aim of this study was to test if reprojected planar images could be used as a surrogate for true planar images in SPECT-only setting.Methods
We performed SPECT-RNV and P-RNV on 47 patients on traditional sodium iodide (NaI) cameras, determining left ventricular ejection fractions (LVEF) for planar (EFP) and SPECT (EFS) techniques. We reprojected the SPECT-RNV data along the best septal separation angle determined from planar scanning. This creates a further planar dataset denoted ‘reprojected P-RNV’ (rP-RNV) giving a reprojected ejection fraction (EFR) which can be used as a validation variable in transitioning to SPECT-only acquisition.Results
Performing t tests showed no statistical difference between EFP and EFR (P > .017) but bias was observed in EFS results compared to EFP and EFS compared to EFR results. An unblinded, comparison of parametric data between the three datasets for a subset of ten patients showed good clinical concordance. False negative and false positive rates were low for rP-RNV compared to P-RNV.Conclusions
The reprojected planar LVEF correlates well to P-RNV EF values. The rP-RNV dataset can aid clinicians in transitioning from planar RNV to SPECT-only acquisition. 相似文献12.
Masakazu Hirakawa Akihiro Nishie Yoshiki Asayama Nobuhiro Fujita Kousei Ishigami Tatsurou Tajiri Tomoaki Taguchi Hiroshi Honda 《Japanese journal of radiology》2014,32(9):529-536
Purpose
The purpose of this study was to evaluate, retrospectively, the clinical efficacy of preoperative transcatheter arterial chemoembolization (TACE) combined with systemic chemotherapy for unresectable hepatoblastoma.Materials and methods
Five boys and three girls (mean age 15.2 months) were treated with preoperative TACE combined with systemic chemotherapy for unresectable hepatoblastomas. Mean tumor diameter and mean alfa-fetoprotein (AFP) level were 11.8 cm and 549,386 ng/mL, respectively. Pretreatment, the extent of disease (PRETEXT) was: II, 1; III, 6; IV, 1. For all patients, preoperative systemic chemotherapy was administered before TACE. At each TACE, carboplatin and adriamycin mixed with iodized oil were infused into the feeding arteries. Tumor response and prognosis after treatment were evaluated.Results
TACE resulted in few Grade 1 adverse effects (AEs), without G3 or more AEs, according to CTACAE 3.0. Mean tumor shrinkage was 60.9 %, and the mean AFP decrease from initial levels was 94.8 %. In all cases TACE combined with systemic chemotherapy enabled subsequent safe and complete surgical resection. After a mean follow-up of 59 months, tumor-free survival was 75 %.Conclusion
Preoperative TACE combined with systemic chemotherapy was effective in inducing surgical resectability of unresectable hepatoblastoma. 相似文献13.
Takeshi Shinozaki Kenichi Utano Hiroyuki Fujii Yuka Utano Takahiro Sasaki Shigeyoshi Kijima Hidenori Kanazawa Yukio Kimura Akifumi Fujita Hideharu Sugimoto 《Japanese journal of radiology》2014,32(8):476-481
Objective
The objective of this study was to compare the diagnostic accuracy of dual-time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) to single-time-point 18F-FDG PET for staging of preoperative lung cancer.Methods
Between November 2008 and December 2009, 107 patients who were diagnosed as having lung cancer or strongly suspected of having lung cancer were enrolled. They underwent dual-time-point 18F-FDG PET following conventional imaging. Dual-time-point 18F-FDG PET imaging (whole body) was performed at 1-h (early) post-FDG injection and repeated (2 h delayed) after injection. The diagnostic accuracy of pre-PET staging and post-PET staging was retrospectively evaluated, and the diagnostic accuracy of dual-time-point 18F-FDG PET was compared to that of single-time-point 18F-FDG PET.Results
In 100 patients, the early 18F-FDG PET scan resulted in upstaging of the tumor in ten (10 %) and down-staging of the tumor in five (5 %) compared to the conventional scan. The delayed phase of 18F-FDG PET provided no additional information on staging for lung cancer patients. The remaining seven patients were diagnosed as not having lung cancer.Conclusion
This study confirmed that dual-time-point 18F-FDG PET is useful for differential diagnosis between benign and malignant lesions, but has no major impact on staging and therapeutic management of patients with pathologically proven lung cancer. 相似文献14.
