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diagnostic imaging, preautopsy imaging and autopsy findings of 8 AIDS cases： a comparative study

Chinese Medical Journal 2009年第18期122卷 2142-2148页

作者： LI Hong-jun GAO Yan-qing CHENG Jing-liang ZHANG Yu-zhong Department of Radiology First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450052 China Therapeutic Centre for AIDS and Sexually Transmitted Diseases Affiliated You'an Hospital Capital Medical University Beijing 100054 China Center for diagnostic Medical imaging Nanfang Hospital Southern Medical University Guangzhou Guangdong 510515 China

Background Aquired immune deficiency syndrome （AIDS） presents a challenge to medical researchers because of its unique pathological and clinical picture. The clinical data, particularly autopsy evidence, from China have failed to provide enough pathological and etiological evidence for AIDS diagnosis, which impairs the reliability of the diagnosis and our full understanding of the occurrence and development of AIDS complications. The purpose of this study was to investigate the imaging and pathologic characteristics of AIDS. Methods Autopsy, imaging and pathological data from 8 cases of AIDS were retrospectively analyzed. Routine CT scanning of different body parts was performed during their periods of hospitalization. Transverse CT scanning was conducted from the skull to the pelvis immediately after the occurrence of death. After routine formalin fixing, 7 cardevers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each section and organs for pathological examinations. Results The autopsy data indicated the presence of parasitic infections, bacterial infections, fungal infections, and virus infections in AIDS patients. Pneumocystis pneumonia, pulmonary tuberculosis, coccobacteria pneumonia, Aspergillus pneumonia, cytomegaJovirus pneumonia, toxoplasma encephalitis, lymphoma and cerebrovascular diseases were found in these patients. Conclusions During the course of AIDS progression, the concurrent multiple infections as well as tumor development may resuJt in multiple organ pathological changes and clinically complex symptoms that further complicate the imaging and pathological manifestations, thus resulting in difficult differential diagnosis. A combination of imaging data and autopsy data can help to clarify the diagnosis.

关键词： AIDS pathology diagnostic imaging autopsy

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Mediastinal emphysema in the context of perforated gastric ulcer

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World Journal of Clinical Cases 2024年第15期12卷 2479-2481页

作者： Debkumar Chowdhury Department of Emergency Medicine Wythenshawe HospitalManchester M239LTUnited Kingdom

In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the pathologies would be through Computed Tomographic imaging of the Thorax and abdomen with oral and intravenous contrast in the context of triple phase imaging.The causes of pneumomediastinum should be differentiated between traumatic and non-traumatic.Oesophageal perforation(Boerhaave syndrome)is associated with Mackler’s triad in upto 50%of patients(severe retrosternal chest pain,pneumomediastinum,mediastinitis).Whereas in cases of lung pathology this can be associated with pneumothorax and pleural effusion.

关键词： Pneumomediastinum Duodenal ulcer Computed tomography Visceral perforation diagnostic imaging Emergency care

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COVID-19 imaging:diagnostic approaches,challenges,and evolving advances

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World Journal of Radiology 2021年第6期13卷 171-191页

作者： Dante L Pezzutti Vibhor Wadhwa Mina S Makary Department of Radiology The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Radiology Weill Cornell Medical CenterNew York CityNY 10065United States

The role of radiology and the radiologist have evolved throughout the coronavirus disease-2019(COVID-19)pandemic.Early on,chest computed tomography was used for screening and diagnosis of COVID-19;however,it is now indicated for high-risk patients,those with severe disease,or in areas where polymerase chain reaction testing is sparsely available.Chest radiography is now utilized mainly for monitoring disease progression in hospitalized patients showing signs of worsening clinical status.Additionally,many challenges at the operational level have been overcome within the field of radiology throughout the COVID-19 pandemic.The use of teleradiology and virtual care clinics greatly enhanced our ability to socially distance and both are likely to remain important mediums for diagnostic imaging delivery and patient care.Opportunities to better utilize of imaging for detection of extrapulmonary manifestations and complications of COVID-19 disease will continue to arise as a more detailed understanding of the pathophysiology of the virus continues to be uncovered and identification of predisposing risk factors for complication development continue to be better understood.Furthermore,unidentified advancements in areas such as standardized imaging reporting,point-of-care ultrasound,and artificial intelligence offer exciting discovery pathways that will inevitably lead to improved care for patients with COVID-19.

