肝细胞癌血管生成的螺旋CT动脉期同层动态扫描与α-平滑肌素免疫组织化学表达的相关性

目的针对肝细胞癌(HCC)血管生成情况,探讨螺旋CT动脉期同层动态扫描特征与α平滑肌素(ASMA)免疫组织化学(简称免疫组化)检查结果之间的相关性。方法术前33例HCC行螺旋CT动脉期同层动态扫描,绘制时间密度曲线(TDC)并计算相应参数;分析HCC强化征象。术后对标本切片进行常规苏木素伊红染色(HE)和ASMA免疫组化染色。对免疫组化染色结果和影像学发现进行相关性分析。结果将33例HCCTDC按强化峰值(PV)>80、40HU相似文献   

子宫肌瘤栓塞中误栓卵巢支对卵巢功能的影响

目的评价子宫肌瘤栓塞中双侧卵巢支被误栓对卵巢功能的影响.方法将在子宫动脉造影中出现双侧卵巢支显影而被误栓的15例子宫肌瘤栓塞病人分成2组,1组是双侧卵巢区有碘油沉积(双侧卵巢碘油沉积组),另1组是双侧卵巢区无碘油沉积、或仅一侧卵巢区有碘油沉积(非双侧卵巢碘油沉积组),分别统计术后闭经的病例,并作Fisher检验.栓塞材料采用超液化碘油和平阳霉素混合液.栓塞前和栓塞6个月后检查促卵泡生成素(FSH)、黄体生成素(LH)和雌二醇(E2),并作t检验.结果 15例年龄26～46岁[(39.00±5.62)岁],追踪16～47个月[(30.5±6.4)个月].12/15的患者月经在栓塞后2～6周[(3.0±0.3)周]恢复,3/15的患者出现闭经,3例术后闭经的性激素呈绝经期改变.双侧卵巢碘油沉积组出现术后闭经(3/3),非双侧卵巢碘油沉积组未出现术后闭经(0/12),两组差异有统计学意义(P=0.002 19).≥45岁的患者有2例,均无术后闭经,<45岁的患者有13例,其中3例出现术后闭经.所有患者在栓塞前和栓塞6个月后的FSH、LH和E2差异无统计学意义(P>0.05).结论子宫肌瘤栓塞中双侧卵巢支被误栓后,若双侧卵巢区被碘油沉积,术后发生闭经的几率极高.若子宫动脉造影中出现双侧卵巢支显影的肌瘤患者,需要慎重选择栓塞剂,超液化碘油可能不是合适的栓塞材料.单纯的双侧子宫动脉卵巢支的误栓,即没有卵巢血管床的误栓情况下,对卵巢功能的影响可能较小.     

ACI大鼠肝细胞癌模型的免疫化疗栓塞术研究

目的:评价生物反应调节剂(BRM)经肝动脉化疗栓塞术(TACE)治疗ACI大鼠肝细胞癌的疗效。方法:在30只雄性ACI大鼠肝包膜下植入Morris Hepatom 3924A肝癌瘤块(2 mm3),移植术后13天行MRI检查,测量肿瘤体积V1;第14天时,经腹部切开术及胃十二指肠动脉逆行插管而采取以下3种介入治疗方案:①A组,0.1 mg丝裂霉素、0.1 ml碘油、7.5μg TNFα和5×103IU IL-2(n=10);②B组,0.1 mg丝裂霉素、0.1 ml碘油、0.05 mg链球菌提取物(OK-432)和5×103IU IL-2(n=10);③C组(对照组),0.1 mg丝裂霉素、0.1 ml碘油(n=10);13天后再次行MRI检查以确定肿瘤体积V2变化。比较肝肿瘤体积生长率V2/V1。结果:肿瘤治疗前和治疗后体积分别为A组0.0377 cm3和0.2752 cm3;B组0.0344 cm3和0.2233 cm3;C组0.0380 cm3和0.3398 cm3。介入治疗后肿瘤体积与治疗前肿瘤体积之比(V2/V1)分别为A组7.31、B组6.53、C组9.14。与对照组相比,采取A组的治疗方案能抑制肝肿瘤体积的生长(P=0.042),采取B组的治疗方案能明显抑制肿瘤的生长(P=0.004)。结论:采取免疫化疗栓塞术能有效抑制ACI大鼠肝细胞癌的生长。     