Rossella Graziani Simona Mautone Maria Chiara Ambrosetti Riccardo Manfredi Thomas J. Re Lucia Calculli Luca Frulloni Roberto Pozzi Mucelli 《La Radiologia medica》2014,119(8):558-571
Multidetector-row computed tomography (MDCT) and magnetic resonance (MR) imaging are currently the most frequently performed imaging modalities for the study of pancreatic disease. In cases of suspected autoimmune pancreatitis (AIP), a dynamic quadriphasic (precontrast, contrast-enhanced pancreatic, venous and late phases) study is recommended in both techniques. In the diffuse form of autoimmune pancreatitis (DAIP), the pancreatic parenchyma shows diffuse enlargement and appears, during the MDCT and MR contrast-enhanced pancreatic phase, diffusely hypodense and hypointense, respectively, compared to the spleen because of lymphoplasmacytic infiltration and pancreatic fibrosis. During the venous phase of MDCT and MR imaging, the parenchyma appears hyperdense and hyperintense, respectively, in comparison to the pancreatic phase. In the delayed phase of both imaging modalities, it shows retention of contrast media. A “capsule-like rim” may be recognised as a peripancreatic MDCT hyperdense and MR hypointense halo in the T2-weighted images, compared to the parenchyma. DAIP must be differentiated from non-necrotizing acute pancreatitis (NNAP) and lymphoma since both diseases show diffuse enlargement of the pancreatic parenchyma. The differential diagnosis is clinically difficult, and dynamic contrast-enhanced MDCT has an important role. In the focal form of autoimmune pancreatitis (FAIP), the parenchyma shows segmental enlargement involving the head, the body-tail or the tail, with the same contrast pattern as the diffuse form on both modalities. FAIP needs to be differentiated from pancreatic adenocarcinoma to avoid unnecessary surgical procedures, since both diseases have similar clinical and imaging presentation. The differential diagnosis is clinically difficult, and dynamic contrast-enhanced MDCT and MR imaging both have an important role. MR cholangiopancreatography helps in the differential diagnosis. Furthermore, MDCT and MR imaging can identify the extrapancreatic manifestations of AIP, most commonly biliary, renal and retroperitoneal. Finally, in all cases of uncertain diagnosis, MDCT and/or MR follow-up after short-term treatment (2–3 weeks) with high-dose steroids can identify a significant reduction in size of the pancreatic parenchyma and, in FAIP, normalisation of the calibre of the upstream main pancreatic duct. 相似文献
15.
Dapeng Xiang Yurong Hong Bo Zhang Pintong Huang Guogang Li Ping Wang Zhiyu Li 《European radiology》2014,24(10):2513-2519
Objectives
To examine the value of CEUS as a non-invasive tool in detecting lateral neck metastasis (LNM) and the enhancement patterns of malignant lymph nodes (LN) for thyroid cancer patients.Methods
Eighty-two consecutive patients, who underwent both preoperative non-enhanced US and CEUS examinations, were retrospectively reviewed. All patients underwent lateral neck dissection (LND). Enhancement patterns of 102 collected LNs matching to CEUS findings were analyzed.Results
CEUS detected LNM in 53 of 65 patients, showing a higher sensitivity and accuracy than that of conventional US (p?=?0.109 and p?=?0.154, respectively). Thirteen patients’ surgical procedures were altered by CEUS findings, including nine true positive and four false positive cases. Five patients’ surgical procedures were altered by conventional US findings, including two true positive and three false positive cases. Heterogeneous enhancement, perfusion defects, microcalcification, and centripetal/hybrid enhancement were all specific criteria for malignant LNs in univariate analysis. In multivariate analysis, only heterogeneous enhancement and centripetal/hybrid enhancement were significantly related to LN metastasis (p?=?0.000 and p?=?0.037, respectively).Conclusions
CEUS may be a potential tool to facilitate conventional US in detecting LNM. Heterogeneous enhancement and centripetal/hybrid enhancement are useful criteria to distinguish between malignant and benign LNs.Key Points
? CEUS findings facilitated conventional US in detecting LNM. ? Heterogeneous, centripetal/hybrid enhancement, microcalcification and perfusion defects were specific criteria of malignant LNs. ? Heterogeneous and centripetal/hybrid enhancement were significantly related to LN metastasis in multivariate analysis. 相似文献16.