关键词： COVID-19 Coronavirus Pandemic diagnostic imaging Radiography Computed tomography Outcomes Future trends

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Inflammation in human cerebral aneurysms: pathogenesis, diagnostic imaging, genetics, and therapeutics

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Neuroimmunology and Neuroinflammation 2015年第1期2卷 77-85页

作者： Sarah A.Dooley Joseph S.Hudson David M.Hasan Department of Neurosurgery University of Iowa Carver College of MedicineIowa CityIA 52242USA Department of Neurosurgery University of IowaIowa CityIA 52242USA Department of Neurosurgery University of Iowa Hospital and ClinicsIowa CityIA 52240USA

Intracranial aneurysms are a life‑threatening cerebrovascular pathology with a probability of spontaneous rupture.Current intervention techniques carry inherent risk.Recent investigation has reinforced inflammation’s role in the pathophysiological process of cerebral aneurysms.These data suggest alternative diagnostic and noninvasive therapeutic strategies.Furthermore,novel characteristics of the underlying disease have been elucidated through distinct bioinformatic and gene expression profile analyses.This article will emphasize the most recent investigation,highlighting findings of clinical significance and etiological relevance.

关键词： diagnostic imaging genetics intracranial aneurysms pathogenesis therape

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Clinical characteristics and prognosis of orbital solitary fibrous tumor in patients from a Chinese tertiary eye hospital

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World Journal of Clinical Cases 2022年第27期10卷 9670-9679页

作者： Ming-Yu Ren Jing Li Yi-Xiang Wu Rui-Miao Li Chi Zhang Li-Min Liu Jing-Jing Wang Yu Gao Department of Orbital Disease and Ocular Tumor Hebei Eye HospitalXingtai 054001Hebei ProvinceChina Intensive Care Unit Xingtai Third HospitalXingtai 054001Hebei ProvinceChina Department of Medical imaging Hebei Eye HospitalXingtai 054001Hebei ProvinceChina

BACKGROUND Solitary fibrous tumor(SFT) is predominant within the pleura but very rare in the orbit,which is why the diagnosis of orbital SFT poses challenges in clinical practice.Accordingly,an integrated approach that incorporates specific clinical features,histological,histopathological,and immunohistochemical(IHC) examinations,and molecular analyses is warranted.AIM To retrospectively explore the clinical and imaging characteristics,treatment,outcomes of a series of patients with orbital SFT.METHODS We conducted a retrospective review of a series of patients diagnosed with a histopathologic orbital SFT treated at a single institution.All data on demographics,clinical characteristics,imaging,treatment,postoperative histopathological and IHC examinations,and prognosis were collected.RESULTS In total,13 patients were enrolled,7(53.8%) of whom had the tumor located in the superomedial quadrant of the orbit.Computed tomography revealed a solitary ovoid lesion in 10(76.9%) patients and irregular lesion in 3(23.1%) patients.Magnetic resonance imaging results were as follows:On T1 weighted images,3(23.1%) patients had hypointense mixed signals,whereas 10(76.9%) patients showed isointense mixed signals;on T2 weighted images(T2 WI),3(23.1%),4 (30.8%),and 6(46.2%) patients exhibited hypointense mixed,isointense mixed,and hyperintense signals,respectively.Notably,12(92.3%) patients showed significant enhancement,whereas there were patchy slightly enhanced areas in the tumor.All patients were treated by surgery.IHC analysis demonstrated that the tumor cells were immunoreactive for CD34,CD99,STAT-6,and vimentin in all patients.The lesions showed Ki-67 positivity 10% in 2(15.4%).Two(15.4%) patients exhibited tumor recurrence.CONCLUSION The clinical manifestations and radiologic characteristics of orbital SFT are diverse and not specific.Accurate diagnosis and treatment require detailed radiological and histopathological/IHC evaluation.

关键词： Orbit Solitary fibrous tumor diagnostic imaging Immunohistochemistry Surgical therapy

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Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm)

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World Journal of Clinical Cases 2022年第24期10卷 8525-8534页

作者： Qi Mei Mei Yu Qiong Chen Department of Ultrasound Shanghai Xuhui Dahua HospitalShanghai 200237China Department of Radiology Shanghai Xuhui Dahua HospitalShanghai 200237China

