Serum sialic acid in malignant tumors,bacterial infections,and chronic liver diseases

Summary The total serum sialic acid concentration was determined in 2,264 persons with various malignant tumors, bacterial infections, rheumatic diseases, and chronic liver diseases, and in a control group. The thiobarbiturate method according to Warren was used [34].The upper limit (95% percentile) in the control group was 2.23 mol/ml. Higher values were found in the groups with neoplasms (mean: 3.04 mol/ml), inflammatory diseases (e.g., pneumonia: 3.02 mol/ml), and active rheumatoid arthritis (3.05 mol/ml). In the group with malignant diseases, the sialic acid concentration at the time of diagnosis was highest for bronchial carcinoma (3.29 mol/ml) and lowest for breast cancer (2.58 mol/ml). In chronic liver diseases the mean sialic acid level was lower than in a heterogeneous group of noninflammatory and nonneoplastic diseases.The estimation of the serum sialic acid concentration could be useful in the detection of tumor burden and metastases, and in the evaluation of the later course and prognosis of malignant neoplasms if bacterial/inflammatory and active rheumatoid processes can be excluded.     

Techniques for high-resolution MR imaging of atherosclerotic plaque

Atherosclerotic cardiovascular disease is the most common cause of death in the United States. Investigation of atherosclerotic plaque morphology and composition is important because the findings may be useful in predicting prognosis or response to therapy. This study presents high-resolution magnetic resonance (MR) imaging techniques developed on a 1.5-T whole-body imager with a custom-built surface coil, for characterizing the composition and morphology of plaque removed at carotid endarterectomy. The initial comparison of MR imaging and histologic results showed good correlation. In conjunction with MR angiography, these techniques could be used in in vivo imaging to define the size, location, and contents of atherosclerotic plaque at the carotid bifurcation.     

Enhanced tumor detection in the presence of fatty liver disease: Cell-specific contrast agents

It is assumed that hepatobiliary, cell-specific contrast agents will be adversely affected by the presence of diffuse liver disease. The diagnostic efficacy for tumor detection in the presence of fatty liver disease was experimentally studied at contrast-enhanced magnetic resonance (MR) imaging with manganese-DPDP (N,N′-dipyridoxylethylenediamine-N,N′-diacetate 5,5′-bis[phosphate]) and gadobenate dimeglumine (Gd-BOPTA/dimeg) and compared with conventional and chemical shift imaging. Carcinosarcoma was implanted into the liver of rats, and fatty liver was induced with L-ethionine. Without contrast agents, the tumor-fatty liver contrast-to-noise ratio (C/N) was increased on T1-weighted and decreased on T2-weighted MR images relative to tumor-bearing control rats without fatty liver. Chemical shift imaging (phase-contrast method) increased the tumor—fatty liver C/N from 2.3 ± 1.0 to 6.1 ± 1.7 (P <.001). Mn-DPDP and Gd-BOPTA/dimeg increased the tumor—fatty liver C/N from -5.4 ± 1.6 to -11.0 ± 1.9 and ?9.8 ± 3.4, respectively (P <.001). The hepatobiliary, cell-specific contrast agents were equally effective in both fatty and nonfatty liver and outperformed both chemical shift and conventional MR imaging in detecting liver tumors.     

Influence of in vivo copper on MR images of the liver in rats

To investigate the effects of in vivo copper on magnetic resonance (MR) images, the authors studied Long-Evans cinnamon rats, which develop hepatitis and hepatocellular carcinoma as a result of abnormal copper metabolism. The livers of the rats were imaged before hepatitis developed; the absence of hepatic disease was confirmed histopathologically. The copper that accumulated in the liver of the rats was thought to exist in the form of divalent ions, which were suspected of reducing the T1 and T2 of neighboring protons. However, the signal intensities of the liver on T1- and T2*-weighted images did not change, suggesting that in vivo copper, even when accumulated abnormally, does not influence the signal intensity of MR images.     

61例腹腔镜胃手术的经验总结

总结61例腹腔镜胃手术的治疗效果。方法:1992年12月至1999年1月,61例腹腔镜胃手术者中,B-Ⅱ式胃大部切除术17例,B-Ⅰ式胃大部切除术1例,近端胃次全切除术2例,高选择性迷走神经切断术5例,胃造瘘术3例,胃壁良性肿瘤切除术33例。54例行全腹腔镜下胃手术,7例行腹腔镜辅助下胃手术。结果:本组有2例早期胃癌行腹腔镜根治术,至今存活4.6年以上;并发症2例,分别通过再手术和内镜治愈;手术用时35～310min,平均164.2min;术中出血50～500ml,平均218.3ml;住院4～11d,平均6.8d;86％病人于术后48h内恢复胃肠功能;仅4例术后使用止痛剂。结论:只要合理使用、严格掌握手术适应证,腹腔镜胃手术可以取得良好效果。     