Nobuyuki Kawai Wei Lin Wei-Dong Cao Daisuke Ogawa Keisuke Miyake Reiji Haba Yukito Maeda Yuka Yamamoto Yoshihiro Nishiyama Takashi Tamiya 《European journal of nuclear medicine and molecular imaging》2014,41(10):1870-1878
Purpose
Hypoxia and its consequences at the molecular level promote tumour progression and affect patient prognosis. One of the main early cellular events evoked by hypoxia is induction of hypoxia-inducible factor 1 (HIF-1) and subsequent upregulation of vascular endothelial growth factor (VEGF). In this study we sought to determine whether hypoxia detected by 18F-fluoromisonidazole (FMISO) PET accurately reflects the expression of HIF-1α and VEGF in the tumour and can be used as a biomarker of antiangiogenic treatment and as a prognostic factor in newly diagnosed and recurrent malignant gliomas.Methods
Enrolled in this study were 32 patients with newly diagnosed glioma and 16 with recurrent glioma of grade III or grade IV. All the patients had undergone FMISO PET preoperatively. The maximum tumour-to-blood FMISO activity ratio (T/Bmax) was used to evaluate the degree of tumour hypoxia and the hypoxic volume (HV) was calculated using a tumour-to-blood FMISO uptake ratio of ≥1.2. Immunohistochemical expressions of HIF-1α and VEGF were evaluated semiquantitatively using the immunoreactivity score (IRS, scores 0 to 12) and the correlation was examined between IRS of HIF-1α or VEGF and FMISO uptake of the tumour (SUVtumour) using navigation-based sampling. Survival was estimated using the Kaplan-Meier method in relation to the T/Bmax and the HV.Results
The T/Bmax and the HV in grade IV gliomas were significantly higher than in grade III gliomas (P?0.01 and P?0.01, respectively). Moderate to strong HIF-1α and VEGF expression was observed in the majority of malignant gliomas. The IRS of HIF-1α and VEGF in the tumour were not significantly different between grade III and grade IV gliomas. The IRS of HIF-1α in the tumour did not correlate with the SUVtumour of FMISO in either newly diagnosed or recurrent glioma. There was a significant but weak correlation between the IRS of VEGF and the SUVtumour of FMISO in newly diagnosed glioma, but not in recurrent glioma. The overall survival time in patients with a small HV and a low FMISO T/Bmax was significantly longer than in those with a large HV and a high FMISO T/Bmax (P?0.01 and P?0.05, respectively).Conclusion
Preoperative FMISO uptake is significantly correlated with the expression of VEGF in the tumour and might be used as a biomarker of antiangiogenic treatment in newly diagnosed malignant gliomas. However, caution is required because the correlation was weak and there was a large overlap of FMISO uptake between glioma with high and low VEGF expression. In addition, hypoxia determined by FMISO PET appears to be a suitable biomarker for predicting a highly malignant tumour and a poor prognosis in patients with malignant glioma. 相似文献17.
Melissa Scheible Soon Hee Kim Kimberly Sturk-Andreaggi Michael D. Coble Jodi A. Irwin 《International journal of legal medicine》2014,128(5):745-746
Mitochondrial DNA (mtDNA) control region (16024-576) sequences were generated from 281 individuals from South Korea. Robotic liquid handling, a redundant sequencing strategy, and a series of quality control checks were implemented to ensure the high quality of the dataset. This population sample showed a low random match probability (0.25 %) and high genetic diversity (0.9933). The haplogroup breakdown was consistent with previous studies describing Korean mtDNA variation. The 224 unique haplotypes (33 shared) presented will supplement the data already publically available. 相似文献
18.