BACKGROUND Hepatocellular carcinoma(HCC)is the most common type of primary liver malignancy.Contrast-enhanced ultrasound(CEUS)uses contrast microbubbles during ultrasound,allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound;however,there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.AIM To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.METHODS A total of 395 patients with 632 nodules at high risk of HCC,who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021,were retrospectively examined.Conventional ultrasonography combined with CEUS was adopted to analyze the echo,size,location,and enhancement characteristics of benign and malignant nodules,as well as the enhancement methods for HCC with different diameters.RESULTS The follow-up rate and duration were 92.15%(364/395)and 51.28±45.09 mo,respectively.Conventional ultrasonography combined with CEUS revealed 65(11.80%)nodules with a follow-up diagnosis of HCC,19(3.45%)dysplastic nodules,and 467(84.75%)benign cirrhotic hyperplastic nodules.Among 65 cases of confirmed HCC,40(61.54%)were transformed from hypoechoic nodules,9(13.85%)from hyperechoic nodules,and the remaining 16(24.62%)from isoechoic nodules.Significant differences in CEUS characteristics were found among cirrhotic nodules,dysplastic nodules,and HCC nodules at each phase.Significant differences in the enhancement mode were observed between nodules≤1 cm and those 1–2 cm.The smaller the HCC nodule,the later the contrast agent began to flush and the longer the duration of contrast enhancement.CONCLUSION Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC.Significant differences in the enhancement mode are noted between nodules≤1 cm and those 1–2 cm.

关键词： Carcinoma Hepatocellular Contrast-enhanced ultrasonography diagnostic imaging

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Advances in application of novel magnetic resonance imaging technologies in liver disease diagnosis

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World Journal of Gastroenterology 2023年第28期29卷 4384-4396页

作者： Yi-Ming Qi En-Hua Xiao Department of Radiology The Second Xiangya Hospital of Central South UniversityChangsha 410000Hunan ProvinceChina

Liver disease is a major health concern globally,with high morbidity and mortality rates.Precise diagnosis and assessment are vital for guiding treatment approaches,predicting outcomes,and improving patient prognosis.Magnetic resonance imaging(MRI)is a non-invasive diagnostic technique that has been widely used for detecting liver disease.Recent advancements in MRI technology,such as diffusion weighted imaging,intravoxel incoherent motion,magnetic resonance elastography,chemical exchange saturation transfer,magnetic resonance spectroscopy,hyperpolarized MR,contrast-enhanced MRI,and radiomics,have significantly improved the accuracy and effectiveness of liver disease diagnosis.This review aims to discuss the progress in new MRI technologies for liver diagnosis.By summarizing current research findings,we aim to provide a comprehensive reference for researchers and clinicians to optimize the use of MRI in liver disease diagnosis and improve patient prognosis.

关键词： diagnostic imaging Liver diseases Fatty liver Liver fibrosis Hepatocellular carcinoma Magnetic resonance imaging

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Prognostic value of preoperative enhanced computed tomography as a quantitative imaging biomarker in pancreatic cancer

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World Journal of Gastroenterology 2022年第22期28卷 2468-2481页

作者： Jian-Feng Gao Yu Pan Xian-Chao Lin Feng-Chun Lu Ding-Shen Qiu Jun-Jun Liu He-Guang Huang Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina Department of Radiology The Hospital of ChangleFuzhou 350200Fujian ProvinceChina

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies with high mortality and short survival time.Computed tomography(CT)plays an important role in the diagnosis,staging and treatment of pancreatic tumour.Pancreatic cancer generally shows a low enhancement pattern compared with normal pancreatic tissue.AIM To analyse whether preoperative enhanced CT could be used to predict postoperative overall survival in patients with PDAC.METHODS Sixty-seven patients with PDAC undergoing pancreatic resection were enrolled retrospectively.All patients underwent preoperative unenhanced and enhanced CT examination,the CT values of which were measured.The ratio of the preoperative CT value increase from the nonenhancement phase to the portal venous phase between pancreatic tumour and normal pancreatic tissue was calculated.The cut-off value of ratios was obtained by the receiver operating characteristic(ROC)curve of the tumour relative enhancement ratio(TRER),according to which patients were divided into low-and high-enhancement groups.Univariate and multivariate analyses were performed using Cox regression based on TRER grouping.Finally,the correlation between TRER and clinicopathological characteristics was analysed.RESULTS The area under the curve of the ROC curve was 0.768(P0.7 was defined as the high-enhancement group.According to the TRER grouping,the Kaplan-Meier survival curve analysis results showed that the median survival(10.0 mo)with TRER≤0.7 was significantly shorter than that(22.0 mo)with TRER>0.7(P0.7(P<0.05).Our results demonstrated that patients in the low TRER group were more likely to have higher American Joint Committee on Cancer stage,tumour stage and lymph node stage(all P<0.05),and TRER was significantly

