Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA: a pilot study

Objectives  

To develop and evaluate a procedure for quantifying the hepatocyte-specific uptake of Gd-BOPTA and Gd-EOB-DTPA using dynamic contrast-enhanced (DCE) MRI.     

Optimising diffusion-weighted MR imaging for demonstrating pancreatic cancer: a comparison of respiratory-triggered, free-breathing and breath-hold techniques

Objectives

To compare respiratory-triggered, free-breathing, and breath-hold DWI techniques regarding (1) image quality, and (2) signal intensity (SI) and ADC measurements in pancreatic ductal adenocarcinoma (PDAC).

Methods

Fifteen patients with histopathologically proven PDAC underwent DWI prospectively at 1.5?T (b?=?0, 50, 300, 600 and 1,000?s/mm²) with the three techniques. Two radiologists, independently and blindly, assigned total image quality scores [sum of rating diffusion images (lesion detection, anatomy, presence of artefacts) and ADC maps (lesion characterisation, overall image quality)] per technique and ranked them. The lesion SI, signal-to-noise ratio, mean ADC and coefficient of variation (CV) were compared.

Results

Total image quality scores for respiratory-triggered, free-breathing and breath-hold techniques were 17.9, 16.5 and 17.1 respectively (respiratory-triggered was significantly higher than free-breathing but not breath-hold). The respiratory-triggered technique had a significantly higher ranking. Lesion SI on all b-values and signal-to-noise ratio on b300 and b600 were significantly higher for the respiratory-triggered technique. For respiratory-triggered, free-breathing and breath-hold techniques the mean ADCs were 1.201, 1.132 and 1.253?×?10^-3?mm²/s, and mean CVs were 8.9, 10.8 and 14.1?% respectively (respiratory-triggered and free-breathing techniques had a significantly lower mean CV than the breath-hold technique).

Conclusion

In both analyses, respiratory-triggered DWI showed superiority and seems the optimal DWI technique for demonstrating PDAC.

Key Points

? Diffusion-weighted magnetic resonance imaging is increasingly used to detect pancreatic cancer ? Images are acquired using various breathing techniques and multiple b-values ? Breathing techniques used: respiratory-triggering, free-breathing and breath-hold ? Respiratory-triggering seems the optimal breathing technique for demonstrating pancreatic cancer     

MSCTA指导下急诊动脉栓塞治疗消化道大出血

目的探讨MSCTA指导下行急诊动脉栓塞治疗消化道大出血的临床价值。方法对14例消化道大出血病例,术前在抗休克治疗同时急诊行MSCTA检查,明确出血部位或出血动脉后行急诊动脉栓塞术,超选择插管至出血动脉支,并以明胶海绵颗粒进行栓塞。结果动脉栓塞后,12例患者有效控制了出血,休克得到纠正。1例明确出血部位及性质后行急诊手术治疗,1例疑静脉出血,后行急诊内镜治疗。结论MSCTA指导下行急诊动脉栓塞术治疗消化道大出血简便迅速、准确性高、安全性好、并发症少。     

经皮球囊扩张椎体后凸成型术治疗急性外伤性椎体压缩性骨折

目的探讨经皮球囊扩张椎体后凸成型术（PKP）治疗急性外伤性椎体压缩性骨折的价值。方法回顾性分析15例接受PKP治疗的急性外伤性椎体压缩性骨折患者（共18个病变椎体）的影像学及临床资料,评价PKP的疗效。结果对15例患者均顺利完成手术,未见严重并发症。术后1周病变椎体前缘、中央、后缘高度均较术前升高,Cobb角减小（P均〈0.05）。术后1周CT检查发现骨水泥渗漏1例（1/15,6.67%）。经PKP治疗,疼痛完全缓解11例（11/15,73.33%）,部分缓解4例（4/15,26.67%）,有效率达100%（15/15）。15例患者的视觉模拟评分在术后1周、1个月、6个月及12个月分别为3.21±0.32、2.67±0.42、2.64±0.51和2.36±0.67,均较术前（8.68±0.88）明显减小（P均〈0.05）。术后6个月患者的生活自理能力评分（86.33±6.30）较术前（29.19±5.61）升高（P〈0.05）。结论 PKP是治疗急性外伤性椎体压缩性骨折的一种微创、安全、有效的方法。     

A Case of Paratubal Serous Borderline Tumor Driven by a Somatic BRAF Mutation in an Adolescent Patient

BackgroundWe describe a rare paratubal serous borderline tumor occurring in an adolescent and provide insight into its molecular underpinnings.CaseA 14-year-old girl presented with irregular menstrual cycles and a large right pelvic mass. Computed tomography imaging revealed a cystic neoplasm arising from the right ovary with peripheral calcification. During laparotomy, a cystic tumor located at the right parametrium independent of the fallopian tube was identified. The ovary was intact and the tumor was successfully removed. Intraoperative diagnosis using the frozen section technique and subsequent pathology revealed a paratubal serous borderline tumor. Molecular analyses revealed a chromosomally stable tumor genome and a pathogenic somatic mutation (c.1799 T > A, p.Val600Glu) in the B-Raf proto-oncogene, serine/threonine kinase (BRAF) gene.Summary and ConclusionThis case shows that the BRAF p.Val600Glu mutation likely acts as an oncogenic driver in this rare neoplasm.