Giulio Zuccoli Ashok Panigrahy Gayathri Sreedher Ariel Bailey Ernest John Laney IV Luca La Colla Gulay Alper 《Neuroradiology》2014,56(8):679-684
Introduction
MR imaging criteria for diagnosing acute disseminated encephalomyelitis (ADEM) have not been clearly established. Due to the wide spectrum of differential considerations, new imaging features allowing early and accurate diagnosis for ADEM are needed. We hypothesized that ADEM lesions would be characterized by vasogenic edema due to the potential reversibility of the disease.Methods
Sixteen patients who met the diagnostic criteria for ADEM proposed by the International Pediatric Multiple Sclerosis Study Group (IPMSSG) and had complete MR imaging studies performed at our institution during the acute phase of the disease were identified retrospectively and evaluated by experienced pediatric neuroradiologists.Results
Vasogenic edema was demonstrated on diffusion-weighted imaging (DWI) and corresponding apparent diffusion coefficient (ADC) maps in 12 out of 16 patients; cytotoxic edema was identified in two patients while the other two patients displayed no changes on DWI/ADC. ADC values for lesions and normal-appearing brain tissue were 1.39?±?0.45?×?10?3 and 0.81?±?0.09?×?10?3 mm/s2, respectively (p?=?0.002). When considering a cutoff of 5 days between acute and subacute disease, no difference between ADC values in acute vs. subacute phase was depicted. However, we found a significant correlation and an inverse and significant relationship between time and ADC value.Conclusion
We propose that vasogenic edema is a reliable diagnostic sign of acute neuroinflammation in ADEM. 相似文献19.
Julie C. Dutoit Matthias A. Vanderkerken Joris Anthonissen Frederick Dochy Koenraad L. Verstraete 《European radiology》2014,24(11):2754-2765
Objectives
To evaluate DWI of the bone marrow in the differentiation of monoclonal gammopathy of undetermined significance (MGUS), smouldering myeloma (SMM) and multiple myeloma (MM).Methods
The retrospective study includes 64 patients with MGUS, 27 with SMM, 64 with new MM and 12 controls. Signal intensity (SI) of spinal SE-MRI and DWI (b0-1000) as well as apparent diffusion coefficients (ADC) were measured in the T10 and L3. Qualitative assessment of b-images was performed by one experienced radiologist.Results
ADC600 and ADC1000 are the best ADC values in differentiating patient groups (p?0.030). SIT2, SIb1000 and ADC1000 are higher and SIT1 lower in L3 compared to T10 (p?0.050). All quantitative parameters of L3 can differentiate significantly between MGUS and MM (p?0.050) and between patients with percentage plasma cells (PC%) between 0-10 % compared to >50 % (p?=?0.001). Only SIT2 for L3 can differentiate MGUS from SMM (p?=?0.044) and PC%0-10 from PC%10-25 (p?=?0.033). Qualitative interpretation of b1000 images allows differentiating MM patients from those with MGUS or SMM (p?0.001).Conclusions
Spinal SE-MRI can differentiate among MGUS, SMM, MM and control subjects. DWI based on the SI on b1000 images and ADC values is increased in MM compared to MGUS and SMM. Qualitative assessment of b-images can differentiate MM from MGUS or SMM.Key points
? ADC values are higher in patients with MM compared to MGUS ? DWI parameters change late in disease evolution ? DWI is sensitive but not specific in diagnosing patients with MM ? Qualitative DWI assessment is good in detecting myeloma patients 相似文献20.
Satoshi Takeuchi Aparna Balachandran Mouhammed Amir Habra Alexandria T. Phan Roland L. Bassett Jr. Homer A. Macapinlac Hubert H. Chuang 《European journal of nuclear medicine and molecular imaging》2014,41(11):2066-2073