关键词： Pancreatic cancer Computed tomography diagnostic imaging Kaplan-Meier curve Prognosis Survival analysis

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Radiomics for the detection of microvascular invasion in hepatocellular carcinoma

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World Journal of Gastroenterology 2022年第20期28卷 2176-2183页

作者： Kun Lv Xin Cao Peng Du Jun-Yan Fu Dao-Ying Geng Jun Zhang Department of Radiology Huashan HospitalFudan UniversityShanghai 200040China Institute of Functional and Molecular Medical imaging Fudan UniversityShanghai 200040China Center for Shanghai Intelligent imaging for Critical Brain Diseases Engineering and Technology Research Science and Technology Commission of Shanghai MunicipalityShanghai 200040China Institute of Intelligent imaging Phenomics International Human Phenome Institutes(Shanghai)Shanghai 200040China

Hepatocellular carcinoma(HCC)is the most common primary liver cancer,accounting for about 90%of liver cancer cases.It is currently the fifth most common cancer in the world and the third leading cause of cancer-related mortality.Moreover,recurrence of HCC is common.Microvascular invasion(MVI)is a major factor associated with recurrence in postoperative HCC.It is difficult to evaluate MVI using traditional imaging modalities.Currently,MVI is assessed primarily through pathological and immunohistochemical analyses of postoperative tissue samples.Needle biopsy is the primary method used to confirm MVI diagnosis before surgery.As the puncture specimens represent just a small part of the tumor,and given the heterogeneity of HCC,biopsy samples may yield false-negative results.Radiomics,an emerging,powerful,and non-invasive tool based on various imaging modalities,such as computed tomography,magnetic resonance imaging,ultrasound,and positron emission tomography,can predict the HCC-MVI status preoperatively by delineating the tumor and/or the regions at a certain distance from the surface of the tumor to extract the image features.Although positive results have been reported for radiomics,its drawbacks have limited its clinical translation.This article reviews the application of radiomics,based on various imaging modalities,in preoperative evaluation of HCC-MVI and explores future research directions that facilitate its clinical translation.

关键词： Microvascular invasion Hepatocellular carcinoma Radiomics Texture analysis diagnostic imaging Liver

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Surgical complications after pancreatic transplantation:A computed tomography imaging pictorial review

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World Journal of Gastroenterology 2023年第46期29卷 6049-6059页

作者： Carlo D'Alessandro Matteo Todisco Caterina Di Bella Filippo Crimì Lucrezia Furian Emilio Quaia Federica Vernuccio Department of Radiology University of PadovaPadova 35128Italy Department of Radiology 2 University Hospital of PadovaPadova 35128Italy Department of Surgical Kidney and Pancreas Transplantation UnitPadova 35128Italy Kidney and Pancreas Transplantation Unit University of PaduaPadova 35128Italy Department of Biomedicine Neuroscience and Advanced Diagnostics(BiND)University of PalermoPalermo 90127Italy Department of Radiology University Hospital of PadovaPadova 35128Italy

Pancreatic transplantation is considered by the American Diabetes Association and the European Association for the Study of Diabetes an acceptable surgical procedure in patients with type 1 diabetes also undergoing kidney transplantation in pre-final or end-stage renal disease if no contraindications are present.Pancreatic transplantation,however,is a complex surgical procedure and may lead to a range of postoperative complications that can significantly impact graft function and patient outcomes.Postoperative computed tomography(CT)is often adopted to evaluate perfusion of the transplanted pancreas,identify complications and as a guide for interventional radiology procedures.CT assessment after pancreatic transplantation should start with the evaluation of the arterial Y-graft,the venous anastomosis and the duodenojejunostomy.With regard to complications,CT allows for the identification of vascular complications,such as thrombosis or stenosis of blood vessels supplying the graft,the detection of pancreatic fluid collections,including pseudocysts,abscesses,or leaks,the assessment of bowel complications(anastomotic leaks,ileus or obstruction),and the identification of bleeding.The aim of this pictorial review is to illustrate CT findings of surgical-related complications after pancreatic transplantation.The knowledge of surgical techniques is of key importance to understand postoperative anatomic changes and imaging evaluation.Therefore,we first provide a short summary of the main techniques of pancreatic transplantation.Then,we provide a practical imaging approach to pancreatic transplantation and its complications providing tips and tricks for the prompt imaging diagnosis on CT.

关键词： Diabetes mellitus Type 1 Pancreas transplantation Complications Computed tomography diagnostic imaging

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