Patient Presentation and Management of Labial Ulceration Following Uterine Artery Embolization

Uterine artery embolization is a safe and effective procedure for the treatment of symptomatic uterine fibroids. Nontarget embolization of adjacent internal iliac artery branches is a reported complication of uterine artery embolization. The following report describes the presentation and management of ulcerations of the labium minora due to nontarget embolization of the internal pudendal artery.     

The Feasibility of Contrast-Enhanced Ultrasound During Uterine Artery Embolization: A Pilot Study

Purpose To evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) during uterine artery embolization (UAE) in order to define the correct end-point of embolization with complete devascularization of all fibroids. Methods In this prospective study of 10 consecutive women undergoing UAE, CEUS was performed in the angiographic suite during embolization. When the angiographic end-point, defined as the “pruned-tree” appearance of the uterine arteries was reached, CEUS was performed while the angiographic catheters to both uterine arteries were kept in place. The decision whether or not to continue the embolization was based on the findings at CEUS. The results of CEUS were compared with those of contrast-enhanced magnetic resonance imaging (MRI) 1 day as well as 3 months following UAE. Results CEUS was successfully performed in all women. In 4 cases injection of particles was continued based on the findings at CEUS despite angiographically complete embolization. CEUS imaging at completion of UAE correlated well with the findings at MRI. Conclusion The use of CEUS during UAE is feasible and may increase the quality of UAE.     

Prognostic and diagnostic accuracy of [<Superscript>18</Superscript>F]FDG-PET/CT in 190 patients with carcinoma of unknown primary

Purpose The aim of the study was to determine the accuracy of [¹⁸F]fluorodeoxyglucose (FDG) PET/CT in the search for the primary and the presence of a malignancy. The prognostic value of FDG-PET/CT information was tested. Methods A total of 190 patients were retrospectively analysed: 82 with histologically proven metastases (HPM) and 108 with clinical suspicion of the presence of a malignancy (CSM). The sensitivity and specificity were determined. Overall survival was calculated to evaluate the prognostic value of the FDG-PET/CT findings. Results In the search for the primary, the sensitivity and specificity were 62.0% and 81.9%, respectively. In the search for the presence of a malignancy, the sensitivity and specificity were 93.6% and 85.7%, respectively. Between the HPM and CSM groups, no significant difference in sensitivity and specificity was found either in the search for the primary or in the search for the presence of a malignancy. No significant difference in the sensitivity and specificity was found between 78 patients who were investigated by contrast-enhanced FDG-PET/CT and the remaining patients. A significantly shorter overall survival was found among patients with positive FDG-PET/CT findings compared with patients with negative findings (p = 0.00001); no significant difference in survival was found between the HPM and the CSM group (p = 0.770). Conclusion FDG-PET/CT imaging is very helpful in the search for the presence of a malignancy in patients with carcinoma of unknown primary syndrome. FDG-PET/CT is less accurate in identifying exactly the site of a primary. Discovery of a hypermetabolic lesion was associated with the worst survival rate. This study was cited in the Highlights Lecture on the EANM Congress, Athens 2006.     