三维超声成像在眼科的初步应用

评价三维超声波成像在眼疾病中的应用价值。材料和方法：对１０只正常眼球和３５只病变眼球进行三维成像研究，描述了正常眼球和眼球内不同疾病的三维成像特征。图像采集方式为机械驱动平行扫查和磁场空间定位自由扫查。     

胶囊内镜在小肠疾病中的临床诊断价值

目的：探讨胶囊内镜在小肠疾病中的诊断价值.方法：分析2009年9月-2012年5月114例行胶囊内镜检查患者的临床资料.结果：113例患者完成检查.胶囊内镜回盲瓣通过率为90.3%（102/113例）;胃内运行时间3～187 min,平均（55.6±26.0）min;小肠内运行时间为24～640 min,平均（303±106） min;胶囊平均排出体外的时间为9～96 h,平均（29±10）h.63例发现小肠病变（55.7%）,病变分别为非特异性炎症24例,血管畸形13例,小肠克罗恩病12例,小肠息肉7例,小肠肿瘤3例,小肠钩虫2例,小肠憩室1例.消化道出血患者小肠病因检出率最高,为80.8%（42/52例）,其次是腹痛45.2%（14/31例）,消瘦33.3%（1/3例）,腹泻20.0%（1/5例）,腹胀14.3%（1/7例）.结论：胶囊内镜对小肠疾病有较高的诊断价值.     

泌尿道螺旋CT仿真内窥镜的临床应用价值

目的 探讨泌尿道螺旋CT仿真内窥镜的临床应用价值。方法 53例临床泌尿道病变的患者，都经纤维膀胱镜或／和手术证实。应用螺旋CT采集排泄期的图像作CTVE成像，双盲法与轴位，多平面重组（MPR），三维重建（3D）图像及纤维膀胱镜所见对照分析。结果 CTVE能清楚地显示泌尿道腔内的各种正常解剖结构，CTVE对膀胱腔内病变的部位，大小，数目，形态及侵犯范围的显示均与纤维膀胱镜基本一致，膀胱癌的检出率为94．7％，2个＜5mm的肿瘤CTVE显示清楚，而轴位图像未显示，CTVE检测膀胱壁增厚和膀胱外侵犯的状况，显示肾盂，输尿管病变的效果明显不如轴位，MPR及3D图像。结论 CTVE对膀胱病变的显示和诊断是一种较可靠的，非侵袭性的方法，但对肾盂，输尿管病变的诊断价值不大，必须结合轴位和MPR图像才能作出全面，准确的评价。     

阻塞性睡眠呼吸暂停综合征发生阻塞部位上呼吸道的CT测量

了解CT测量对阻塞性睡眠呼吸道暂停综合征（obstructive sleep apnea syndrome,OSAS）患者上呼吸道狭窄的定位诊断意义。已知上呼吸道阻塞部位的OSAS患者共35例，将其阻塞部位CT测量资料与年龄性别相近的35名正常对照组比较，结果显示，患者组的各平面气道横截面积，气道前后径，左右径均明显小于对照组，咽喉壁和咽侧壁软组织厚度多大于对照组，发生睡眠期呼吸道阻塞的部位中有72．13％在患者清醒时其气道横截面积低于正常值，研究表明，阻塞部位的CT测量结果与正常对照组比较差异显著，72．13％的病例可以在常规的CT扫描测量中发现呼吸道解剖性狭窄。     

0.5 T MR单激发快速自旋回波在胆系梗阻性病变诊断中的应用

目的评估0.5 T MR单激发半傅立叶采集快速自旋回波胰胆管水成像(HASTE-MRCP)的定位及定性准确性,并与三维快速自旋回波胰胆管水成像(3D-TSE-MRCP)进行比较.方法所有95例病人均行HASTE-MRCP及结合呼吸门控的3D-TSE-MRCP检查及最大信号强度投影(MIP)(设备为Philips 0.5 T T5-NT 磁共振成像系统).分析95例患者的胆管解剖显示情况、病变显示情况并与手术结果比较.结果 HASTE-MRCP胆总管及1～3级胆管的显示率为100.0%,4～5级胆管为94.7%,胆囊为74.1%,胰管为63.2%;结石部位显示100.0%,恶性病变及术后狭窄显示率100.0%.与3D-TSE-MRCP比较,对4～5级胆管、胆囊颈及结石,尤其泥沙样结石的显示率更高,统计学上两者间差异有显著性意义(χ2 值分别为3.92、6.62、11.76 及29.93,P<0.05 或<0.01);对恶性病变及术后狭窄的显示率均为100.0%.结石主要表现为胆道内呈低信号的"充盈缺损";恶性病变则表现为截断及梗阻征象,并可显示软组织轮廓.结论 HASTE-MRCP是优秀的胰胆管超快速成像技术,在0.5 T MR 也能非常好的运用;比较结合呼吸门控的3D-TSE-MRCP ,HASTE-MRCP在重症病人成像或显示小结石及泥沙样结石上有明显优势,建议对急诊、重症及临床疑为结石的病人,首先考虑选择HASTE-MRCP技术.