早期乳腺导管原位癌X线表现与预后生物学标记关系的研究

目的评价乳腺导管原位癌（DCIS）及DCIS伴微浸润的X线片表现，分析X线表现与预后生物学标记的相关性。方法对50例乳腺DCIS及45例DCIS伴微浸润的患者行X线检查，共62例行预后生物学标记，分析影像表现与孕激素受体（PR）、癌基因（C—erbB-2）、抑癌基因（p53）的相关性。用卡方检验进行统计学处理，并对有意义者行优势比（OR值）分析。结果（1）单独1个X线征象表现者62例；合并2个征象26例；阴性7例。（2）各种X线征象单独分析显示，62例有钙化的病灶中恶性钙化占73％（45例），其余为中间性钙化；钙化以簇状分布最为常见（36例），其次为段样分布（18例）。22例有肿块的病灶中，以卵圆形肿块最为常见（13例）；肿块的边缘表现为浸润、小分叶、清晰和模糊各为15、1、4和2例；等密度肿块占的比例较高（55％，12例）。结构扭曲7例，除1例外多与其他征象伴行；局灶性不对称占16％（15／95），可单独发生或与其他征象伴发。（3）将病灶的X线表现分成恶性钙化、中间性钙化和非钙化3组，PR与C-erbB-2在3组中的分布有统计性意义，PR阳性表达者X线上非钙化征象发生率是中间性钙化的11．00倍[χ^2=8．571，P=0．003；95％可信区间（CI）为1．998～60．572]、恶性钙化的8．80倍（χ^2=9．748，P=0．002；95％CI为2．024～38．253）；而C—erbB-2高表达者，恶性钙化是非钙化发生的12．35倍（χ^2=7．353，P=0．007；95％CI为1．447—105．443），中间性钙化的5．74倍（χ^2=4．977，P=0．026；95％CI为1．110～29．645）。结论乳腺DCIS及DCIS伴微浸润X线征象有特征。X线征象可以作为早期乳腺DCIS的一个预后因子。     

18F-FDG PET/CT对非小细胞肺癌区域淋巴结诊断的假阴性与假阳性研究

目的探讨18^F-FDG PET／CT在检测非小细胞肺癌（NSCLC）区域淋巴结中出现假阴性和假阳性的因素。方法随机选择手术治疗的NSCLC患者48例，术前1周内行18^F—FDG PET／CT检查，同期行CT增强扫描，术后根据病理检查结果分析PET／CT诊断NSCLC区域淋巴结转移的假阴性与假阳性因素。结果48例患者共切除区域淋巴结313枚，转移淋巴结51枚，PET／CT结果7枚假阴性。8枚假阳性，阳性预测值和阴性预测值分别为85％，97％，高于CT（57％，94％；P=0．002，0．045）。3枚假阴性淋巴结内的癌灶较小；2枚淋巴结短径约为0．4mm，小于PET／CT的空间分辨率；2枚紧邻原发灶的淋巴结，图像无法区分而视为原发灶。8枚假阳性淋巴结为患者在原发病灶基础上并发不同程度的肺部疾病和淋巴结炎症，使其糖代谢率增高。结论假阳性出于（1）淋巴结的短径小于PET／CT的空间分辨率；（2）淋巴结内的小癌灶糖代谢率较低；（3）紧邻原发灶的淋巴结与原发灶无法区分。原发肿瘤合并肺部疾病是导致PET／CT出现假阳性的重要原因。     

宫腔声学造影对子宫腺肌病的鉴别诊断价值

目的探讨宫腔声学造影对子宫腺肌病的鉴别诊断价值。方法对120例子宫腺肌病及子宫肌瘤患者于术前一周内行宫腔声学造影。实验结果与病理结果对照,统计方法有t检验、x2检验等,结果用均数±标准差(x2±S)表示。结果宫腔声学造影可使诊断敏感性提高至80%,准确性提高至95%,鉴别诊断特异性100%。结论宫腔声学造影对子宫腺肌病有很好的鉴别诊断价值。     

介入治疗输卵管妊娠

目的：探讨介入治疗输卵管妊娠的临床价值。方法：16例患者经子宫动脉插管灌注氨甲喋呤(MTX)并栓塞。术后以患者症状、体征、尿β—hCG水平及胚囊的B超动态变化作为疗效的监测指标。结果：16例插管成功率、治愈率分别为100％和93．8％。尿β—hCG值平均下降时间为11．6d(4～30d)。妊娠囊块18～60d吸收。在治疗后26～45d内月经恢复。结论：介入治疗输卵管妊娠有较好的临床应用价值。